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Tumlin P, Sunyecz I, Cui R, Armeni M, Freiser ME. Rapid Production Nasal Osteotomy Simulators With Multi-Modality Manufacturing: 3D Printing, Casting, and Molding. Otolaryngol Head Neck Surg 2024; 171:1000-1007. [PMID: 38943441 DOI: 10.1002/ohn.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/28/2024] [Accepted: 06/10/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE To expand and improve upon previously described nasal osteotomy models with the goals of decreasing cost and production time while ensuring model fidelity. To assess change in participant confidence in their understanding of and ability to perform nasal osteotomies following completion of the simulation course. STUDY DESIGN Prospective study. SETTING Simulation training course for otolaryngology residents at West Virginia University. METHODS A combined methodology of 3D printing, silicone molding, and resin casting was used to design a nasal osteotomy model to address material issues such as print delamination. Multiple models were then used in a simulation lab on performing nasal osteotomies. Model utility and impact on participant confidence was assessed at baseline, postlecture, and postsimulation lab. RESULTS Using a combined manufacturing methodology, we achieved a production time reduction of 97.71% and a cost reduction of 82.02% for this polyurethane resin nasal osteotomy model relative to a previously described osteotomy model. Participants in the simulation course were noted to have a significant improvement in confidence in their understanding of and ability to perform nasal osteotomies from baseline and postlecture and also from postlecture and postsimulation lab (P < .05 for all). CONCLUSION By incorporating multiple manufacturing modalities (molding and casting) in addition to 3D printing, this study achieved a large reduction in both production time and cost in fabrication of a nasal osteotomy simulator and addressed material limitations imposed by fused deposition modeling printers. This design methodology serves as an example on how these barriers may be addressed in unrelated simulation projects. Model fidelity was improved with addition of a silicone soft tissue midface. Improvement in participant confidence was noted following completion of the simulation lab.
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Affiliation(s)
- Parker Tumlin
- Department of Otolaryngology, West Virginia University, Morgantown, West Virginia, USA
| | - Ian Sunyecz
- Department of Otolaryngology, West Virginia University, Morgantown, West Virginia, USA
| | - Ruifeng Cui
- Department of Otolaryngology, West Virginia University, Morgantown, West Virginia, USA
| | - Mark Armeni
- Department of Otolaryngology, West Virginia University, Morgantown, West Virginia, USA
| | - Monika E Freiser
- Department of Otolaryngology, West Virginia University, Morgantown, West Virginia, USA
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Adams JK, Marinelli JP, De Jong R, Spear SA, Erbele ID. Modern Trends in Otologic Surgery and Implications for Residency Training. Otolaryngol Head Neck Surg 2024; 170:1404-1410. [PMID: 38251771 DOI: 10.1002/ohn.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/22/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE Placing a middle ear prosthesis is considered a key competency for the general otolaryngologist, but surgeons struggle to obtain and maintain this skill. The current study aims to characterize pre-coronavirus disease 2019 trends in stapedectomy and ossiculoplasty. STUDY DESIGN Database review. SETTING Tricare beneficiaries are treated at civilian and military facilities. METHODS The Department of Defense beneficiary population of more than nine million persons per year was reviewed for patients undergoing either stapedectomy or ossiculoplasty between 2010 and 2019, identified by the current procedural terminology code. RESULTS A total of 3052 stapedectomies and 7197 ossiculoplasties were performed. Over the 10-year study period, stapedectomy decreased by 23%, with an average annual rate of -2.7% per year (Pearson r = -.91, P = .0003). Ossiculoplasties declined by 18%, an average annual rate of -1.9% (r = -.8, P = .006). In combination, cases declined by 20%, an average annual rate of -2.2% (r = -.87, P = .001). CONCLUSION While declines in stapedectomy surgery have been well reported, here we show steady declines in ossiculoplasty as well. If these trends continue, more cochlear implantations may be performed annually than stapedectomy and ossiculoplasty combined, with cochlear implantation likely to overtake ossicular chain surgery in the near future. These changes in surgical volume have a direct implication on resident education and general otolaryngology expectations after graduation. Strong consideration should be made to replace "Stapedectomy/Ossiculoplasty" as resident key indicator with "Cochlear Implantation," a more professionally meaningful skill.
