From Innovation to Implementation: A Scoping Review of Simulation in Otolaryngology Education

To systematically map the otolaryngology simulation literature according to learner stage, primary educational objective, and depth of outcome measurement, and to propose a structured implementation framework for integrating emerging technologies and developing standardized, national simulation curricula.

A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed/MEDLINE, Embase, and Web of Science were searched for studies published from January 2010 through August 2026 describing simulation used for education, training, or assessment in otolaryngology. Included studies were charted across three domains: learner stage (medical students, residents, practicing otolaryngologists), primary educational objective (exposure, acquisition, refinement, assessment), and outcome depth (face/content validity, pre-post or construct validity, behavior/clinical correlation). Evidence from adjacent surgical specialties and emerging technologies was synthesized narratively to inform a stepwise implementation framework.

Of 9081 records identified, 979 unique studies met inclusion criteria, yielding 1142 learner entries. Simulation efforts were heavily concentrated in resident education (56.0% of learner entries) and skill acquisition (53.0%), with skill refinement concentrated among practicing otolaryngologists and almost no studies designed primarily for assessment. Face or content validity remained the most common highest measured outcome (53.7%); behavior-level outcomes were rare (1.1%). These distributions demonstrate insufficient alignment between learner stage, educational intent, and validation depth. Lessons from adjacent surgical specialties, together with emerging technologies such as artificial intelligence and extended reality, offer a practical pathway toward scalable, objective assessment.

Otolaryngology is poised to advance simulation education beyond historically fragmented initiatives toward a deliberately designed simulation ecosystem aligned with learner level, educational intent, and outcome depth. A coordinated national framework that leverages emerging technologies while building on existing infrastructure, implemented through phased pilot programs and attentive to cost, faculty, and technical barriers, can position the field as a leader in surgical education.