Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice

Malik, M. Shaheer; Varela, David A. Diaz Voss; Park, EunMi; Masood, Hamid; Laeeq, Kulsoom; Bhatti, Nasir I.; Francis, Howard W.

doi:10.1002/lary.24179

Cited by 24 publications

(25 citation statements)

References 17 publications

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“…Another discovered that an interest in otology and cumulative number of cases were positively associated with mastoidectomy performance, while self-directed laboratory simulation practice was negatively associated. 30 Finally, the group also developed three sets of technical milestones based on stages of their TBC to establish training benchmarks. These were based on the number of cases to achieve competency at each milestone and intended to better identify residents in need of remediation using this scale.…”

Section: Discussionmentioning

confidence: 99%

Performance Assessment for Mastoidectomy: State of the Art Review

Sethia

Kerwin

Wiet

2016

Otolaryngol.--head neck surg.

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Objective The aim of this report is to provide a review of the current literature for assessment of performance for mastoidectomy, to identify the current assessment tools available in the literature, and to summarize the evidence for their validity. Data Sources The MEDLINE database was accessed via PubMed. Review Methods Inclusion criteria consisted of English-language published articles that reported use of a mastoidectomy performance assessment tool. Studies ranged from 2007 to November 2015, and were divided into two groups: intra-operative assessments or those performed with simulation (cadaveric laboratory or virtual reality). Studies that contained specific reliability analyses were also highlighted. For each publication, validity evidence data was analyzed and interpreted based on conceptual definitions provided in a recent systematic review on the modern framework of validity evidence. Conclusions Twenty-three studies were identified that met our inclusion criteria for review including four intra-operative objective assessment studies, five cadaveric studies, ten virtual reality (VR) simulation studies, and four that used both cadaveric and VR. Implications for Practice A review of the literature revealed a wide variety of mastoidectomy assessment tools and varying levels of reliability and validity evidence. The assessment tool developed at Johns Hopkins possesses the most validity evidence of those reviewed. However, there are a number of agreed upon specific metrics which could be integrated into a standardized assessment instrument to be used nationally. A universally agreed upon assessment tool will provide a means for developing standardized benchmarks for performing mastoid surgery.

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Section: Discussionmentioning

confidence: 99%

Performance Assessment for Mastoidectomy: State of the Art Review

Sethia

Kerwin

Wiet

2016

Otolaryngol.--head neck surg.

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“…One of the more challenging areas to gain proficiency in is temporal bone surgery [2]. Procedures involving the temporal bone require knowledge of complex micro-anatomy, use of an operating microscope, and avoidance of devastating complications [3,4]. Unfortunately, the opportunities to perform otologic procedures in residency are decreasing and procedures are usually performed individually, making it difficult for trainees to learn in the operating room (OR) [4].…”

Section: Introductionmentioning

confidence: 99%

Assessment of a virtual reality temporal bone surgical simulator: A national face and content validity study

Compton

Agrawal

Ladak

et al. 2020

Journal of Otolaryngology - Head & Neck Surgery

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Background: Trainees in Otolaryngology-Head and Neck Surgery must gain proficiency in a variety of challenging temporal bone surgical techniques. Traditional teaching has relied on the use of cadavers; however, this method is resource-intensive and does not allow for repeated practice. Virtual reality surgical training is a growing field that is increasingly being adopted in Otolaryngology. CardinalSim is a virtual reality temporal bone surgical simulator that offers a high-quality, inexpensive adjunct to traditional teaching methods. The objective of this study was to establish the face and content validity of CardinalSim through a national study. Methods: Otolaryngologists and resident trainees from across Canada were recruited to evaluate CardinalSim. Ethics approval and informed consent was obtained. A face and content validity questionnaire with questions categorized into 13 domains was distributed to participants following simulator use. Descriptive statistics were used to describe questionnaire results, and either Chi-square or Fishers exact tests were used to compare responses between junior residents, senior residents, and practising surgeons. Results: Sixty-two participants from thirteen different Otolaryngology-Head and Neck Surgery programs were included in the study (32 practicing surgeons; 30 resident trainees). Face validity was achieved for 5 out of 7 domains, while content validity was achieved for 5 out of 6 domains. Significant differences between groups (p-value of < 0.05) were found for one face validity domain (realistic ergonomics, p = 0.002) and two content validity domains (teaching drilling technique, p = 0.011 and overall teaching utility, p = 0.006). The assessment scores, global rating scores, and overall attitudes towards CardinalSim, were universally positive. Open-ended questions identified limitations of the simulator. Conclusion: CardinalSim met acceptable criteria for face and content validity. This temporal bone virtual reality surgical simulation platform may enhance surgical training and be suitable for patient-specific surgical rehearsal for practicing Otolaryngologists.

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“…Malik stated that high fidelity simulators that better simulate more challenging anatomy may advance skill faster than even cadaveric specimens. Additionally, support for more complex procedures is necessary to support advanced milestones for higher-level learning [34]. In particular, these authors state the trans-mastoid approach to the middle ear, known as the facial recess approach, needed to be supported to differentiate the higher-level performers.…”

Section: Discussionmentioning

confidence: 99%

Integration of high-resolution data for temporal bone surgical simulations

et al. 2016

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Purpose To report on the state of the art in obtaining high-resolution 3D data of the microanatomy of the temporal bone and to process that data for integration into a surgical simulator. Specifically, we report on our experience in this area and discuss the issues involved to further the field. Data Sources Current temporal bone image acquisition and image processing established in the literature as well as in house methodological development. Review Methods We reviewed the current English literature for the techniques used in computer-based temporal bone simulation systems to obtain and process anatomical data for use within the simulation. Search terms included “temporal bone simulation, surgical simulation, temporal bone.” Articles were chosen and reviewed that directly addressed data acquisition and processing/segmentation and enhancement with emphasis given to computer based systems. We present the results from this review in relationship to our approach. Conclusions High-resolution CT imaging (≤100μm voxel resolution), along with unique image processing and rendering algorithms, and structure specific enhancement are needed for high-level training and assessment using temporal bone surgical simulators. Higher resolution clinical scanning and automated processes that run in efficient time frames are needed before these systems can routinely support pre-surgical planning. Additionally, protocols such as that provided in this manuscript need to be disseminated to increase the number and variety of virtual temporal bones available for training and performance assessment.

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Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice

Cited by 24 publications

References 17 publications

Performance Assessment for Mastoidectomy: State of the Art Review

Performance Assessment for Mastoidectomy: State of the Art Review

Assessment of a virtual reality temporal bone surgical simulator: A national face and content validity study

Integration of high-resolution data for temporal bone surgical simulations

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