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Ears on the Web


Blinded Randomized Controlled Study of a Web-Based Otoscopy Simulator in Undergraduate Medical Education.  Stepniak C, Wickens B, Husein M, Paradis J, Ladak HM, Fung K, Agrawal SK

Laryngoscope, (published online ahead of print).  https://dx.doi.org/10.1002/lary.26246

Reviewed by Chris Bergsman

Tags:  pre-clerkship, simulation, technology, technical skills

What was the study question?

The study’s purpose was to evaluate the effectiveness of a Web-based otoscopy simulator (OtoTrain) in teaching diagnostic otoscopy to 2nd year medical students.

How was the study conducted?

41 M2 student volunteers at a single Canadian medical school were enrolled and randomly assigned to a control group and simulator group. All students took part in a pretest consisting of a series of otoscopy videos followed by an open-answer format assessment.  Both groups attended standard otology lectures. The intervention group was given access to a web based otoscopy simulator for one week.  The online program gave trainees the ability to learn otoscopic techniques, browse pathologies, and take a simulator tutorial.  Afterwards, both the control and simulator groups completed a post-test assessment.  Three experts graded the tests based on a previously created detailed marking scheme. The evaluators were blinded to student names and group assignment.

What were the outcomes?

No significant difference was seen between the 2 groups in baseline pretest scores.  The control group had a 31% improvement in their post-test total score whereas the intervention group had a 71% improvement.  Overall, the simulator group had a 24% higher final total score compared to the control group (P < .01).

What are the implications of these findings?

Skill acquisition and knowledge retention are critical tasks for young medical school learners.  This can be a challenge in an era of increasing class sizes and limited resources. This blinded randomized controlled study demonstrates the potential value of using an online self-guided teaching tool incorporating simulation activities.

Editor’s Note:  This well-designed study provides a cheaper alternative to the artificial ears that have been used as simulators before.   What remains to be seen is whether it translates into skill with real patients (JG).

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