title: Development and evaluation of a rigid esophagoscopy simulator for residency training.
abstract: OBJECTIVE
  Rigid esophagoscopy is performed less frequently by resident trainees. Nonetheless, it remains important for certain indications, including foreign body extraction. This study describes the construction of a simulator and evaluates its utility in training residents.
  
  
  METHODS
  Simulator development, fabrication, and procedural evaluation of postgraduate trainees.
  
  
  METHODS
  A simulator was developed and constructed in collaboration with a biomedical engineering team. Residents with varied experience in upper aerodigestive procedures performed rigid esophagoscopy on the model. Key steps and Accreditation Council for Graduate Medical Education's Objective Structured Assessment of Technical Skills (OSATS) criteria for rigid esophagoscopy were evaluated by a faculty surgeon. Pressure measurements were obtained from force sensors at the tip of the endoscope and incisors.
  
  
  RESULTS
  Fourteen trainees were evaluated. Operative rigid esophagoscopy and direct laryngoscopy case numbers were noted for each subject. OSATS scores and key steps of the procedure correlated with resident experience (R(2)  = 0.75, P < .0001 and R(2)  = 0.66, P < .001, respectively). Maximal pressure exerted on the simulator esophagus by the esophagoscope was inversely correlated with case number and was statistically significant (R(2)  = 0.51, P = .02), whereas length of procedure did not correlate (R(2)  = 0.04, P = .49). Maximal pressure on the incisors did not correlate (R(2)  = 0.25, P = .15).
  
  
  CONCLUSIONS
  A simulator for training residents to perform rigid esophagoscopy was developed and utilized by a faculty proctor to objectively evaluate trainees. OSATS scores, performance of key procedural steps, and pressure exerted on the simulator tissue correlated with upper aerodigestive cases performed, demonstrating validity of the simulator.
  
  
  METHODS
  NA Laryngoscope, 126:616-619, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Amir
authors.initials: A
authors.lastname: Allak
authors.affiliation: Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Yizhen E
authors.initials: YE
authors.lastname: Liu
authors.affiliation: Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Marianna S
authors.initials: MS
authors.lastname: Oliynyk
authors.affiliation: Department of Biomedical Engineering, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Kai H
authors.initials: KH
authors.lastname: Weng
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Jameson
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
authors.forename: David C
authors.initials: DC
authors.lastname: Shonka
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods; D020701:Esophagoscopes; D004945:Esophagoscopy / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D017145:Models, Educational
keywords: Esophagoscopy; head and neck surgery; laryngology; simulation; simulator; training