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Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice
Author(s) -
Malik Mohammad U.,
Diaz Voss Varela David A.,
Park EunMi,
Masood Hamid,
Laeeq Kulsoom,
Bhatti Nasir I.,
Francis Howard W.
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24179
Subject(s) - mastoidectomy , otology , medicine , competence (human resources) , audiology , checklist , attendance , surgery , cholesteatoma , psychology , cognitive psychology , social psychology , economics , economic growth
Objectives/Hypothesis This study explores the influence of selected factors on achievement of competency in mastoid surgery. Study Design A prospective study of surgical performance and a retrospective survey of learner and training factors. Methods The longitudinal performance of 15 residents was evaluated using the mastoidectomy task‐based checklist (TBC). The influence of surgical experience, resident interest, and training factors (course attendance, voluntary use of simulation laboratory) was also examined and compared for the acquisition of distinct levels of technical skill difficulty (cortical mastoidectomy vs. facial recess). Results Ninety‐six observations made during the first otology rotation were analyzed. Cortical mastoidectomy tasks showed positive associations with cumulated case numbers (OR 1.13, CI 1.04–1.23, P = .003) and interest in otology (OR 3.86, CI 1.21–12.27, P = .022). Facial recess tasks showed a larger positive association with interest in otology (OR 10.38, CI 2.25–47.94, P = .003), and negative association with extra time spent in laboratory practice (OR .05, CI 0.011–0.23, P = .000). Conclusions Learning trajectory for cortical mastoidectomy and facial recess may be influenced by different factors. Interest in otology, in particular, may have a moderating effect on the acquisition of more complex skills in mastoid surgery. A negative association between self‐directed laboratory simulation and performance may reflect the impact of assessment‐guided feedback in promoting deliberate practice. Further investigations are suggested to explore the interactions between individual trainee differences, educational models, and learning outcomes. Level of Evidence N/A. Laryngoscope , 123:3162–3167, 2013