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Teaching paradigm for decision making in facial skin defect reconstructions
K H Calhoun1, H Seikaly, F B Quinn
1Department of Otolaryngology, University of Texas Medical Branch, Galveston 77551, USA. kcalhoun@utmb.edu
Objective:
To present a decision paradigm for facial defect reconstruction, and test the ability of this paradigm to improve resident performance.
Design:
A decision paradigm for reconstruction of facial skin defects is proposed and explained, with patient examples. The paradigm's usefulness is then tested with residents.
Setting:
Otolaryngology residency training program at a tertiary hospital.
Study Participants:
Otolaryngology residents.
Interventions:
Twelve residents took a pretest wherein they were presented with drawings of skin defects and asked to choose the "best" (most aesthetically pleasing) type of reconstruction from a closed set. This paradigm was presented to these residents, and their posttest consisted of choosing again with the same defects and closed set of choices.
Main Outcome Measures:
Cosmetic outcomes of reconstructive decisions on the pretest and posttest were rated on a scale of 0 to 5 (with 0 indicating poor; 5, excellent).
Results:
There was a significant improvement in reconstructive choices between the pretest and posttest (P<.001, Student t test).
Conclusion:
This paradigm can be easily modified to accommodate different surgical approaches preferred by individual surgeons and is thus useful in almost any reconstructive teaching situation.