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Content Validity of a High-Fidelity Surgical Middle Ear Simulator: A Randomized Prospective International Multicenter Trial Publisher Pubmed



Youner ER1 ; Chillakuru YR1 ; Xu H2 ; Dedmon M3 ; Labadie R4 ; Djalilian H5 ; Mahboubi H6 ; Westerberg B7 ; Vaisbuch Y8 ; Blevins N9 ; Chen J10 ; Lin V11 ; Joyce MG1 ; Moncada PX1 Show All Authors
Authors
  1. Youner ER1
  2. Chillakuru YR1
  3. Xu H2
  4. Dedmon M3
  5. Labadie R4
  6. Djalilian H5
  7. Mahboubi H6
  8. Westerberg B7
  9. Vaisbuch Y8
  10. Blevins N9
  11. Chen J10
  12. Lin V11
  13. Joyce MG1
  14. Moncada PX1
  15. Dabiri S12
  16. Gurgel RK13
  17. Kouhi A12
  18. Monfared AS1
Show Affiliations
Authors Affiliations
  1. 1. Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, United States
  2. 2. Department of Otolaryngology, Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
  3. 3. Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, NC, United States
  4. 4. Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN, United States
  5. 5. Department of Otolaryngology-Head and Neck Surgery and Biomedical Engineering, University of California, Irvine, CA, United States
  6. 6. PIH Health, Downey, CA, United States
  7. 7. BC Rotary Hearing and Balance Centre, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
  8. 8. Department of Otolaryngology-Head and Neck Surgery, Rambam Medical Center, Haifa, Israel
  9. 9. Department of Otolaryngology, Stanford University, Stanford, CA, United States
  10. 10. Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Canada
  11. 11. Department of Otolaryngology-Head & Neck Surgery, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, Canada
  12. 12. Department of Otolaryngology-Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran
  13. 13. Division of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Utah, Salt Lake City, UT, United States

Source: Otology and Neurotology Published:2023


Abstract

Objective After demonstration of face validity of a surgical middle ear simulator (SMS) previously, we assessed the content validity of the simulator with otolaryngology residents. Study Design Multicenter randomized prospective international study. Setting Four academic institutions. Methods Novice participants were randomized into control, low-fidelity (LF), and high-fidelity (HF) groups. Control and LF produced 2 recordings from 2 attempts, and HF produced 4 recordings from 10 attempts, with trials 1, 4, 7, and 10 used for scoring. Three blinded experts graded videos of the simulated stapedectomy operation using an objective skills assessment test format consisting of global and stapedotomy-specific scales. Results A total of 152 recordings from 61 participants were included. Baseline characteristics did not differ significantly between groups. Depending on the step of the operation, inter-rater reliability ranged from 24 to 90%. For LF and HF, years of training was significantly associated with improved scores in certain objective skills assessment test subparts. HF outperformed the control group on stapes and global scores (p < 0.05). The HF group demonstrated improvement in global score over trials, but plateaued after four trials. Scores varied greatly for participants from different institutions in certain operative steps, such as transecting incudostapedial joints, likely due to differences in instrumentation and time elapsed since manufacture. Conclusion Practice with SMS led to better performance in both global and stapes-specific scores. Further studies are needed to examine construct validity and to create otology-appropriate grading systems. Variables like instrumentation and decline in flexibility of the simulator after 12 months greatly affect performance on the simulator. © Wolters Kluwer Health, Inc. All rights reserved.