Harbison Richard A, Johnson Kaalan E, Miller Craig, Sardesai Maya G, Davis Greg E
Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle, WA.
Department of Otolaryngology-Head and Neck Surgery, Seattle Children's Hospital, Seattle, WA.
Int Forum Allergy Rhinol. 2017 Apr;7(4):405-413. doi: 10.1002/alr.21883. Epub 2016 Nov 16.
The purpose of this study was to evaluate face and content validity of a low-cost, low-technology, non-biologic endoscopic sinus surgery (ESS) task trainer and knowledge-based curriculum followed by construct validation of the task trainer.
A sinus surgery task trainer and curriculum were developed. Attending otolaryngologists were surveyed regarding the utility of the task trainer and curriculum. A cross-sectional construct validation study was performed including medical students, residents, and attending otolaryngologists. Nine tasks were performed on the task trainer and graded using a global rating scale (GRS). Predictors of task trainer performance were evaluated, and spatial performance was measured. Regression analyses were performed to assess main associations.
All attending physicians (n = 7) agreed that the task trainer accelerates the learning curve and incorporates essential ESS techniques and that the knowledge-based curriculum describes anatomical and technical knowledge germane to ESS. Twelve medical students, 9 otolaryngology residents, and 5 attending otolaryngologists completed task trainer testing. GRS score varied by level of training after adjusting for potential confounders (slope = 2.63; p = 0.001). There was evidence of an association between a history of video gaming (slope = 1.33; p = 0.077), sports experience (slope = 2.08; p = 0.033), and sinus surgery simulation (slope = 2.72; p = 0.023) with GRS score, although not statistically significant.
This study demonstrated validity of a knowledge-based sinus surgery curriculum and low-cost, sinus task trainer supporting use in early training. Participants with prior video gaming, sports participation, and sinus surgery simulation experience perform better at baseline on the task trainer.
本研究的目的是评估一种低成本、低技术含量、非生物性的鼻内镜鼻窦手术（ESS）任务训练器和基于知识的课程的表面效度和内容效度，随后对任务训练器进行结构效度验证。
开发了一种鼻窦手术任务训练器和课程。就任务训练器和课程的实用性对耳鼻咽喉科主治医师进行了调查。进行了一项横断面结构效度研究，纳入了医学生、住院医师和耳鼻咽喉科主治医师。在任务训练器上执行了九项任务，并使用整体评分量表（GRS）进行评分。评估了任务训练器表现的预测因素，并测量了空间表现。进行回归分析以评估主要关联。
所有主治医师（n = 7）都认为任务训练器加快了学习曲线，纳入了基本的ESS技术，并且基于知识的课程描述了与ESS相关的解剖学和技术知识。12名医学生、9名耳鼻咽喉科住院医师和5名主治医师完成了任务训练器测试。在调整潜在混杂因素后，GRS评分因培训水平而异（斜率 = 2.63；p = 0.001）。有证据表明，电子游戏史（斜率 = 1.33；p = 0.077）、体育经历（斜率 = 2.08；p = 0.033）和鼻窦手术模拟（斜率 = 2.72；p = 0.023）与GRS评分之间存在关联，尽管无统计学意义。
本研究证明了基于知识的鼻窦手术课程和低成本鼻窦任务训练器在早期培训中的有效性。有电子游戏、体育活动和鼻窦手术模拟经验的参与者在任务训练器上的基线表现更好。