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Affiliation(s)
- Jason K Adams
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
| | - John P Marinelli
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
| | - Russell De Jong
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
| | - Samuel A Spear
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
- Department of Defense Hearing Center of Excellence, San Antonio, Texas, USA
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Isaac D Erbele
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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The Case Against Stapedectomy as a Core Competency for General Practice: A Study of Care Patterns in the Department of Defense. Otol Neurotol 2022; 43:1011-1015. [PMID: 36006782 DOI: 10.1097/mao.0000000000003657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Stapedectomy remains a key indicator case reportable to the Accreditation Council of Graduate Medical Education despite the decline in the incidence of otosclerosis over the last half century. This study compared the rates of stapedectomy performed by otolaryngologists at academic and nonacademic centers. STUDY DESIGN Retrospective review. SETTING Tertiary referral academic centers, nonacademic centers, and civilian purchased-care across the Department of Defense between 2015 and 2020. PATIENTS Department of Defense beneficiaries with otosclerosis near a military treatment facility with an otolaryngologist. INTERVENTIONS Stapedectomy (Current Procedural Terminology codes 69,660, 69,661, and 69,662). MAIN OUTCOME MEASURES Number of stapedectomies performed by setting. RESULTS From 2015 to 2020, 426 stapedectomies were performed at or near a military treatment facility with an otolaryngologist (274 directly by military otolaryngologists, 152 by community providers). Military providers performed 94% of stapedectomies at or near military academic centers, versus only 30% at or near nonacademic centers ( p < 0.0001). Among the 60 stapedectomies performed at nonacademic centers, only 30 were performed by general otolaryngologists (7% of all stapedectomies performed; 11% of procedures by military providers) while the rest were performed by fellowship-trained otologist or neurotologist. CONCLUSIONS Low stapes surgical volume by military general otolaryngologists reinforces recent epidemiologic trends and suggests that few general otolaryngologists graduate residency with sufficient competency to pursue independently performing stapedectomy or have difficulty maintaining competency after graduation.
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Krishnan PS, Daggumati S, Widmeyer J, Quinn KJ, Yu C, Vahidi N, Kamdar R, Kandl C. The Lasting Impact of the COVID-19 Pandemic on Surgical Key Indicator Cases for Otolaryngology Residency Education. Ann Otol Rhinol Laryngol 2022:34894221123121. [PMID: 36123958 DOI: 10.1177/00034894221123121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Early on during the COVID-19 pandemic, the US Centers for Medicare & Medicaid Services (CMS) and other government as well as medical institutions recommended that surgeons postpone nonessential surgeries. The aim of our study is to examine the impact of the COVID-19 pandemic on otolaryngology surgical training by evaluating changes in surgical volumes through various time points relative to the height of the pandemic. METHODS We performed a retrospective review of all surgical cases performed by the Otolaryngology-Head and Neck Surgery department at a tertiary care academic center from 3 time periods: July 1st, 2018, to June 30th, 2019; July 1st, 2019, to June 30th, 2020; and July 1st, 2020, to June 30th, 2021. RESULTS From the 2018-19 period to the 2020-21 period, the total number of overall cases decreased by 9.9%, from 2386 to 2148 cases. During this same time duration, the number of key indicator cases decreased by 13.4%, from 1715 to 1486 cases. Relative to other cases, ethmoidectomy, rhinoplasty, and stapes/OCR cases decreased the most during the 2019-20 period by 41.9%, 41.8%, and 29.5%, respectively. From the 2018-19 period to the 2020-21 period, thyroid/parathyroid cases decreased the most by 35.4%. Only ethmoidectomy and oral cavity cases showed increases during this period at 9.7% and 24.4%, respectively. CONCLUSIONS Although case volumes have stayed relatively constant, key indicator case volumes at the present tertiary care academic center have not yet fully recovered from the COVID-19 pandemic. Efforts must be made to determine how this has impacted residency surgical education.
