Utilization of Video Otoscopes for Otoscopy Skills Training of Third Year Medical Students

Abstract

Purpose

Effective teaching and assessment of otologic examinations are challenging. Current methods of teaching otoscopy using traditional otoscopes have significant limitations. We hypothesized that use of all-in-one video otoscopes provides students with an opportunity for real-time faculty feedback and re-practicing of skills, increasing self-reported confidence.

Methods

An otoscopy microskills competency checklist was provided to third-year medical students during their pediatric clerkship to self-assess otoscopy technique during patient examinations, and to clinical preceptors to assess and provide feedback during exams. Over the course of two years, we collected data from students randomly assigned to train on a video otoscope or a traditional otoscope during the clerkship. Pre- and post-clerkship surveys measured confidence in performing otoscopy microskills, making a diagnosis and documentation of findings. For those students who trained on the video otoscope, we solicited post-clerkship feedback on the experience of using a video otoscope.

Results

Pre-clerkship confidence did not differ between the groups, but the video otoscope trained group had significantly higher scores than the traditional otoscope trained group on all self-reported technical and diagnostic microskills confidence questions items post-clerkship. Students trained on video otoscopes had a significant increase in confidence with all microskills items (p-values<0.001), however confidence in the traditional otoscope trained group did not change over time (p-values>0.10). Qualitative feedback from the video otoscope trained group reflected positive experiences regarding “technique/positioning” and “feedback from preceptors.”.

Conclusion

Teaching otoscopy skills to pediatric clerkship medical students using a video otoscope significantly enhanced confidence compared to those training on a traditional otoscope by 1. enabling preceptors and students to simultaneously visualize otoscopy findings 2. allowing preceptors to provide real-time feedback and 3. providing opportunity for deliberate practice of microskills. We encourage the use of video otoscopes to augment student confidence and self-efficacy when training in otoscopy.

Keywords:

• medical students
• technology
• physical diagnosis
• otoscopy

Abbreviations

VOT, video otoscope trained; TOT, traditional otoscope trained; TM, tympanic membrane; MCQ, multiple choice questions; AOM, acute otitis media.

Acknowledgments

We would like to thank: Jeffrey Bird, Director Educational Data and Analytics, and Marybeth Wright, Program Coordinator, for their invaluable contributions to this study. A grant awarded by the Academy of Medical Educators at the Donald and Barbara Zucker school supported purchase of the video otoscopes used in this study.

Disclosure

Dr Marie Cavuoto Petrizzo reports a grant from the Zucker School of Medicine’s Academy of Medical Educators during the conduct of the study. The authors report no other conflicts of interest in this work.