Yi Grace, Hu Amanda, Jeffery Caroline C, Nisenbaum Rosane, Lin R Jun
Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
Division of Otolaryngology-Head and Neck Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada.
J Voice. 2023 Jul 6. doi: 10.1016/j.jvoice.2023.05.020.
Conventional reference images of laryngeal pathologies may provide educational value for Otolaryngology-Head & Neck Surgery (OHNS) residents, but observing dynamic vocal fold function is critical for diagnosis. Our aim was to develop and validate a video atlas of laryngeal pathologies for resident education in OHNS.
A multi-institution, prospective case-control study.
SETTING/PARTICIPANTS: Ten videos showing 10 representative laryngeal pathologies were verified by two laryngologists. Six videos per category with kappa>0.8 were included in the video database. A collection of the videos was shown to a group of OHNS residents in a quiz fashion to determine if senior trainees would score higher than junior trainees. Another group of residents in OHNS was recruited and randomized to control or intervention. The control group was shown a quiz of 10 laryngeal videos at baseline and 24 weeks later. The intervention group was shown quizzes at baseline and every 6 weeks, ending at 24 weeks. Free-text diagnoses were scored for accuracy. Descriptive statistics, two-tailed tests, and analysis of covariance were performed.
Twenty-nine residents participated, with 14 (48.3%) randomized to control, and 15 (51.7%) to the intervention. The postgraduate year (PGY) level had a significant impact on diagnostic performance. PGY1 and 2 had a significantly lower score than PGY5 (P = 0.017 and P = 0.035, respectively). PGY3 and PGY4 scores were not statistically different from PGY5 scores. The mean score difference between groups decreases as the PGY level increases (mean difference between groups = 0.87, P = 0.153), but this was not significant.
The current study has created a validated collection of videos that are representative of common laryngeal pathologies and can be easily incorporated into resident video-based learning. Future directions include larger multi-site studies to further elucidate whether repeated viewing of this video atlas can improve OHNS resident laryngology knowledge.
喉部疾病的传统参考图像可能对耳鼻咽喉头颈外科（OHNS）住院医师具有教育价值，但观察动态声带功能对诊断至关重要。我们的目的是开发并验证一部用于OHNS住院医师教育的喉部疾病视频图谱。
一项多机构前瞻性病例对照研究。
设置/参与者：由两名喉科医生验证了展示10种代表性喉部疾病的10个视频。每类中kappa>0.8的6个视频被纳入视频数据库。以测验的方式向一组OHNS住院医师展示这些视频集合，以确定高级受训者的得分是否会高于初级受训者。招募另一组OHNS住院医师并随机分为对照组或干预组。对照组在基线和24周后接受10个喉部视频的测验。干预组在基线时以及每6周接受一次测验，至24周结束。对自由文本诊断的准确性进行评分。进行描述性统计、双尾检验和协方差分析。
29名住院医师参与，其中14名（48.3%）被随机分配到对照组，15名（51.7%）被分配到干预组。研究生年级（PGY）水平对诊断表现有显著影响。PGY1和PGY2的得分显著低于PGY5（分别为P = 0.017和P = 0.035）。PGY3和PGY4的得分与PGY5的得分无统计学差异。随着PGY水平的升高，组间平均得分差异减小（组间平均差异 = 0.87，P = 0.153），但这并不显著。
本研究创建了一个经过验证的视频集合，这些视频代表了常见的喉部疾病，并且可以轻松纳入基于视频的住院医师学习中。未来的方向包括更大规模的多地点研究，以进一步阐明反复观看这部视频图谱是否可以提高OHNS住院医师的喉科学知识。
