Learning curve for competency in flexible laryngoscopy

Laeeq, Kulsoom; Pandian, Vinciya; Skinner, Michael; Masood, Hamid; Stewart, C. Matthew; Weatherly, Robert A.; Cummings, Charles W.; Bhatti, Nasir I.

doi:10.1002/lary.21063

Cited by 37 publications

(34 citation statements)

References 11 publications

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“…This suggests that the benefits of repetition quickly become appreciable. A recent study has shown that learners become competent after 6 endoscopies [6]. Our study is in keeping with this notion of rapid skill acquisition with repeat endoscopy.…”

Section: Discussionsupporting

confidence: 90%

Use of a Low-fidelity simulator to improve trans-nasal fibre-optic flexible laryngoscopy in the clinical setting: A randomized, single-blinded, prospective study

Deutschmann

Yunker

Cho

et al. 2013

Journal of Otolaryngology - Head & Neck Surgery

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BackgroundTrans-nasal flexible fibre-optic laryngoscopy (TFFL) is an essential skill for otolaryngologists. There is evidence to suggest that simulators help residents acquire procedural skills. The objective of this study was to examine the effect of simulation on endoscopy skill acquistion.MethodsA randomized controlled trial was conducted utilizing medical students and junior residents with limited experience in TFFL. Learners all performed a baseline endoscopy and were then randomized to receive either 45 minutes of simulation training or not. Following this, a second endoscopy was performed. Time to adequate visualization of the glottis, the percentage of time adequate visualization of the airway was maintained, and the number of collisions with mucosa were analyzed. Qualitative assessments were also obtained from the learner, patient, and staff laryngologist.ResultsTime to adequate visualization of the glottis and the number of mucosal collisions were significantly less during the second endoscopy, irrespective of the use of simulation (84.8 sec vs. 68 sec, p < 0.01; 5.0 vs. 3.2, p < 0.01, respectively). Analysis using a two-way ANOVA with interaction established that none of the quantitative measures analyzed in this study improved with the addition of simulation.ConclusionImprovements in time to visualization of the glottis and number of mucosal contacts were seen between the first and second endoscopy irrespective of simulator use. No additional benefit was conferred with the use of a low-fidelity simulator.

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Section: Discussionsupporting

confidence: 90%

Use of a Low-fidelity simulator to improve trans-nasal fibre-optic flexible laryngoscopy in the clinical setting: A randomized, single-blinded, prospective study

Deutschmann

Yunker

Cho

et al. 2013

Journal of Otolaryngology - Head & Neck Surgery

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show abstract

“…The optimal method for examining the larynx is using a flexible fiberoptic scope videolaryngoscopy, which provides documentation for review and comparison of function before versus after surgery, if needed. Recent work has suggested that an average of 6 attempts for novices are necessary in order to become technically competent in performing flexible laryngoscopy . Interpretation of all laryngeal findings may take greater clinical experience.…”

Section: Resultsmentioning

confidence: 99%

Management of invasive well‐differentiated thyroid cancer: An American head and neck society consensus statement: AHNS consensus statement

et al. 2014

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Background. Invasive differentiated thyroid cancer (DTC) is relatively frequent, yet there is a paucity of specific guidelines devoted to its management. The Endocrine Committee of the American Head and Neck Society (AHNS) convened a panel to provide clinical consensus statements based on review of the literature, synthesized with the expert opinion of the group.Methods. An expert panel, selected from membership of the AHNS, constructed the manuscript and recommendations for management of DTC with invasion of recurrent laryngeal nerve, trachea, esophagus, larynx, and major vessels based on current best evidence. A Modified Delphi survey was then constructed by another expert panelist utilizing 9 anchor points, 1 5 strongly disagree to 9 5 strongly agree. Results of the survey were utilized to determine which statements achieved consensus, near-consensus, or non-consensus. Results. After endorsement by the AHNS Endocrine Committee and Quality of Care Committee, it received final approval from the AHNS Council.

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“…However, in our study, the scope operator and the offsite reviewer did not always agree on the ability to visualize anatomical subsites, which is a more specific characteristic than diagnosis alone. This may be due to the difference in training levels because it has been found that laryngoscopy skills improve with increased experience . This further demonstrates the value of a recorded exam—instead of a verbal exchange of information alone—for communication between residents and attendings.…”

Section: Discussionmentioning

confidence: 91%

Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

2019

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Objective To determine whether a smartphone adaptor can record laryngoscopic videos of adequate quality for clinical diagnosis and communication among otolaryngologists and assess the impact of recorded exams on patient satisfaction. Methods Twenty adult inpatients undergoing flexible laryngoscopy in a tertiary care medical center were prospectively enrolled. Each subject's larynx was visualized with the standard laryngoscope eyepiece and with an attached mobile phone adaptor with video recording capabilities. A 5‐point Likert scale was used by the resident performing the scope to grade the adaptor and eyepiece exams. The same scale was used by an offsite otolaryngology attending to grade the adaptor video. Patients were shown the video, and a satisfaction survey was administered. Results In all patients, the adaptor was easy to use and required minimal setup. Ninety percent of patients reported an increase in satisfaction after watching the video of their exam. The eyepiece was superior to the adaptor in resolution, focus, color fidelity, brightness, and optical fluidity (P < 0.05). The video recording was deemed sufficient for clinical assessment in 90% of cases. The offsite reviewer determined that there would be “little” (15%) or “no value” (65%) in repeating the scope exam in the majority of patients. The laryngeal subsites were equally visible with the eyepiece and the adaptor (“full view,” 85%–100%). Conclusion Laryngoscopy videos recorded by a portable smartphone adaptor are sufficient for clinical evaluation in the majority of cases. This technology may improve patient satisfaction and communication among clinicians. Level of Evidence 4 Laryngoscope, 129:2147–2152, 2019

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Learning curve for competency in flexible laryngoscopy

Cited by 37 publications

References 11 publications

Use of a Low-fidelity simulator to improve trans-nasal fibre-optic flexible laryngoscopy in the clinical setting: A randomized, single-blinded, prospective study

Use of a Low-fidelity simulator to improve trans-nasal fibre-optic flexible laryngoscopy in the clinical setting: A randomized, single-blinded, prospective study

Management of invasive well‐differentiated thyroid cancer: An American head and neck society consensus statement: AHNS consensus statement

Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

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