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Affiliation(s)
- Pavan S Krishnan
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Srihari Daggumati
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Jonathan Widmeyer
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Kevin J Quinn
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Cheryl Yu
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Nima Vahidi
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
| | - Rushabh Kamdar
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Christopher Kandl
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, VA, USA
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Kreicher KL, Rutherford KD, Goldstein TA, Trahan SC, Kavanagh KR. Development of a Three-Dimensional Printed Model for Rhinoplasty Simulation in Surgical Education. Facial Plast Surg Aesthet Med 2022. [DOI: 10.1089/fpsam.2022.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kathryn L. Kreicher
- Division of Otolaryngology, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Kimberley D. Rutherford
- Division of Otolaryngology, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Todd A. Goldstein
- Center for 3D Design and Innovation, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Sean C. Trahan
- Division of Otolaryngology, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA
- Center for 3D Design and Innovation, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Katherine R. Kavanagh
- Division of Otolaryngology, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA
- Department of Otolaryngology, Connecticut Children's, Hartford, Connecticut, USA
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Chen JX, Riccardi AC, Shafique N, Gray ST. Are otolaryngology residents ready for independent practice? A survey study. Laryngoscope Investig Otolaryngol 2021; 6:1296-1299. [PMID: 34938865 PMCID: PMC8665426 DOI: 10.1002/lio2.678] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/04/2021] [Accepted: 09/27/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE We surveyed otolaryngology program directors (PDs) and recent otolaryngology residency graduates on the operative autonomy of graduating residents and their comfort with independent practice. METHODS An anonymous survey was sent to otolaryngology PDs and recent graduates of training programs (members of the Young Physicians Section [YPS] of the American Academy of Otolaryngology-Head and Neck Surgery Foundation). Questions were developed around the 14 key indicator procedures (KIPs) defined by the Accreditation Council for Graduate Medical Education. RESULTS Fifty PDs (43% of PDs) and 152 recent graduates (6% of YPS members) responded. Over 90% of participating PDs felt their graduating residents were either somewhat or extremely comfortable performing 12 out of 14 KIPs. Among the 12 procedures PDs felt their graduating residents were comfortable performing, 57% to 95% of recent graduates also felt either somewhat or extremely comfortable performing them by graduation. Similarly, at least 90% of responding PDs felt their residents achieved meaningful autonomy in the last 2 months of residency prior to graduation for 11 of 14 KIPs. For these same 11 procedures, 74% to 95% of recent graduates indicated they achieved meaningful autonomy. The procedures that PDs and recent graduates felt required the most surgical assistance were ossiculoplasty/stapedectomy, rhinoplasty, and mastoidectomy. All PDs agreed or strongly agreed that graduating residents are comfortable operating and taking call as general otolaryngologists, compared to 86% and 93% of recent graduates. CONCLUSION Most PDs and recent graduates agree that residents are well-prepared for general otolaryngology practice with the exception of select KIPs.Level of evidence: 4.
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Affiliation(s)
- Jenny X. Chen
- Department of Otolaryngology–Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
- Department of Otolaryngology–Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Aaliyah C. Riccardi
- Department of OtolaryngologyUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Neha Shafique
- General SurgeryUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Stacey T. Gray
- Department of Otolaryngology–Head and Neck SurgeryMassachusetts Eye and EarBostonMassachusettsUSA
- Department of Otolaryngology–Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
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Fieux M, Gavoille A, Subtil F, Bartier S, Tringali S. Otoskills training during covid-19 pandemic: a before-after study. BMC MEDICAL EDUCATION 2021; 21:284. [PMID: 34006283 PMCID: PMC8129703 DOI: 10.1186/s12909-021-02706-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The ongoing COVID-19 pandemic has disrupted the surgical training of residents. There is a real concern that trainees will not be able to meet their training requirements. Low-fidelity surgical simulation appears to be an alternative for surgical training. The educational benefits of repeating ossiculoplasty simulations under a microscope have never been evaluated. With this study we aimed to evaluate the differences in performance scores and on a global rating scale before and after training on an ossiculoplasty simulator. METHODS In this quasi-experimental, prospective, single-centre, before-after study with blinded rater evaluation, residents performed five microscopic ossiculoplasty tasks with a difficulty gradient (sliding beads onto rods, the insertion of a partial prosthesis, the insertion of a total prosthesis, and the insertion of a stapedotomy piston under microscopic or endoscopic surgery) before and after training on the same simulator. Performance scores were defined for each task, and total performance scores (score/min) were calculated. All data were collected prospectively. RESULTS Six out of seven intermediate residents and 8/9 novices strongly agreed that the simulator was an effective training device and should be included in the ENT residency program. The mean effect of training was a significant increase in the total performance score (+ 0.52 points/min, [95 % CI, 0.40-0.64], p < 0.001), without a significant difference between novice and intermediate residents. CONCLUSIONS This preliminary study shows that techniques for middle-ear surgery can be acquired using a simulator, avoiding any risk for patients, even under lockdown measures.
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Affiliation(s)
- Maxime Fieux
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, 165 Chemin du Grand Revoyet, F-69495, Pierre-Bénite cedex, France.
- Université de Lyon, Université Lyon 1, F-69003, Lyon, France.
- Univ Paris Est Créteil, INSERM, IMRB, F-94010, Créteil, France.
