Jones Woodson Scott
Department of Pediatrics, Uniformed Services University of the Health Sciences (USUHS), San Antonio Military Pediatric Center, 2200 Bergquist Dr. STE1, Lackland AFB, San Antonio, TX 78236, United States.
Int J Pediatr Otorhinolaryngol. 2006 Nov;70(11):1875-83. doi: 10.1016/j.ijporl.2006.06.014. Epub 2006 Aug 9.
Several billion dollars are spent each year on otitis media, a diagnosis for which educational approaches and diagnostic skills are suboptimal. The Center for Disease Control has identified improvement in otoscopy skills as a key intervention to curb inappropriate antibiotic usage. Educators are looking for interventions to both improve and assess otoscopy skills. Video otoscopy (VO) uses endoscopic technology to project the image of the ear onto a monitor for all to see, offering unexplored educational opportunity. The objective of this study is to perform an evaluation of VO systems in medical education from a review of the literature and hands-on experience of available technology.
The evaluation will focus on the technical acceptability (user requirements), clinical appropriateness (validity, reliability, feasibility), operational effectiveness (training requirements and implementation), and equipment selection.
The technical requirements in pediatric education exceed those available in some VO systems, specifically pneumatic capability, sophisticated cameras and optics, and pediatric-sized ear speculums. VO images are comparable to the conventional otoscopic and otomicroscopic examinations. VO is feasible in a primary care setting and can be integrated into resident and medical student education. The technology in VO systems is changing rapidly, necessitating comparison of systems before equipment is purchased.
VO is technically acceptable, clinically appropriate and can be integrated into the otoscopic education of residents and medical students. VO provides an opportunity to bring the pediatric ear examination out of the "black box," potentially improving diagnostic skills, quality of care, and reducing antibiotic overuse.
每年在中耳炎治疗上花费数十亿美元，而针对该病症的教育方法和诊断技能并不理想。疾病控制中心已将耳镜检查技能的提高确定为遏制不适当抗生素使用的关键干预措施。教育工作者正在寻找既能提高又能评估耳镜检查技能的干预措施。视频耳镜检查（VO）利用内窥镜技术将耳部图像投射到监视器上供所有人观看，提供了尚未探索的教育机会。本研究的目的是通过对文献的综述和对现有技术的实际操作经验，对医学教育中的VO系统进行评估。
评估将侧重于技术可接受性（用户需求）、临床适用性（有效性、可靠性、可行性）、操作有效性（培训要求和实施）以及设备选择。
儿科教育中的技术要求超出了一些VO系统的现有水平，特别是气动能力、精密相机和光学设备以及儿科尺寸的耳镜。VO图像与传统耳镜检查和耳显微镜检查相当。VO在初级保健环境中是可行的，并且可以整合到住院医师和医学生的教育中。VO系统中的技术变化迅速，因此在购买设备之前需要对系统进行比较。
VO在技术上是可接受的，临床上是合适的，并且可以整合到住院医师和医学生的耳镜检查教育中。VO提供了一个将儿科耳部检查带出“黑箱”的机会，有可能提高诊断技能、护理质量并减少抗生素的过度使用。
