Development and Validation of a Laryngeal Microsurgery Simulation Training System for Otolaryngology Residents

Abstract

ObjectiveThis study aims to create a synthetic laryngeal microsurgery simulation model and training program; to assess its face, content, and construct validity; and to review the available phonomicrosurgery simulation models in the literature.Study DesignNonrandomly assigned control study.SettingSimulation training course for the otolaryngology residency program at Pontificia Universidad Católica de Chile.MethodsResident (postgraduate year 1 [PGY1]/PGY2) and expert groups were recruited. A laryngeal microsurgery synthetic model was developed. Nine tasks were designed and assessed through a set of programmed exercises with increasing difficulty, to fulfill 5 surgical competencies. Imperial College Surgical Assessment Device sensors applied to the participants' hands measured time and movements. The activities were video‐recorded and blindly assessed by 2 laryngologists using a specific and global rating scale (SRS and GRS). A 5‐point Likert survey assessing validity was completed by experts.ResultsEighteen participants were recruited (14 residents and 4 experts). Experts performed significantly better than residents in the SRS (p = .003), and GRS (p = .004). Internal consistency was demonstrated for the SRS (α = .972, p < .001). Experts had a shorter execution time (p = .007), and path length with the right hand (p = .04). The left hand did not show significant differences. The survey assessing validity resulted in a median 36 out of 40 points score for face validity; and 43 out of 45 points score, for global content validity. The literature review revealed 20 available phonomicrosurgery simulation models, only 6 with construct validity.ConclusionThe face, content, and construct validity of the laryngeal microsurgery simulation training program were established. It could be replicated and incorporated into residents' curricula.

Educational Research on Medical Residency Programs in Chile: A Scoping Review and Analysis of the Impact of the New Accreditation Policy

“…Teaching and learning methodologies within residency programs were the most frequent research focus during the ve-year period analyzed, with 18 articles representing almost 60% of the total analyzed (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Nearly eighty percent (15/18) of the teaching and learning methodologies articles described simulation as an educational strategy or assessment tool (17-19, 22-30, 32-34).…”

“…Nine articles in the simulation area were related to procedural simulation training, assessing residents' technical skills through low-delity simulations or animal models. These articles focused on general surgery training in trauma (24)(25)(26), open intestinal anastomosis (34), anesthesiology residents' training in central venous access (23) and percutaneous dilatational tracheostomy (27), otorhinolaryngology training in laryngeal microsurgery skills (33), orthopedic residents' training in arthroscopic partial meniscectomy (22) and forefoot osteotomy skills (30), and head and neck surgery residents' skills in performing total parotidectomy (29). The most common research protocol design was pre-post intervention assessment, conducted in the context of deliberate practice programs with on-site or remote feedback provided by trained simulation instructors.…”