title: Development and validation of a low-cost microsurgery Ear Trainer for low-resource settings.
abstract: OBJECTIVE
  Chronic suppurative otitis media is a neglected condition affecting up to 330 million people worldwide, with the burden of the disease in impoverished countries. The need for non-governmental organisations to hardwire training into their programmes has been highlighted. An ear surgery simulator appropriate for training in resource-poor settings was developed, and its effectiveness in facilitating the acquisition of headlight and microsurgical skills necessary to safely perform procedures via the ear canal was investigated.
  
  
  METHODS
  Face validity was assessed via questionnaires. Six tasks were developed: a headlight foreign body removal task, and microscope tasks of foreign body removal, ventilation tube insertion, tympanomeatal flap raising, myringoplasty and middle-ear manipulation. Participants with varying ENT experience were video-recorded performing each task and scored by a blinded expert observer to assess construct validity.
  
  
  RESULTS
  Face validity results confirmed that our Ear Trainer was a realistic representation of the ear. Construct validity results showed a statistically significant trend, with experts performing the best and those with limited experience performing better than novices.
  
  
  CONCLUSIONS
  This study validates our Ear Trainer as a useful training tool for assessing headlight and microsurgical skills required to perform otological procedures.
authors: ENT Department,Gloucestershire Hospitals NHS Foundation Trust,Gloucester,UK.
authors: M P A
authors: MP
authors: Clark
authors: Department of Surgery,University of British Columbia,Vancouver,Canada.
authors: B D
authors: BD
authors: Westerberg
authors: ENT Department,Frimley Park Hospital,Frimley,UK.
authors: J E
authors: JE
authors: Mitchell
mesh_terms: D003198:Computer Simulation; D006295:Health Resources / Q000191:economics*; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008866:Microsurgery / Q000193:education* / Q000379:methods; D008953:Models, Anatomic; D010035:Otitis Media, Suppurative / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000193:education* / Q000379:methods; D011203:Poverty; D015203:Reproducibility of Results; D000066908:Simulation Training / Q000191:economics / Q000379:methods*
keywords: Education; Foreign Bodies; Global Health; Otologic Surgical Procedures; Training Techniques; Tympanic Membrane; Tympanoplasty; Tympanostomy Tube Insertion; Validation Studies