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Pilot testing of a novel surgical simulator for endoscopic zenker's diverticulotomy
Author(s) -
Wiebracht Nathan D.,
Giliberto John P.,
Myer Charles,
Casper Keith,
Johnson Kaalan E.
Publication year - 2017
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.26129
Subject(s) - trainer , otorhinolaryngology , medicine , intra rater reliability , reliability (semiconductor) , inter rater reliability , rating scale , medical physics , likert scale , physical therapy , dysphagia , surgery , confidence interval , psychology , computer science , developmental psychology , power (physics) , physics , quantum mechanics , programming language
Objectives/Hypothesis Restrictions on resident work hours and the increasing purview of otolaryngology reduce the efficacy of the traditional surgical training model. With limited case volumes at many institutions and the unique instrumentation of endoscopic Zenker's diverticulotomy (EZD), simulation may be useful to improve training. In this study, a novel surgical simulator for EZD is developed and validated. Study Design Simulation model development. Methods An EZD model was designed using an intubation trainer and disposable diverticulum inserts. A novel objective structured assessment of technical skill (OSATS) for EZD was developed. Performance of otolaryngology residents on simulations using the OSATS and time to completion were evaluated during an instructional course. Pre‐ and postencounter surveys were completed. Inter‐rater and intrarater reliability were evaluated via blinded video review of resident performance. Results Seventeen residents participated (n = 17). Surveys showed confidence improved two points on a five‐point scale ( P < .001), and 94% agreed that the model would improve resident performance with in vivo EZD. More experienced trainees (postgraduate year [PGY] 3–5, n = 11 vs. PGY 1–2, n = 6) had shorter times to completion ( P < .001) and higher assessment scores on initial attempts ( P = .006). Both groups showed significant improvements from initial to final attempts on 30‐point scales for global rating by 6.2 ± 4.2 (mean ± standard deviation, P < .001). The novel OSATS demonstrated fair live/video reliability (к = 0.40) and inter‐rater reliability (к = 0.44), and moderate intrarater reliability (к = 0.60). Conclusions Pilot testing of an EZD simulator demonstrated acceptability, content validity, and construct validity. A novel OSATS was developed and evaluated. Further investigation of the impact on operative performance and validation of the OSATS in vivo is needed. Level of Evidence NA Laryngoscope , 127:592–596, 2017