title: Resident participation in cadaveric temporal bone dissection correlates with improved performance on a standardized skill assessment instrument.
abstract: OBJECTIVE
  Increasing numbers of cadaveric temporal bone (CTB) dissection translates to improved scores on a timed microdissection of a CTB.
  
  
  BACKGROUND
  Recent literature regarding resident education has focused on virtual learning. However, advocates for virtual temporal bone drilling admit that there is not yet a substitute for drilling a CTB.
  
  
  METHODS
  Retrospective review of resident performance on a standardized instrument during a timed microdissection of CTBs. Resident performance on the graded dissection was compared with the number of CTBs drilled during the year. Graded performance was also compared with the total number of CTBs dissected over 4 years of residency. Faculty assessed intraoperative skill of the senior residents. These rankings were compared with the number of CTBs drilled. Comparisons were made using Pearson's and Spearman's correlations.
  
  
  RESULTS
  Comparison of test scores from the most recent resident year to the number of CTBs drilled during the corresponding year correlated well (r = 0.41, p = 0.002). The correlation between the score during the highest year of training and the cumulative number of CTB drilled during residency was even stronger (r = 0.604, p = 0.005). Faculty rankings correlated well comparing general surgical skills with TB surgical skills (r = 0.655, p = 0.008). Comparing faculty rankings of TB surgical skill with the number of CTB drilled during the final year of residency yielded a negative correlation (r = -0.8) but was not significant (p = 0.1).
  
  
  CONCLUSIONS
  Greater exposure to CTB dissection correlates with improved scoring on a standardized instrument. Residents who struggle with temporal bone surgery tend to use CTB dissection more than those who are more facile.
authors.affiliation: *Department of Otolaryngology, Medical College of Georgia at Georgia Regents University, Augusta, Georgia; and †Department of Otolaryngology, University of Iowa Hospital and Clinics, Iowa City, Iowa, U.S.A.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Mowry
authors.forename: Marlan R
authors.initials: MR
authors.lastname: Hansen
mesh_terms: D002983:Clinical Competence; D004210:Dissection; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D012189:Retrospective Studies; D013701:Temporal Bone