title: Objective Evaluation of Otoscopy Skills Among Family and Community Medicine, Pediatric, and Otolaryngology Residents.
abstract: BACKGROUND
  The objective of this study is to evaluate and compare the perceived need for otolaryngology training and otoscopy diagnostic skills in primary care (Family and Community Medicine, Pediatric Medicine), and Otolaryngology Head and Neck Surgery (OTO-HNS) postgraduate trainees. Participant otoscopy skills were evaluated using the OtoSim simulator.
  
  
  METHODS
  Family and Community Medicine, Pediatric, and OTO-HNS residents were recruited. Each resident participated in 3 separate otoscopy training and assessment sessions. The ability to correctly identify middle ear pathology was objectively evaluated using OtoSim™. Pretest, posttest, and 3-month retention test results were compared among residents in a paired comparison paradigm. Survey data assessing exposure to OTO-HNS during undergraduate and postgraduate training were also collected.
  
  
  RESULTS
  A total of 57 residents participated in the study. All residents reported limited exposure to OTO-HNS during undergraduate medical training. Primary care trainees performed poorly on pretest assessments (30% ± 7.8%; 95% CI). Significant improvement in diagnostic accuracy was demonstrated following a single 1-hour teaching session (30%-62%; p < 0.001). Primary care residents demonstrated a significant decrease in diagnostic accuracy at a 3-month follow-up assessment (62%-52%, p < 0.001). Self-perceived comfort with otology was poorly correlated to pretest performance among primary care trainees (r = 0.26) and showed a stronger positive correlation among OTO-HNS trainees (r = 0.56).
  
  
  CONCLUSIONS
  A single teaching session with an otoscopy simulator significantly improved diagnostic accuracy in primary care and OTO-HNS trainees. Improved performance is susceptible to deterioration at 3 months if acquired skills are not frequently used. Self-perceived comfort with otology may not be an accurate predictor of otoscopic diagnostic skill.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada.
authors.forename: Modupe
authors.initials: M
authors.lastname: Oyewumi
authors.affiliation: Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada. Electronic address: drmbrandt@gmail.com.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Brandt
authors.affiliation: Centre for Image Guided Innovation & Therapeutic Intervention, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Carrillo
authors.affiliation: Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Adelle
authors.initials: A
authors.lastname: Atkinson
authors.affiliation: Department of Family and Community Medicine, St. Michael's Hospital, University of Toronto, Toronto, Canada.
authors.forename: Karl
authors.initials: K
authors.lastname: Iglar
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Vito
authors.initials: V
authors.lastname: Forte
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Canada.
authors.forename: Paolo
authors.initials: P
authors.lastname: Campisi
mesh_terms: D002983:Clinical Competence; D003154:Community Medicine / Q000193:education*; D005194:Family Practice / Q000193:education*; D007396:Internship and Residency; D010036:Otolaryngology / Q000193:education*; D038781:Otoscopy / Q000592:standards*; D010372:Pediatrics / Q000193:education*; D000066908:Simulation Training
keywords: Family and Community Medicine; Medical Knowledge; OtoSim; Patient Care; Practice-Based Learning and Improvement; acute otitis media; ear pathology; family medicine; otitis externa; otolaryngology; otoscopy; pediatrics; primary care