title: Development and validation of a novel ear simulator to teach pneumatic otoscopy.
abstract: BACKGROUND
  Otoscopy is an important skill in diagnosing conditions of the middle ear. This study evaluated the ability of a novel ear simulator to teach medical students diagnostic and pneumatic otoscopy. We hypothesized that exposure to this simulator improves the ability of medical students to apply an appropriate pneumatic pressure during insufflation and accurately identify the presence of a middle ear effusion in a simulated setting.
  
  
  METHODS
  An ear simulator was created to teach otoscopic skills to medical students. Third-year medical students attended a workshop on pediatric otoscopy, including a demonstration, videos, and verbal instruction on otoscope use. A cohort of these students then practiced pneumatic otoscopy with the simulator. All students, as well as a group of experts who had not been exposed to the trainer, then diagnosed the presence or absence of middle ear fluid in six simulator ears and pneumatic pressures generated were recorded.
  
  
  RESULTS
  Interaction with the simulator enabled students to insufflate with pressures in the proper range (0.4-20 in H2O) more often, apply an average pressure (12.7 in H2O) in the appropriate range, and diagnose middle ear fluid more accurately (79.2%) than students who were not exposed to the trainer (57.3%). The students exposed to the simulator also performed closer to the level of the experts who diagnosed presence of effusion 100% accurately with an average insufflation pressure of 3.8 in H2O.
  
  
  CONCLUSIONS
  Medical students trained with the ear simulator applied appropriate pneumatic pressure more consistently and diagnosed the presence of effusion more accurately and more like experts than students not exposed to the simulator. This ear trainer is a valuable tool for teaching pneumatic otoscopy.
authors.affiliation: Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Morris
authors.forename: Bradley W
authors.initials: BW
authors.lastname: Kesser
authors.forename: Shayn
authors.initials: S
authors.lastname: Peirce-Cottler
authors.forename: Meg
authors.initials: M
authors.lastname: Keeley
mesh_terms: D000208:Acute Disease; D002983:Clinical Competence / Q000592:standards; D015331:Cohort Studies; D003939:Diagnostic Techniques, Otological / Q000295:instrumentation*; D004432:Ear, Middle / Q000503:physiopathology*; D004521:Educational Measurement; D006801:Humans; D008348:Manikins; D010033:Otitis Media / Q000175:diagnosis; D010034:Otitis Media with Effusion / Q000175:diagnosis; D019720:Otoscopes; D038781:Otoscopy / Q000379:methods*; D010372:Pediatrics / Q000193:education; D013337:Students, Medical; D013663:Teaching / Q000379:methods