Objective assessment of Myringotomy and tympanostomy tube insertion: A prospective single-blinded validation study

Laryngoscope. 2016 Sep;126(9):2140-6. doi: 10.1002/lary.25746. Epub 2015 Oct 26.

Abstract

Objectives/hypothesis: Despite the transition to competency-based education in surgery, few standardized assessment tools exist in otolaryngology training. In particular, myringotomy and tympanostomy tube insertion (M+T) is a common surgical procedure with few validated assessment tools available. Our objectives were to develop an objective structured assessment of operative skills in M+T and to provide validity evidence for the developed assessment tool within otolaryngology training.

Study design: Prospective study involving the evaluation of an assessment tool.

Methods: Through consultation with a panel of experts in otolaryngology and medical education we developed a Task-Specific Checklist and Global Rating Scale for M+T. Postgraduate year 2 junior residents, postgraduate year 3 senior residents, and attending otolaryngologists were video recorded performing M+T at a tertiary care pediatric hospital. The videos were subsequently reviewed and independently evaluated by three blinded raters from an unaffiliated academic institution.

Results: The average score of junior residents, senior residents, and attending otolaryngologists using the Task-Specific Checklist was 21.7/30 (±7.1), 26.3/30 (±3.5), and 27.3/30 (±6.2), respectively (P = .04). For the Global Rating Scale, the scores for junior residents, senior residents, and attending surgeons were 27.7/50 (±11.2), 34.5/50 (±9.5), and 45.1/50 (±4.6), respectively (P < .001). The inter-rater and intrarater reliability were both above 0.88.

Conclusions: The Task-Specific Checklist and Global Rating Scale for M+T appear reliable, with validity evidence supporting their use in otolaryngology training.

Level of evidence: NA Laryngoscope, 126:2140-2146, 2016.

Keywords: Myringotomy; competency-based education; residency; tympanostomy.

Publication types

  • Validation Study

MeSH terms

  • Checklist
  • Clinical Competence*
  • Competency-Based Education*
  • Humans
  • Middle Ear Ventilation / education*
  • Otolaryngology / education*
  • Prospective Studies
  • Single-Blind Method