Knowledge and confidence in managing obstructive sleep apnea patients in Canadian otolaryngology - head and neck surgery residents: A cross sectional survey

Abstract

Background: Obstructive sleep apnea is an expected competency for Otolaryngology-Head and Neck surgery residents and tested on the Royal College of Physicians and Surgeons examination. Our objective was to evaluate the knowledge, attitudes and confidence of Canadian Otolaryngology-Head and Neck surgery residents in managing Obstructive Sleep Apnea (OSA) patients. Methods: An anonymous, online, cross-sectional survey was distributed to all current Canadian Otolaryngology-Head and Neck surgery residents according to the Dillman Tailored Design Method in English and French. The previously validated OSA Knowledge and Attitudes (OSAKA) questionnaire was administered, along with questions exploring resident confidence levels with performing OSA surgeries. Descriptive statistics, Wilcoxon Rank Sum and unpaired Student's t tests were calculated in Excel. Results: Sixty-six (38.4%) out of 172 residents responded (60.6% male; 80.3% English-speaking). Median OSAKA knowledge score was 16/18 (88.9%; Interquartile range: 14-16). Although all respondents believed that OSA was an important clinical disorder, only 45.5% of residents felt confident in managing OSA patients, while only 15.2% were confident in managing continuous positive airway pressure therapy (CPAP). Senior residents were more confident than junior residents in identifying OSA patients (96.7% vs 69.4%; p < 0.005) and managing the disease (60.0% vs. 33.3%; p = 0.03), including CPAP (26.7% vs. 5.6%; p = 0.01). Residents had lowest confidence levels in performing tongue base suspension (1.5%), transpalatal advancement pharyngoplasty (3.0%), and laser assisted uvulopalatoplasty (6.1%). Highest confidence levels were described in performing septoplasty (56.1%), adult tonsillectomy (75.8%), and tracheotomy (77.3%). Conclusions: Otolaryngology-Head and Neck surgery residents' knowledge of OSA was very good; however, confidence levels for managing OSA and performing OSA surgeries were varied. Several areas of perceived strengths and weaknesses in OSA training were identified by Canadian Otolaryngology-Head and Neck surgery residents.

Obstructive Sleep Apnea Knowledge Among Dentists and Physicians

“…For this study, data were combined for all physician groups to compare dentists' and physicians' responses to each knowledge item and total percentagecorrect scores. Based on previously published studies, each item was examined to determine what were considered "gaps" (< 60% correct) 37 and "competencies" (≥ 80% correct), 42 as well as to identify disparities between dentists' and physicians' knowledge gaps and competencies. The decision to use ≥ 80% correct as the cutoff score for competencies in specific OSA knowledge domains was based on otolaryngology residents' comparatively high level of OSA knowledge overall, and that assessment and treatment of patients with OSA are expected competencies for otolaryngology residents in Canada.…”

“…The OSAKA was developed for educational needs assessment and evaluation research and has been widely used across multiple physician populations in at least 10 countries around the world. [34][35][36][37][38][39][40][41][42][43][44][45] To identify publications of studies reporting on dentists' and physicians' knowledge of OSA using the OSAKA, a search of the literature was conducted using PubMed and Google Scholar using the search terms, "obstructive sleep apnea knowledge and attitudes". Of the 129 papers published through April 30, 2020, a total of 12 unique, peer-reviewed, original research publications (in print or online ahead of print) reporting total OSA-knowledge scores from physician surveys were found.…”

“…Of the 129 papers published through April 30, 2020, a total of 12 unique, peer-reviewed, original research publications (in print or online ahead of print) reporting total OSA-knowledge scores from physician surveys were found. [34][35][36][37][38][39][40][41][42][43][44][45] No peer-reviewed, published, dentist survey studies of OSA knowledge using the OSAKA Questionnaire were found. Nine of the 12 publications were eligible for inclusion in analysis of individual items, because scores for each item were published [34][35][36][37][38][39][40][41][42] or the authors [34][35][36][37][38][39][40][41][42][43][44][45][46] shared individual-item scores with the first author (personal communication emails: Dr. Navin Devaraj on March 8, 2020; 35 Dr. Sohan Solanki on March 15, 2020; 36 and Dr. Donna Jeffe on April 3, 2020.…”

“…[34][35][36][37][38][39][40][41][42][43][44][45] No peer-reviewed, published, dentist survey studies of OSA knowledge using the OSAKA Questionnaire were found. Nine of the 12 publications were eligible for inclusion in analysis of individual items, because scores for each item were published [34][35][36][37][38][39][40][41][42] or the authors [34][35][36][37][38][39][40][41][42][43][44][45][46] shared individual-item scores with the first author (personal communication emails: Dr. Navin Devaraj on March 8, 2020; 35 Dr. Sohan Solanki on March 15, 2020; 36 and Dr. Donna Jeffe on April 3, 2020. 34 Four of the 12 manuscripts also reported results for physician subgroups (eg, by level of training, physician specialties, or geographic location).…”

Effect of otolaryngology residency program on confidence of obstructive sleep apnea managements

“…The total score of knowledge was 88.9% and in the attitude part they had greatest problem with CPAP and just 15.2% were con dent with in managing CPAP. The senior residents had better knowledge scores and had better con dent towards identifying patients at risk for obstructive sleep apnea, ability to manage these patients and even management of patient with CPAP 21 .…”