Face and Content Validity of a Probe Tube Placement Training Simulator

Abstract

Background: Probe tube placement is an important skill audiologists must learn to make real-ear measurements in an audiology clinic. With current evidence-based guidelines recommending insertion of the probe tube within 5 mm of the tympanic membrane (TM) for proper acoustical measurements, students must be well trained to ensure they are capable to perform this placement in clinical practice. This is not always the case as it has been found that real-ear measurements are not performed in a clinic as often as required. To address this, a simulator consisting of a 3D-printed ear model and an optical tracking system was developed to provide a training system for students to practice probe tube placement and to provide a method to evaluate competency before starting clinical practicum placements. Two simulators were developed, an adult model and a pediatric model. Purpose: To assess the face and content validity of the two probe tube placement simulators (adult and pediatric) and define barriers and facilitators to implementing this system into an educational setting. Research Design: Participants followed the setup and operating instructions designed to guide them through each functionality of the simulator. A questionnaire was used to assess face and content validity, applicability to an educational setting, and to determine perceived barriers and facilitators to using the probe tube simulators for training purposes. Five additional probe tube placements with each simulator were performed in which distance-to-TM was recorded. Study Sample: Twelve participants with significant probe tube placement experience. Data Collection and Analysis: Participants rated each question in the questionnaire from 0% to 100% depending on their level of agreement. Averages and standard deviations (SDs) were compiled and presented for each section (face validity, content validity, and applicability to an educational setting). Final facilitators and barriers for the simulator were compiled and the top answers of each are presented. The five quantitative probe tube placement measurements for each participant were averaged, SDs were calculated, and contacts with the TM while placing the probe tube were recorded. Results: The average face validity score over all questions for the adult model was 65% (SD = 18.2) whereas the pediatric model received a score of 64% (16.4). The overall content validity average score was 78.7% (17) and applicability to an educational setting had an average score of 80% (5.33). The average distance-to-TM across all trials and participants was 3.74 mm (1.82) for the adult model and 2.77 mm (0.94) for the pediatric model with only one participant exceeding the recommended maximum of 5 mm. Listed shortcomings of the current simulator included realism of the 3D-printed ear, ease of insertion of an otoscope tip into the ear, ability to visualize the ear canal ?landmarks? and the TM, and foam tip insertion experience. Conclusions: Results were generally very positive for the simulator, and future...

Skill Transference of a Probe-Tube Placement Training Simulator

“…I n medical simulator research, a typical validation sequence consists of a qualitative study aiming to receive early-stage feedback (face and content validity), backed with quantitative studies to prove its utility within educational settings (construct validity, discriminant validity, and skill transference validity). Our previous study (Koch et al, 2018) confirmed the simulator's training ability and provided feedback to guide the product development discussed previously. The present study accomplished a second-level evaluation of the developed audiology training simulator.…”

“…Briefly, the simulator consisted of an artificial adultsized head with a pliable, realistic ear and a camera mounted within the head to measure the probe-tube insertion depth using an associated custom-developed software package. The original simulator has been previously described by Koch et al (2018) and used a Styrofoam head that lacked realism as the first-generation prototype. Several improvements were made based on suggestions from the participants in the first validation study.…”

“…The simulator allows students to receive real-time feedback of their probe-tube placement and to become comfortable with the procedure, and provides instructors with the ability to evaluate the students' performance before clinical placement. A previous validation study was performed evaluating the realism and training ability of the simulator, while outlining clear areas of improvement that needed attention before implementation into training programs (Koch et al, 2018). The results from this first study were encouraging; participants indicated that the simulator had high teaching value and provided an excellent opportunity for trainees to gain additional preclinical experience.…”

Training outcomes for audiology students using virtual reality or traditional training methods

“…aheadsimulations.com/carl-for-training). They are used to train hearing aid manipulation, the removal of cerumen, real-ear unaided response measurements, and high-gain hearing aid fitting [21,22]. Some computerized simulations allow training for specific tasks such as otoscopy, pure-tone air and bone conduction audiometry with online virtual patients [23].…”

A Virtual-Reality Training Simulator for Cochlear Implant Surgery

“…Using the functional system put forth herein, future work will continue along two main paths in tandem: 1) validity and skill transference studies and 2) the development of standalone mass-spring framework that will be released as an asset on the Unity asset store for public use. Similar to work conducted previously in the lab for an audiological probe tube simulator (Koch et al, 2018), face and content validity will be assessed with feedback from additional otolaryngologists and medical students. After incorporating the feedback into the simulator, skills transference can proceed and the efficacy of the simulator can be quantitatively assessed.…”