- CNRS ERL 7000, F-94010, Créteil, France.
| | - Antoine Gavoille
- Université de Lyon, Université Lyon 1, F-69003, Lyon, France
- Hospices Civils de Lyon, Service de Biostatistique et Bioinformatique, Lyon, France
- CNRS, Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, Villeurbanne, France
| | - Fabien Subtil
- Université de Lyon, Université Lyon 1, F-69003, Lyon, France
- Hospices Civils de Lyon, Service de Biostatistique et Bioinformatique, Lyon, France
- CNRS, Laboratoire de Biométrie et Biologie Évolutive, UMR 5558, Villeurbanne, France
| | - Sophie Bartier
- Univ Paris Est Créteil, INSERM, IMRB, F-94010, Créteil, France
- CNRS ERL 7000, F-94010, Créteil, France
- Service d'ORL, de chirurgie cervico faciale, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France
| | - Stéphane Tringali
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, 165 Chemin du Grand Revoyet, F-69495, Pierre-Bénite cedex, France
- Université de Lyon, Université Lyon 1, F-69003, Lyon, France
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8
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Evaluating resident involvement and the 'July effect' in parotidectomy. The Journal of Laryngology & Otology 2021; 135:452-457. [PMID: 33910657 DOI: 10.1017/s0022215121000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effect of resident involvement and the 'July effect' on peri-operative complications after parotidectomy. METHOD The American College of Surgeons National Surgical Quality Improvement Program database was queried for parotidectomy procedures with resident involvement between 2005 and 2014. RESULTS There were 11 733 cases were identified, of which 932 involved resident participation (7.9 per cent). Resident involvement resulted in a significantly lower reoperation rate (adjusted odds ratio, 0.18; 95 per cent confidence interval, 0.05-0.73; p = 0.02) and readmission rate (adjusted odds ratios 0.30; 95 per cent confidence interval, 0.11-0.80; p = 0.02). However, resident involvement was associated with a mean 24 minutes longer adjusted operative time and 23.5 per cent longer adjusted total hospital length of stay (respective p < 0.01). No significant difference in surgical or medical complication rates or mortality was found when comparing cases among academic quarters. CONCLUSION Resident participation is associated with significantly decreased reoperation and readmission rates as well as longer mean operative times and total length of stay. Resident transitions during July are not associated with increased risk of adverse peri-operative outcomes after parotidectomy.
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Miller RH, McCrary HC, Gurgel RK. Assessing Trends in Fellowship Training Among Otolaryngology Residents: A National Survey Study. Otolaryngol Head Neck Surg 2021; 165:655-661. [PMID: 33618575 DOI: 10.1177/0194599821994477] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To summarize trends in otolaryngology fellowship applications, fellowships selected, and reasons for pursuing a fellowship. STUDY DESIGN One-page anonymous questionnaire. SETTING A survey was completed by examinees at the conclusion of their American Board of Otolaryngology-Head and Neck Surgery oral examination from 2011 to 2019. METHODS Data included age, gender, fellowship type, reasons for doing a fellowship, and type of practice that examinees will enter. Spearman correlation and Pearson chi-square tests were completed. RESULTS Over the 8-year study, 58% of the 2243 responding examinees did fellowships. The most frequently chosen fellowship was facial plastic surgery (25%), followed by pediatric otolaryngology (21%), head and neck surgery (19%), rhinology (13%), laryngology (9%), and neurotology (8%). The 2 most common reasons for doing a fellowship were desire for additional expertise beyond residency training (35%) and intellectual appeal (30%). Over the study period, the number of residents choosing to do a fellowship increased from 45.6% in 2011 to 61.5% in 2019, with a positive correlation between year and number of residents (r = 0.73, P = .036). When the data were stratified by gender, there were statistically significant differences in fellowship selection (P < .001), notably with women selecting pediatric otolaryngology at a higher frequency than men (30.9% vs 15.8%). CONCLUSION There is a statistically significant increasing trend of otolaryngology residents who choose to undergo further training in fellowship. These data from a large, long-term study will be valuable in planning for training and workforce needs in the future.
