Pediatric flexible laryngoscopy: Trends in diagnostic abilities throughout training

Area of Science:

• Pediatric Otolaryngology
• Medical Education
• Diagnostic Imaging

Background:

• Accurate diagnosis of pediatric laryngeal pathology is crucial for effective treatment.
• Assessing and improving diagnostic skills during residency training is essential.
• The utility of video review in enhancing diagnostic accuracy requires further investigation.

Purpose of the Study:

• To evaluate resident diagnostic accuracy for pediatric laryngeal pathology via laryngoscopy.
• To track diagnostic skill progression throughout otolaryngology residency.
• To compare resident performance with pediatric otolaryngologists.
• To determine if slow-motion video review improves diagnostic capabilities.

Main Methods:

• An online test using 15 pediatric laryngoscopy videos was administered via Qualtrics.
• Participants diagnosed pathologies after viewing videos at full speed and then in slow motion.
• Statistical analysis included T-tests and ANOVA to compare diagnostic scores.

Main Results:

• Median diagnostic scores were 47% for full-speed and 60% for slow-motion review.
• Post Graduate Year 4 residents and pediatric otolaryngologists demonstrated the highest proficiency (69% and 77%, respectively).
• Base of tongue, subglottic, and laryngeal cleft lesions were most challenging; motor, laryngeal, and vallecular pathologies were identified more accurately.

Conclusions:

• Diagnostic ability for pediatric laryngeal pathology improves with residency training.
• Slow-motion video review significantly enhances diagnostic accuracy.
• Certain laryngeal pathologies, such as base of tongue and subglottic lesions, present greater diagnostic challenges.