Improved Training and Testing Otoscopy Simulation: From Classroom to OSCE

Transcription

1 Improved Training and Testing Otoscopy Simulation: From Classroom to OSCE A. Chiodo, MD, FRCSC Associate Professor and Otolaryngologist-in-Chief, Toronto East General Hospital Department of Otolaryngology-Head and Neck Surgery University of Toronto

2 Disclosures No conflict of interest for Dr. Chiodo Supporters:

3 Objectives Challenges of Otoscopy Training OtoSim (Ear) Novel Validated Training & Testing Solutions Training and Testing Modes Self Training One-on-One & Small Workshops Mass Training (Lecture Format) OSCE s and other testing

4 The Challenges of Otoscopy Training 95% of recent grads NOT comfortable with their otology skills <50% Diagnostic Accuracy for GP s and Pediatricians Gaps in accuracy leads to $5B overprescription of antibiotics Limited Field of View

5 The Challenges of Otoscopy Training Learning by reading Limited field of view in practice Doesn t transfer to the clinic Uncooperative patients

6 The Previous Gold Standard in Training Lectures and Reading Books - Results in 50% Accuracy

7 Otoscopy Training Limitations 1. Time within the curriculum 2. PowerPoint presentations, large 2-D photos in books 3. Practice on each other (normal ears) 4. Painful for patients 5. Limited breadth of pathology 6. There is no way for the teacher to confirm that students actually see it

8 The Evolution of the Concept Screen Computer Model Ear Canal Otoscope

9 Requirements Small, light weight Easy to connect and use Reliable, simple optics Separation of computer from simulator Excellent optical quality Ergonomic design Inexpensive

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11 Earform: o Otologic Simulation realistic feel, shape, and composition with various ear canal complexities. Tympanic Membrane: o o Content: o o Unique optics enables OtoSimTM to project a 1cm wide image of the tympanic membrane a realistic clinical scenario. Combined with the use of an otoscope, the small image and narrow field of view caused by the speculum creates a realistic simulation Proprietary database of over 200 high-resolution images of various ear pathologies. Detailed educational descriptions

12 Otologic Simulation Allow for otoscope positioning o Holding otoscope o Bracing otoscope o Straightening canal o Pneumatic otoscopy Normative Anatomy o Ossicular landmarks o pars tensa/flacida o Cone of light o Ear Canal Pathologic Slides o External ear diseases o Middle ear diseases

13 Why do this in the Classroom or Seminar Room? Classroom Instructor can use landmarking function on software Enables the instructor and students to interact through the device. Real-time and immediate guidance is provided to students through the device s internal display mechanism and through their otoscope. Stimulates student to do this on their own later

14 Addressable Market Size Technology Platform is Growing PneumatoSim OphthoSim 1.0 Q2 13 Mass Trainer Q2 14 Full Class Training V2.0 s Q4 14 Additional Features OtoSim 1.0 Q4 11 Ear Examination Q4 12 Pneumatic Otoscopy Eye Examination

15 Used in Training and Testing 1. Student Self Teaching 2. Student Review with OtoSim Companion before or after a training session 3. One-On-One and Small Group 4 to12 OtoSim s depending on platform and OS 4. Mass Training Teach an entire lecture theater at a time (66 at U of Toronto) 5. Remote Training - Lecturer and students in different locations (in Beta) 6. Use in OSCE s and other testing 7. Student Log-in, testing and tracking in the next software release

16 Used in Training and Testing Use in OSCE s and other testing Set up a Single unit and Laptop in a Standardized Patient exam room Student debrief s the standardized patient for history and symptoms (or have a case study to read) Refer the student to the OtoSim to view the Pathology Write down or give diagnosis verbally

17 Validation Studies Otoscopy - Looking at residents in various specialties and retention to 6 months Large Class-room Session or Mass Training Seminar Based Otoscopy Training Teaching Normative Anatomy to 1 st Year Med. Students Validating Use in OSCE examinations

18 Laryngoscope 121 (suppl.):s246, Medical students participated in the study. Control (n = 24) vs. simulation group (n = 41)

19 Methodology: o o o o Randomized, prospective trial Students randomized to Standard curriculum Standard curriculum + OtoSim session The students were presented a panel of 15 pathological states via the otoscope**. The percentage of correct answers and the time to complete the task were recorded Pre-Study Assessment Recruitment Simulation* * Week 1 Week 2 Evaluation

20 Teaching Otoscopy and Normative Anatomy to 1 st Year Medical Students

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22 Otosim Mass Training

23 THANK YOU