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Affiliation(s)
- Robert H Miller
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Hilary Caitlyn McCrary
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Utah, USA
| | - Richard K Gurgel
- Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Utah, USA
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10
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Balhareth A, AlDuhileb MA, Aldulaijan FA, Aldossary MY. Impact of COVID-19 pandemic on residency and fellowship training programs in Saudi Arabia: A nationwide cross-sectional study. Ann Med Surg (Lond) 2020; 57:127-132. [PMID: 32754313 PMCID: PMC7377677 DOI: 10.1016/j.amsu.2020.07.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 11/30/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has profoundly impacted residency and fellowship training and education. However, how and to what extent the daily involvement of trainees in clinical and surgical activities was compromised by the COVID-19 pandemic is currently unknown. Materials and methods We conducted an electronic survey. An invitation was sent through the executive training administration of the Saudi Commission for Health Specialties (SCFHS) randomly to 400 residents and fellows over two weeks period from April 23, 2020 until May 6, 2020. Descriptive statistics were presented using counts and proportions (%). The comparison between the trainees among the socio-demographic and the characteristics of trainees toward the impact of COVID-19 pandemic on their training had been conducted using the Chi-square test. A p-value cut off point of 0.05 at 95% Confidence Interval (CI) used to determine statistical significance. Results Out of the 400 questionnaires distributed, 240 trainees responded, resulting in a response rate of 60%. The most frequently cited specialty was surgical (41.3%) and medical (38.3%). Approximately 43% of them had direct contact with patients with COVID-19, and 43.8% had enough training regarding the proper use of Personal Protective Equipment (PPE). There were seven responders (2.9%) who had been infected by the disease. Among them, 6 (2.5%) members of their family had also been infected. Approximately 84.6% reported a reduction in training activities due to the current pandemic. Of those with surgical specialties, almost all (97%) reported that their surgical exposure reduced due to the COVID-19 pandemic. Conclusion The adoption of smart learning is critical. For those who have been affected by examination delays, we recommend continuing to revise steadily using webinars, podcasts, prerecorded sessions, and social media. Routine activities such as journal clubs and departmental teaching should continue through webinars, if possible. The first cross-sectional survey study to show the impact of COVID-19 pandemic on training programs in Saudi Arabia. Almost 97% of the participants reported that their surgical exposure was reduced due to the pandemic. We recommend continuing to revise steadily using webinars, podcasts, prerecorded sessions, and social media. Routine activities such as journal clubs and departmental teaching should continue through webinars if possible.
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Affiliation(s)
- Ameera Balhareth
- Department of General Surgery, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
| | | | - Fozan A Aldulaijan
- Department of General Surgery, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia
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Totten DJ, Marinelli JP, Spear SA, Bowe SN, Carlson ML. With the Incidence of Otosclerosis Declining, Should Stapedectomy Remain a Key-Indicator Case for Otolaryngology Residents? Otolaryngol Head Neck Surg 2020; 163:1070-1072. [PMID: 32689881 DOI: 10.1177/0194599820941836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Stapedectomy remains a joint key-indicator case with ossiculoplasty for otolaryngology residents in the United States. Yet, residents consistently report feeling inadequately prepared to perform stapes surgery following graduation. Applying recently described age- and sex-standardized incidence rates of surgically confirmed cases of otosclerosis to the US populace, upper and lower estimates of residents' case exposure to stapedectomy can be approximated. With this, uppermost projections estimate 6484 new cases of stapes surgery are performed annually nationwide. With approximately 1424 otolaryngology residents nationally, the average case exposure is 7.8 stapedectomies throughout their training, with upper and lower estimates of 17.1 and 4.2 cases, respectively. As such, proficiency in stapedectomy is no longer a realistic expectation for US graduating residents. This reality supports the removal of "stapedectomy" from the list of 14 key-indicator case requirements, leaving ossiculoplasty as its own key-indicator case, thereby reinforcing true competence in this fundamental procedure for the graduating otolaryngologist.
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Affiliation(s)
- Douglas J Totten
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - John P Marinelli
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
| | - Samuel A Spear
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
| | - Sarah N Bowe
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Crosby DL, Sharma A. Insights on Otolaryngology Residency Training during the COVID-19 Pandemic. Otolaryngol Head Neck Surg 2020; 163:38-41. [PMID: 32312158 DOI: 10.1177/0194599820922502] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Otolaryngology residency training programs are facing a novel challenge due to severe acute respiratory syndrome coronavirus 2. The widespread impact and chronicity of this pandemic makes it unique from any crisis faced by our training programs to date. This international medical crisis has the potential to significantly alter the course of training for our current resident cohort. The decrease in clinical opportunities due to the limitations on elective surgical cases and office visits as well as potential resident redeployment could lead to a decline in overall experience as well as key indicator cases. It is important that we closely monitor the impact of this pandemic on resident education and ensure the implementation of alternative learning strategies while maintaining an emphasis on safety and well-being.
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Affiliation(s)
- Dana L Crosby
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA
| | - Arun Sharma
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Southern Illinois University, Springfield, Illinois, USA
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