Bright Rakesh R, Varghese Lalee, Kurien Regi
Department of Otorhinolaryngology, Christian Medical College, Vellore, India.
Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):1638-1645. doi: 10.1007/s12070-021-02775-7. Epub 2021 Aug 2.
Most simulation models in rhinology are costly and are primarily meant to enhance endoscopic surgical skills. The present study aimed to construct a 3-dimensional model of the nose which is easily constructible with commonly available low cost plaster of Paris (POP) and assess its usefulness in training residents in basic transnasal procedures. A nose model was created using plaster of Paris and assessed for face and content validity by experts in rhinology while a construct validation was performed on five specified tasks by residents. All experts agreed with the resemblance of 10 of the 13 anatomical landmarks in the POP model and its utility in teaching basic transnasal procedures. There was a statistically significant difference in the time taken by I and III year residents in performing a diagnostic nasal endoscopy ( = 0.007), anterior nasal packing with polyvinyl alcohol tampon ( = 0.007), posterior nasal packing with Foley's catheter ( = 0) and nasopharyngeal swabbing ( = 0.025). This study demonstrates the construct of a low cost 3-dimensional POP model and validates its utility in training residents in routine transnasal rhinological procedures. Face and content validation showed a high degree of resemblance to human anatomy with good agreement that this model could increase resident competency. The significant difference in time taken by residents at various levels of experience in performing rhinological procedures also confirmed a reliable construct validity. The described model could be an affordable and easily constructible alternative tool to other simulation models in otorhinolaryngology residency programs especially in developing countries.
鼻科学中的大多数模拟模型成本高昂,主要用于提高内镜手术技能。本研究旨在构建一种易于用常见的低成本熟石膏(POP)制作的三维鼻模型,并评估其在培训住院医师基本经鼻手术方面的实用性。使用熟石膏制作了一个鼻模型,并由鼻科学专家评估其外观和内容效度,同时对住院医师的五项特定任务进行了结构效度验证。所有专家都认可POP模型中13个解剖标志点中的10个与实物相似,以及其在教授基本经鼻手术方面的实用性。一年级和三年级住院医师在进行诊断性鼻内镜检查(P = 0.007)、用聚乙烯醇棉塞进行前鼻孔填塞(P = 0.007)、用Foley导管进行后鼻孔填塞(P = 0)和鼻咽拭子采集(P = 0.025)时所花费的时间存在统计学显著差异。本研究展示了一种低成本三维POP模型的构建,并验证了其在培训住院医师进行常规经鼻鼻科手术方面的实用性。外观和内容效度显示该模型与人体解剖结构高度相似,且一致认为该模型可提高住院医师的能力。不同经验水平的住院医师在进行鼻科手术时所花费时间的显著差异也证实了可靠的结构效度。所描述的模型对于耳鼻咽喉科住院医师培训项目中的其他模拟模型而言,可能是一种经济实惠且易于构建的替代工具,尤其是在发展中国家。