Low-cost otolaryngology simulation models for early-stage trainees: a scoping review.
Low- and middle-income country
Low-cost
Medical student
Otolaryngology
Simulation
Task trainer
Trainee
Journal
BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679
Informations de publication
Date de publication:
01 May 2024
01 May 2024
Historique:
received:
27
11
2023
accepted:
24
04
2024
medline:
2
5
2024
pubmed:
2
5
2024
entrez:
1
5
2024
Statut:
epublish
Résumé
Medical simulation is essential for surgical training yet is often too expensive and inaccessible in low- and middle-income countries (LMICs). Furthermore, in otolaryngology-head and neck surgery (OHNS), while simulation training is often focused on senior residents and specialists, there is a critical need to target general practitioners who carry a significant load of OHNS care in countries with limited OHNS providers. This scoping review aims to describe affordable, effective OHNS simulation models for early-stage trainees and non-OHNS specialists in resource-limited settings and discuss gaps in the literature. This scoping review followed the five stages of Arksey and O'Malley's Scoping Review Methodology. Seven databases were used to search for articles. Included articles discussed physical models of the ear, nose, or throat described as "low-cost," "cost-effective," or defined as <$150 if explicitly stated; related to the management of common and emergent OHNS conditions; and geared towards undergraduate students, medical, dental, or nursing students, and/or early-level residents. Of the 1706 studies screened, 17 met inclusion criteria. Most studies were conducted in HICs. Most models were low-fidelity (less anatomically realistic) models. The most common simulated skills were peritonsillar abscess aspiration and cricothyrotomy. Information on cost was limited, and locally sourced materials were infrequently mentioned. Simulations were evaluated using questionnaires and direct observation. Low-cost simulation models can be beneficial for early medical trainees and students in LMICs, addressing resource constraints and improving skill acquisition. However, there is a notable lack of contextually relevant, locally developed, and cost-effective models. This study summarizes existing low-cost OHNS simulation models for early-stage trainees and highlights the need for additional locally sourced models. Further research is needed to assess the effectiveness and sustainability of these models.
Sections du résumé
BACKGROUND
BACKGROUND
Medical simulation is essential for surgical training yet is often too expensive and inaccessible in low- and middle-income countries (LMICs). Furthermore, in otolaryngology-head and neck surgery (OHNS), while simulation training is often focused on senior residents and specialists, there is a critical need to target general practitioners who carry a significant load of OHNS care in countries with limited OHNS providers. This scoping review aims to describe affordable, effective OHNS simulation models for early-stage trainees and non-OHNS specialists in resource-limited settings and discuss gaps in the literature.
METHODS
METHODS
This scoping review followed the five stages of Arksey and O'Malley's Scoping Review Methodology. Seven databases were used to search for articles. Included articles discussed physical models of the ear, nose, or throat described as "low-cost," "cost-effective," or defined as <$150 if explicitly stated; related to the management of common and emergent OHNS conditions; and geared towards undergraduate students, medical, dental, or nursing students, and/or early-level residents.
RESULTS
RESULTS
Of the 1706 studies screened, 17 met inclusion criteria. Most studies were conducted in HICs. Most models were low-fidelity (less anatomically realistic) models. The most common simulated skills were peritonsillar abscess aspiration and cricothyrotomy. Information on cost was limited, and locally sourced materials were infrequently mentioned. Simulations were evaluated using questionnaires and direct observation.
CONCLUSION
CONCLUSIONS
Low-cost simulation models can be beneficial for early medical trainees and students in LMICs, addressing resource constraints and improving skill acquisition. However, there is a notable lack of contextually relevant, locally developed, and cost-effective models. This study summarizes existing low-cost OHNS simulation models for early-stage trainees and highlights the need for additional locally sourced models. Further research is needed to assess the effectiveness and sustainability of these models.
Identifiants
pubmed: 38693491
doi: 10.1186/s12909-024-05466-3
pii: 10.1186/s12909-024-05466-3
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
483Subventions
Organisme : FIC NIH HHS
ID : D43 TW010543
Pays : United States
Organisme : NIH HHS
ID : NIH/FIC- 5R21HD103052-02
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
Akhtar KSN, Chen A, Standfield NJ, Gupte CM. The role of simulation in developing surgical skills. Curr Rev Musculoskelet Med. 2014;7(2):155–60. https://doi.org/10.1007/s12178-014-9209-z .
doi: 10.1007/s12178-014-9209-z
Smith A, Siassakos D, Crofts J, Draycott T, Simulation. Improving patient outcomes. Semin Perinatol. 2013;37(3):151–6. https://doi.org/10.1053/j.semperi.2013.02.005 .
