A randomized controlled trial of nasolaryngoscopy training techniques.
OBJECTIVE
Flexible nasolaryngoscopy is an essential skill for otolaryngology trainees to develop, but there is a lack of standardized training for this procedure. The aim of this study was to assess whether using training on a realistic human mannequin together with structured video feedback improved trainees' performance at flexible nasolaryngoscopy.


METHODS
Three-armed, single-blinded, randomized controlled study.


METHODS
Thirty-six junior doctors and final-year medical students were randomly allocated to one of three groups. All received a lecture and video presentation on flexible nasolaryngoscopy. One group received additional tuition using a training mannequin. The last group received mannequin training and feedback on their performance using a video recording. The trainees then undertook flexible nasolaryngoscopy on volunteers with these endoscopies recorded. Blinded observers scored the trainees on a range of objective and subjective measures. The volunteers who were also blinded to the candidates' training scored the comfort of the procedure.


RESULTS
Adding mannequin training showed a trend toward improvement of performance but did not reach statistical significance. Mannequin training together with video feedback produced significant performance improvement in patient comfort (P = .0065), time to reach the vocal folds (P = .017), and global ability (P = .0006). Inter-rater reliability was excellent with P < .01 in all assessments.


CONCLUSIONS
Simulation-based training using an anatomically correct model of the upper airway together with formalized video-assisted feedback on that training is a simple and effective way to improve endoscopy skills prior to starting flexible nasolaryngoscopy on patients.
ENT Department, Colchester Hospital University NHS Foundation Trust, Essex County Hospital, Colchester, United Kingdom.
Matthew E
ME
Smith
Billy C
BC
Leung
Rishi
R
Sharma
Sammar
S
Nazeer
Don J
DJ
McFerran
D006801:Humans; D007828:Laryngoscopy / Q000193:education*; D008348:Manikins; D009666:Nose; D010036:Otolaryngology / Q000193:education*; D016037:Single-Blind Method
Medical education; airway skills; flexible nasolaryngoscopy; simulation