Kaf Wafaa A, Masterson Caleb G, Dion Nancy, Berg Susan L, Abdelhakiem Mohamed K
Communication Sciences and Disorders Department, Missouri State University, Springfield, MO.
J Am Acad Audiol. 2013 Oct;24(9):859-66. doi: 10.3766/jaaa.24.9.9.
Scope of practice in audiology encompasses proficiency in visual inspection of ear canal and tympanic membrane (TM) as well as otoscopy interpretation skills to determine normal versus abnormal conditions of outer and middle ear. Audiology students can develop skills in otoscopy through education and supervised training. Studies have shown that additional otoscopy training increased skills in medical students and general practitioners. However, educational and supervised practices targeting otoscopy competency during audiology graduate coursework are lacking. Also, no studies have attempted to determine otoscopy skills among audiology students.
To determine the effectiveness of the otoscopy training model on clinical competency and confidence level of audiology students in performing and interpreting otoscopy.
A combination of experimental treatment design with random assignment of treatment and control groups and delayed treatment for control group.
Thirty-two first- and second-year audiology graduate students who were enrolled in a pediatric audiology class participated in this study. Students were randomly assigned to the control (n = 16, 14 females) or experimental (n = 16, 14 females) group.
Participants in the experimental group received supplementary otoscopy training including didactic otoscopy lectures as well as clinical training using manikin ears. The control group received the same pretest and posttest and then completed a third assessment (posttest 2) after receiving the same training.
An evaluation of knowledge and skills regarding otoscopy between groups and time was conducted at three times: (a) pretraining, (b) upon completion of training for the experimental group, (c) upon completion of training by the control group. The evaluation consisted of a written exam, a clinical exam, and a self-perception rating of confidence. Both written exam scores and clinical exam scores (otoscopy manikin) were analyzed via two-way analyses of variance (ANOVAs), whereas chi-square (χ²) statistic was conducted to evaluate the effects of training on the confidence level of students of both groups.
Experimental and control groups demonstrated significant increased overall competency in otoscopy following the otoscopy training model with didactic and laboratory components. Posttest confidence ratings showed increases in all groups, and there were no significant differences between groups.
The need for supplementary otoscopy training was warranted by low knowledge and clinical competency in otoscopy skills of audiology students as measured by pretest mean scores. After completing the training, both experimental and control groups showed significant improvement in knowledge and competency. Results also suggest that perceived confidence ratings may be misleading in determining students' clinical otoscopy skills.
听力学的执业范围包括熟练进行耳道和鼓膜（TM）的视觉检查以及耳镜检查解读技能，以确定外耳和中耳的正常与异常情况。听力学专业学生可通过教育和监督培训来培养耳镜检查技能。研究表明，额外的耳镜检查培训提高了医学生和全科医生的技能。然而，在听力学研究生课程中，针对耳镜检查能力的教育和监督实践尚缺。此外，尚无研究试图确定听力学专业学生的耳镜检查技能。
确定耳镜检查培训模式对听力学专业学生进行耳镜检查及解读的临床能力和信心水平的有效性。
采用实验性治疗设计，将治疗组和对照组随机分配，并对对照组进行延迟治疗。
32名参加小儿听力学课程的一、二年级听力学研究生参与了本研究。学生被随机分配到对照组（n = 16，14名女性）或实验组（n = 16，14名女性）。
实验组参与者接受补充耳镜检查培训，包括耳镜检查理论讲座以及使用人体模型耳朵的临床培训。对照组接受相同的前测和后测，然后在接受相同培训后完成第三次评估（后测2）。
在三个时间点对两组之间以及不同时间的耳镜检查知识和技能进行评估：（a）预培训时，（b）实验组培训完成后，（c）对照组培训完成后。评估包括书面考试、临床考试以及信心的自我感知评分。书面考试成绩和临床考试成绩（耳镜检查人体模型）通过双向方差分析（ANOVA）进行分析，而卡方（χ²）统计用于评估培训对两组学生信心水平的影响。
实验组和对照组在接受包含理论和实验室部分的耳镜检查培训模式后，耳镜检查的总体能力均显著提高。后测信心评分显示所有组均有所提高，且组间无显著差异。
根据前测平均分衡量，听力学专业学生耳镜检查技能的知识和临床能力较低，因此有必要进行补充耳镜检查培训。培训完成后，实验组和对照组在知识和能力方面均有显著改善。结果还表明，在确定学生的临床耳镜检查技能时，感知到的信心评分可能具有误导性。
