A randomized controlled trial of nasolaryngoscopy training techniques

Area of Science:

• Medical Education
• Otolaryngology
• Surgical Simulation

Background:

• Flexible nasolaryngoscopy is a crucial skill for otolaryngology trainees.
• Standardized training methods for this procedure are currently lacking.
• Effective training is essential for improving patient outcomes and trainee competency.

Purpose of the Study:

• To evaluate the impact of mannequin-based training with video feedback on flexible nasolaryngoscopy performance.
• To determine if simulation-based training enhances trainee skills beyond traditional methods.
• To assess improvements in objective and subjective measures of flexible nasolaryngoscopy.

Main Methods:

• A three-armed, single-blinded, randomized controlled study involving 36 junior doctors and medical students.
• Participants were allocated to three groups: lecture/video, mannequin training, or mannequin training with video feedback.
• Performance was assessed via blinded observers and patient comfort scores during flexible nasolaryngoscopy on volunteers.

Main Results:

• Mannequin training alone showed a trend towards improvement but lacked statistical significance.
• Mannequin training combined with video feedback significantly improved patient comfort (P = .0065), time to vocal folds (P = .017), and global ability (P = .0006).
• Excellent inter-rater reliability was achieved across all assessments (P < .01).

Conclusions:

• Simulation-based training using an anatomically correct airway model and video feedback is effective.
• This approach enhances flexible nasolaryngoscopy skills prior to patient procedures.
• It offers a simple and effective method for improving endoscopy competency in trainees.