• The Laryngoscope · Sep 2014

    Randomized Controlled Trial

    A randomized controlled trial of nasolaryngoscopy training techniques.

    • Matthew E Smith, Billy C Leung, Rishi Sharma, Sammar Nazeer, and Don J McFerran.
    • ENT Department, Colchester Hospital University NHS Foundation Trust, Essex County Hospital, Colchester, United Kingdom.
    • Laryngoscope. 2014 Sep 1;124(9):2034-8.

    Objectives/HypothesisFlexible nasolaryngoscopy is an essential skill for otolaryngology trainees to develop, but there is a lack of standardized training for this procedure. The aim of this study was to assess whether using training on a realistic human mannequin together with structured video feedback improved trainees' performance at flexible nasolaryngoscopy.Study DesignThree-armed, single-blinded, randomized controlled study.MethodsThirty-six junior doctors and final-year medical students were randomly allocated to one of three groups. All received a lecture and video presentation on flexible nasolaryngoscopy. One group received additional tuition using a training mannequin. The last group received mannequin training and feedback on their performance using a video recording. The trainees then undertook flexible nasolaryngoscopy on volunteers with these endoscopies recorded. Blinded observers scored the trainees on a range of objective and subjective measures. The volunteers who were also blinded to the candidates' training scored the comfort of the procedure.ResultsAdding mannequin training showed a trend toward improvement of performance but did not reach statistical significance. Mannequin training together with video feedback produced significant performance improvement in patient comfort (P = .0065), time to reach the vocal folds (P = .017), and global ability (P = .0006). Inter-rater reliability was excellent with P < .01 in all assessments.ConclusionsSimulation-based training using an anatomically correct model of the upper airway together with formalized video-assisted feedback on that training is a simple and effective way to improve endoscopy skills prior to starting flexible nasolaryngoscopy on patients.© 2014 The American Laryngological, Rhinological and Otological Society, Inc.

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