Chern Alexander, Sharma Rahul K, Maurrasse Sarah E, Drusin Madeleine A, Ciarleglio Adam J, Golub Justin S
Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons and Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, NY, USA.
Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College and NewYork-Presbyterian Hospital, New York, NY, USA.
Ann Otol Rhinol Laryngol. 2022 Feb;131(2):147-153. doi: 10.1177/00034894211012600. Epub 2021 May 6.
To compare the educational value of endoscopic ear surgery versus microscopic ear surgery among medical students.
Medical students anonymously completed a cross-sectional survey immediately after observing endoscopic or microscopic ear surgery. A Likert scale (1 = worst, 5 = best) was used to analyze variables across 3 domains including: (1) area of interest visibility, (2) optical quality, (3) education and understanding. The Mann-Whitney -test and multivariable linear regression were used to compare mean scores of individual items and domain means between endoscopic and microscopic groups.
Forty-four surveys were analyzed (20 endoscopic and 24 microscopic ear surgeries). Across domains, the endoscope was superior to the microscope (adjusted < .05) for visibility of the area of interest (mean ± SD: 4.74 ± 0.26 vs 4.28 ± 0.50), optical quality (4.78 ± 0.38 vs 4.28 ± 0.64), and education and understanding (4.70 ± 0.47 vs 4.13 ± 0.61). In multivariable linear regression, the mean domain score for visibility of the area of interest was 1.23 (95% CI = 0.56, 1.90; adjusted < .01) points higher for the endoscopic group, compared to the microscopic group, adjusting for surgeon, procedure, and student type. The mean domain score for education and understanding was 1.19 (95% CI = 0.49. 1.90; adjusted < 0.01) points higher for the endoscopic group, compared to the microscopic group, adjusting for the same confounders.
Among medical students, endoscopic ear surgery was superior to microscopic ear surgery for several visual quality indicators and perceived educational benefit. These findings have implications for medical student education and surgical training.
比较医学生中内镜下耳科手术与显微镜下耳科手术的教育价值。
医学生在观察内镜下或显微镜下耳科手术后立即匿名完成一项横断面调查。采用李克特量表（1=最差，5=最佳）分析3个领域的变量，包括：（1）感兴趣区域的可视性，（2）光学质量，（3）教育与理解。采用曼-惠特尼检验和多变量线性回归比较内镜组和显微镜组各单项的平均得分及领域平均分。
分析了44份调查问卷（20例内镜下耳科手术和24例显微镜下耳科手术）。在各个领域，内镜在感兴趣区域的可视性（均值±标准差：4.74±0.26 vs 4.28±0.50）、光学质量（4.78±0.38 vs 4.28±0.64）以及教育与理解（4.70±0.47 vs 4.13±0.61）方面均优于显微镜（校正<0.05）。在多变量线性回归中，在内镜组中，调整外科医生、手术和学生类型后，感兴趣区域可视性的平均领域得分比显微镜组高1.23分（95%CI=0.56，1.90；校正<0.01）。在内镜组中，调整相同混杂因素后，教育与理解的平均领域得分比显微镜组高1.19分（95%CI=0.49，1.90；校正<0.01）。
在医学生中，内镜下耳科手术在多个视觉质量指标和感知教育效益方面优于显微镜下耳科手术。这些发现对医学生教育和外科培训具有启示意义。
