Simulation in medicine has gained significant traction in both undergraduate and postgraduate training over the last couple of decades or so – the benefits to all involved are clear. The airline industry models for human factors and crew resource management around interactions between individuals and the teams they work in are now firmly embedded in medical training. Technical and clinical skills are progressing rapidly, albeit slightly behind the curve of non-technical skills teaching. Virtual reality (VR) and augmented reality (AR) are much vaunted as training tools of the future, but lack some of the haptic feedback and physicality of undertaking procedures, not to mention the cost implication of the kit required for VR and AR. This month’s Editors’ Choice describes a low-cost practical training device for draining peri-tonsillar abscesses using a mannequin head and “an implantable packet of goo”. The improvement seen in confidence and skills in the medical students and junior doctors who used this simple, yet effective tool was statistically significant. These types of simple, yet high-fidelity devices are a clear adjunct to clinical training and can certainly help overcome the first-time nerves of practical procedures – such as sticking a needle or knife into the back of someone’s throat! As always, the editors would like to thank all the reviewers for their valuable contributions.
Nazia and Hannah
It’s 3am, night three of four, with an equal number of coffees consumed. BLEEP! Your trembling hands fumble with the pager. “My patient cannot open their mouth and they are spiking; help me please!” You arrive and take a look – it can only be quinsy. There is no registrar in town tonight. You guide your shaking scalpel and cannot help but think, “God, I wish I had practised this more!” Sounds familiar? Simulation is ubiquitous in otolaryngology training and exists on a wide spectrum of fidelity. It allows trainees to practise clinical skills repeatedly in a safe, non-pressured environment. Its role is increasing as technology and realism improve, and the availability of clinical educators declines. Thanks to the work of researchers like Marouf and colleagues, juniors are accessing a wealth of new simulation tools to teach them the fundamental skills of otolaryngology. In this study, the researchers created a mannequin head with an implantable packet of goo mimicking a peritonsillar abscess. Three medical students, 17 PGY-1, and 10 PGY-2 residents attended a lecture and training course where they learned to perform an oropharyngeal examination and quinsy incision and drainage (I&D) using the prototype head. Confidence in skills was evaluated with a pre- and post-course Likert scale questionnaire. A statistically significant improvement in confidence scores was found overall, and for the PGY-1 subgroup only. These findings are consistent with previously published data. Marouf’s team has created a low-cost learning tool that improves quinsy I&D confidence in newly qualified doctors. Further validation and cost-effectiveness analysis are certainly required. However, they have clearly shown the feasibility of designing simple simulation tools to supplement hospital training curriculums, ensuring that when real-life emergencies strike, every doctor is prepared and poised to act.
A Reproducible Peritonsillar Abscess Incision and Drainage Model for Junior Trainees.
Marouf A, Doty S, Quereshy HA, et al.
ANN OTOL RHINOL LARYNGOL
2024;133(7):654–7.
