Endoscopic ear examination improves self-reported confidence in ear examination skills among undergraduate medical students compared with handheld otoscopy

Objectives: Handheld otoscopy is the standard tool used to teach ear examination in undergraduate and postgraduate medical education. Previous studies have shown that the undergraduate teaching of ear examination with handheld otoscopes is inadequate, resulting in low self-reported levels of student confidence in their diagnostic skills. With the increase in popularity of endoscopic ear surgery, an increasing number of otolaryngologists are using endoscopes for office examinations of the ear due to the method's superior visualization and excellent image qualities. However, medical students usually do not receive exposure to endoscopic ear examination during their undergraduate curriculum. The aim of this study is to assess our preliminary experience with teaching endoscopic ear examination to undergraduate medical students. Methods: A two-hour-long pilot practical course on basic ear examination was administered to undergraduate medical students with little to no previous experience with ear examination. The course was designed to minimize the duration of campus attendance and patient contact during the COVID-19 pandemic. The course included theoretical didactics, exemplary digital endoscopic images and peer physical practice of ear examination with both a handheld otoscope and a 0-degree endoscope. At the end of the course, the students completed a survey questionnaire consisting of eight questions mainly relating to their subjective confidence level with ear examination using either handheld otoscopes or endoscopes and their overall preference for either examination tool. Results: Most students expressed a preference for ear examination with endoscopes over that with handheld otoscopes and reported an improved confidence level in their diagnostic ability with the former technique. The vast majority of students supported the teaching of endoscopic ear examination to future medical students. Conclusion: The findings of this pilot project report and survey study support the early exposure of novice medical learners to endoscopic ear examination, which may help improve the confidence and diagnostic skill of medical students with regard to ear examination. The findings may have implications for the undergraduate teaching of ear examination in the post-COVID-19 era.

Digital practical course of otorhinolaryngology and examination technique "to go"

Objective: The development of presentation-free teaching formats for practical exercises is a particular challenge. The objective of the presented project was the implementation of the practical course in otorhinolaryngology for learning examination techniques through digital distance learning. Methods: Disposable instruments for a comprehensive otorhinolaryngologic examination were purchased and made available to the students. The necessary light sources were everyday sports headlamps or flashlight constructions. The theoretical basics were taught using the learning platform CaseTrain, including photographic, audio and video material. Corresponding success controls in the sense of a digital short test were integrated here. In addition, video tutorials were used to present the examinations to be imitated in detail. In order to increase motivation, a creative photo competition was also announced, in which the practical tasks that were finally carried out independently were checked. Results: All students of the semester received a set of instruments for independent practical training. The entrance exam was passed by all students, and at least one photo was received from all students, many of which were particularly creative in the competition. Conclusion: The presented concept is a possibility to convert practical teaching formats into a digital presence-free concept. It included the teaching and testing of basic knowledge, instructions for practical exercises, the independent performance of subject-specific examination techniques and an increase in motivation and simultaneous control through gamification. We consider this teaching principle to be an attractive option for future "Flipped Classroom" concepts with a gradual resumption of face-to-face teaching.