277 - Utilization of video otoscopes for otoscopy skills training of third-year medical students

Poster Number: 277
Publication Number: 277.331

Roya Samuels, Zucker Hofstra Northwell SOM, Great Neck, NY, United States; Marie Petrizzo, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Doreen M. Olvet, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Melissa Pawelczak, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; shara steiner, Keck School of Medicine of the University of Southern California, hollywood, FL, United States; Aleena Paul, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States; Janice T. John, Albert Einstein COM, Syosset, NY, United States

Background: Effective teaching and assessment of otoscopic examinations are challenging in undergraduate medical education. Otoscopy teaching methods using traditional otoscopes have significant limitations resulting in student difficulty performing skills adequately, struggling to obtain satisfactory views, and misinterpreting findings. Implementation of video otoscope training (VOT) for students can fine-tune technical skills through simultaneous visualization with faculty, real-time analysis of images obtained, and direct observation with feedback (Deliberate Practice model).

Objective: To provide students superior otoscopy training resulting in measurable improvement in confidence and skills.

Design/Methods: After participating in a didactic otoscopy sessions, 72 MS3s were assigned to VOT (n=36) or traditional otoscope training (TOT) sites (n=36) during the ambulatory week of their pediatric clerkship over the course of one academic year. All students were expected to practice predefined otoscopy microskills when examining patients. However, students at VOT sites utilized video otoscopes, trained by preceptors providing real-time visual coaching. Pre- and post-clerkship questionnaires compared students' diagnostic accuracy of otoscopic images and self-reported confidence in their technical and diagnostic otoscopy skills.

Results: There were no significant differences in otoscopic diagnostic ability over time or between groups based on multiple choice questions using stock images. The VOT group scored significantly higher than the TOT group on confidence with correct placement of the otoscope (p < 0.04) and diagnosing serous otitis media (p=0.046) post-clerkship. There was a trend towards higher confidence in the VOT group on positioning a patient, visualizing the tympanic membrane, identifying the tympanic membrane as normal, and diagnosing acute otitis media. VOT resulted in a significant increase in confidence for all technical and diagnostic skills queried over time (p-values < 0.02) while TOT did not demonstrate any change from baseline.Conclusion(s): To our knowledge, this the first study directly comparing VOT with TOT for students. VOT demonstrates promotion of confidence in technical and diagnostic skills of otoscopy. A follow-up study will objectively assess skills in an Observed Structured Clinical Exam (OSCE) setting. The limitation of using commonly accessible stock photos may be causative in finding no difference in diagnostic accuracy between cohorts. The cost of video otoscopes (approximately $700) can be budgeted and use of a microskills checklist is transferable across sites.