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. 2020 Feb;40(1):19-25.
doi: 10.14639/0392-100X-N0128.

An innovative and safe way to train novice ear nose and throat residents through simulation: the SimORL experience

Valeria Dell'Era  1 , Massimiliano Garzaro  1 , Luca Carenzo  2 , Pier Luigi Ingrassia  2 , Paolo Aluffi Valletti  1
Affiliations

An innovative and safe way to train novice ear nose and throat residents through simulation: the SimORL experience

Valeria Dell'Era et al. Acta Otorhinolaryngol Ital. 2020 Feb.

Abstract

Didattica innovativa per specializzandi in otorinolaringoiatria: l’esperienza di SimORL.

Riassunto: La simulazione in ambito medico è uno strumento didattico efficace e validato. In letteratura emerge chiaramente come un’esperienza riproducibile ed un contesto sicuro favoriscano l’apprendimento. Obiettivo dello studio è di descrivere un’ esperienza di simulazione rivolta a specializzandi in Otorinolaringoiatria (SimORL) indagando come vari la sicurezza dei partecipanti nell’eseguire procedure otorinolaringoiatriche di base ed indagandone il gradimento in termini didattici (efficacia formativa). SimORL è un evento di due giorni, svoltosi presso il centro di simulazione SIMNOVA dell’Università del Piemonte Orientale - Novara. Il corso era rivolto a specializzandi ORL di tutt’Italia: i partecipanti erano divisi in 5 gruppi e ruotavano all’interno delle 10 stazioni allestite (5 il primo giorno, 5 il secondo). La simulazione si avvaleva di scenari ad alta fedeltà, diagnostica endoscopica su cadavere, simulatori “umidi”, simulazione basata su computer e simulazione guidata dall’esperto. Le stazioni erano le seguenti: otoscopia diagnostica virtuale (OtoSim®), casi clinici simulati con l’ausilio di manichini ad alta fedeltà (HAL®) o pazienti standardizzati (tra cui ad esempio un caso di epistassi posteriore ed uno di vertigine vestibolare), studio anatomico 3D della laringe (zSPACE AIO®), endoscopia naso-sinusale su cadavere, tracheostomia chirurgica su simulatori umidi, suture chirurgiche (Limbs&Things SkinPad®), stazione di familiarizzazione con la strumentazione chirurgica otorinolaringoiatrica ed esercizi di team building. Ai partecipanti è stato chiesto di compilare un questionario prima e dopo il corso per indagare eventuali precedenti esperienze e la sicurezza nell’eseguire procedure specifiche mediante una scala di valutazione numerica con punteggio da 1 a 5. I risultati sono stati espressi come mediana (25-75 percentile). Il livello di soddisfazione tra i partecipanti è stato misurato mediante l’impiego di una scala di gradimento a 5 campi validata per le esperienze di simulazione (Satisfaction Simulation Experience Scale - SSES). All’evento hanno partecipato 23 specializzandi ORL e di questi solo 3 riferivano una precedente e limitata esperienza nell’ambito della simulazione. La sicurezza nell’eseguire le procedure oggetto del corso è stata registrata con un post-test, risultando significativamente migliorata rispetto a quella emersa nei pre-test, così come elevato è stato l’indice globale di gradimento (SSES = 4,5/5). SimORL si è rivelato uno strumento didattico valido e gradito per specializzandi ORL nello svolgimento di procedure di base.

Keywords: ENT residents training; educational ENT program; medical simulation; wet lab.

Plain language summary

Medical simulation enables trainees to learn procedural skills in a tailored, non-threatening, controlled environment that can provide feedback and educational experiences. The goals of this study are to describe the set-up and execution of an educational intervention (SimORL) in Ear Nose and Throat (ENT) simulation, to report confidence in performing basic ENT procedures before and after the event and investigate whether participants would find it useful and educationally effective. SimORL was a two-day formative event held at SIMNOVA - Eastern Piedmont Simulation Centre, Italy. The event was open to ENT trainees from any Italian ENT training program; participants were divided into 5 teams and rotated around 10 different simulation stations over two days. Stations included: high-fidelity, skill trainer, computer based, wet lab and dissection. Stations were: virtual otoscopy (OtoSim®), simulated clinical cases with high-fidelity mannequin (e.g. epistaxis) or standardised patients (e.g. vestibular neuronitis), robotic surgery (Da Vinci®), human anatomy (zSPACE AIO®), surgical tracheostomy (wet model), cadaveric sino-nasal endoscopy (wet model), crisis resource management (team exercise), surgical sutures (Limbs&Things SkinPad®), surgical set station and team building exercises. Participants were asked to complete a pre- and post-test that queried previous experience and confidence using 10-item unanchored semantic scales. Results are presented as median (25-75 percentile). Satisfaction was assessed by a validated 5-item Likert Simulation Experience Scale (SSES). Twenty-three ENT trainees attended SimORL 2018. Only 3 participants reported limited previous simulation experience. Pre-post confidence significantly improved between before and after the event. Overall satisfaction with Simulation Experience Scale (SSES) was very high with a median of 4.5 of 5. Regarding simulation evaluation, the most appreciated station was nasal endoscopy (10/10), while the least appreciated was otoscopy (6/10). SimORL proved to be a highly rated and useful educational tool to improve junior ENT trainees’ confidence in performing basic ENT procedures.

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Figures

Figure 1.
Figure 1.
Radar chart presenting median self-confidence perception level before (dotted white) and after (grey) the event. Apexes of polygon represent each simulation station (1: diagnostic otoscopy; 2: diagnostic nasal endoscopy; 3: surgical anatomy; 4: common ENT management scenarios; 5: surgical tracheostomy; and finally 6: suturing). Axes in each radar chart represent the 10-points semantic unanchored scale.
See this image and copyright information in PMC

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