Mastering diagnostic skills: Enhancing Proficiency in Otitis Media, a model for diagnostic skills training.
OBJECTIVE
We developed a program for training in the diagnosis of otitis media that included images illustrating various otoscopic findings, mnemonic guides to recollection, and discrimination sessions that included feedback and assessments of diagnostic skills.


METHODS
We prepared a computerized, interactive curriculum, Enhancing Proficiency in Otitis Media (ePROM), that was centered around assemblages of clinically diverse, still and video images of tympanic membranes (TMs). To assess curriculum effectiveness, we constructed a test, the Diagnostic Ear Assessment Resource, that consisted of 50 video TM images. We administered the test to 84 residents in pediatrics or family practice who had not been exposed to ePROM and, varying the order in which the images were presented, to another group of 102 residents in the same programs both before and after exposure to ePROM.


RESULTS
o Mean proportions of correct diagnoses in the Diagnostic Ear Assessment Resource were larger among residents who had been exposed to ePROM than among residents at comparable levels of training who had not been exposed (67% vs 62%; P = .007). Among residents exposed to ePROM, mean proportions of correct diagnoses were larger after exposure than before (67% vs 55%; P < .001).


CONCLUSIONS
A structured, computerized curriculum to supplement standard clinical training can enhance residents' abilities to interpret still and video images of TMs and may improve their skills in diagnosing otitis media.
Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Dr, 4401 Penn Ave, General Academic Pediatrics, CHOB 3rd Floor, Pittsburgh, PA 15224, USA. phillip.kaleida@chp.edu
Phillip H
PH
Kaleida
Dianna L
DL
Ploof
Marcia
M
Kurs-Lasky
Nader
N
Shaikh
D Kathleen
DK
Colborn
Mary Ann
MA
Haralam
Sean
S
Ray
Diana
D
Kearney
Jack L
JL
Paradise
Alejandro
A
Hoberman
D000208:Acute Disease; D000328:Adult; D002983:Clinical Competence; D003162:Competency-Based Education; D003194:Computer-Assisted Instruction; D004503:Education, Medical, Graduate / Q000379:methods; D006776:Hospitals, Pediatric; D006801:Humans; D007396:Internship and Residency; D008297:Male; D017145:Models, Educational; D010033:Otitis Media / Q000175:diagnosis*; D010034:Otitis Media with Effusion / Q000175:diagnosis; D038781:Otoscopy; D010414:Pennsylvania; D014741:Video Recording