Council on Medical Student Education in Pediatrics


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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).

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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