doi: 10.1053/j.semperi.2013.02.005
McGaghie WC, Draycott TJ, Dunn WF, Lopez CM, Stefanidis D. Evaluating the impact of Simulation on Translational Patient outcomes. Simul Healthc J Soc Simul Healthc. 2011;6(Suppl):S42–7. https://doi.org/10.1097/SIH.0b013e318222fde9 .
doi: 10.1097/SIH.0b013e318222fde9
Gheza F, Oginni FO, Crivellaro S, Masrur MA, Adisa AO. Affordable laparoscopic camera system (ALCS) designed for low- and Middle-Income countries: a feasibility study. World J Surg. 2018;42(11):3501–7. https://doi.org/10.1007/s00268-018-4657-z .
doi: 10.1007/s00268-018-4657-z
Massoth C, Röder H, Ohlenburg H, et al. High-fidelity is not superior to low-fidelity simulation but leads to overconfidence in medical students. BMC Med Educ. 2019;19:29. https://doi.org/10.1186/s12909-019-1464-7 .
doi: 10.1186/s12909-019-1464-7
Nimbalkar A, Patel D, Kungwani A, Phatak A, Vasa R, Nimbalkar S. Randomized control trial of high fidelity vs low fidelity simulation for training undergraduate students in neonatal resuscitation. BMC Res Notes. 2015;8(1):636. https://doi.org/10.1186/s13104-015-1623-9 .
doi: 10.1186/s13104-015-1623-9
The Use of Simulation for Undergraduate Surgical Education in Sub-Saharan Africa: A Scoping Review | Research Square. Accessed September 5. 2023. https://www.researchsquare.com/article/rs-2242593/v1 .
World Report on Hearing - Executive Summary. Accessed March 21. 2021. https://www.who.int/publications/m/item/WHO-UCN-NCD-SDR-20.22 .
The Global Otolaryngology. –Head and Neck Surgery Workforce | Oncology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network. Accessed September 27, 2023. https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2808978 .
Malekzadeh S, Pfisterer MJ, Wilson B, Na H, Steehler MK. A novel low-cost sinus surgery task trainer. Otolaryngol–Head Neck Surg off J Am Acad Otolaryngol-Head Neck Surg. 2011;145(4):530–3. https://doi.org/10.1177/0194599811413373 .
doi: 10.1177/0194599811413373
Javia L, Deutsch ES. A systematic review of simulators in otolaryngology. Otolaryngol–Head Neck Surg off J Am Acad Otolaryngol-Head Neck Surg. 2012;147(6):999–1011. https://doi.org/10.1177/0194599812462007 .
doi: 10.1177/0194599812462007
Steyer TE. Peritonsillar abscess: diagnosis and treatment. Am Fam Physician. 2002;65(1):93–6.
Construct validity of a simulator for myringotomy with ventilation tube insertion - PubMed. Accessed September 5. 2023. https://pubmed.ncbi.nlm.nih.gov/19861198/ .
Pankhania R, Pelly T, Bowyer H, Shanmugathas N, Wali A. A systematic review of low-cost simulators in ENT surgery. J Laryngol Otol. 2021;135(6):486–91. https://doi.org/10.1017/S0022215121000839 .
doi: 10.1017/S0022215121000839
Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. https://doi.org/10.1080/1364557032000119616 .
doi: 10.1080/1364557032000119616
Tricco AC, Lillie E, Zarin W, et al. PRISMA Extension for scoping reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73. https://doi.org/10.7326/M18-0850 .
doi: 10.7326/M18-0850
Bush D, Lamb C, Braun A. Interrater reliability of the Simulation Fidelity (SiFi) Scale. Proc Hum Factors Ergon Soc Annu Meet. 2022;66(1):1982–6. https://doi.org/10.1177/1071181322661073 .
doi: 10.1177/1071181322661073
Wasson J, Pearce L, Alun-Jones T. Improving correspondence to general practitioners regarding patients attending the ENT emergency clinic: a regional general practitioner survey and audit. J Laryngol Otol. 2007;121(12):1189–93. https://doi.org/10.1017/S0022215107000746 .
doi: 10.1017/S0022215107000746
Addison AB, Watts S, Fleming J. Effective communication between ENT and primary care - a survey of outpatient correspondence. Clin Otolaryngol off J ENT-UK off J Neth Soc Oto-Rhino-Laryngol Cervico-Facial Surg. 2015;40(3):191–6. https://doi.org/10.1111/coa.12343 .
doi: 10.1111/coa.12343
Feinstein AH, Cannon HM. Fidelity, Verifiability, and Validity of Simulation: Constructs for Evaluation. Dev Bus Simul Exp Learn Proc Annu ABSEL Conf. 2001;28. Accessed September 5, 2023. https://absel-ojs-ttu.tdl.org/absel/article/view/801 .