Construct validity of a simulator for myringotomy with ventilation tube insertion

Volsky PG, Hughley BB, Peirce SM, Kesser BW. University of Virginia School of Medicine, University of Virginia Health System, Charlottesville, VA 22908-0713, USA. Otolaryngol Head Neck Surg. 2009 Nov;141(5):603-608.e1. Epub 2009 Oct 1.


OBJECTIVES: To establish construct validity of an anatomic model as a simulator for myringotomy with ventilation tube insertion and to assess its subjective appeal.

STUDY DESIGN: Cross-sectional, repeated-measures comparative evaluation of simulator.

SETTING: University academic otolaryngology residency program.

SUBJECTS AND METHODS: Using an anatomic model of the human auricle, ear canal, eardrum, and middle ear space, 18 otolaryngologists of various levels of training performed 10 timed procedures: myringotomy with ventilation tube insertion. Errors were recorded, and participants reported the quality of their experience.

RESULTS: Both time-to-completion and errors per trial discriminated novices from non-novice participants; novices (02:23, 95% confidence interval [CI], 01:42-03:04) were 3.6 times slower than non-novices (00:39, 95% CI, 00:35-00:43) and 6.5 times more error prone (novices 2.16 errors/trial, 95% CI, 1.68-2.64; non-novices 0.33 errors/trial, 95% CI, 0.21-0.45). Errors were strongly correlated with prior surgical experience. All participants required more time to complete the first trial, and their performance stabilized thereafter. Overall, the simulation was perceived as a valuable experience.

CONCLUSION: Our model is a valid platform for simulating myringotomy with ventilation tube insertion. The model discriminates novices from non-novices, has a learning curve, and is perceived to be a valuable and realistic teaching tool by users.

PMID: 19861198 [PubMed – indexed for MEDLINE]