An innovative and safe way to train novice ear nose and throat residents through simulation: the SimORL experience

Medical simulation enables trainees to learn procedural skills in a tailored, non-threatening, controlled environment that can provide feedback and educational experiences. The goals of this study are to describe the set-up and execution of an educational intervention (SimORL) in Ear Nose and Throat (ENT) simulation, to report confidence in performing basic ENT procedures before and after the event and investigate whether participants would find it useful and educationally effective. SimORL was a two-day formative event held at SIMNOVA - Eastern Piedmont Simulation Centre, Italy. The event was open to ENT trainees from any Italian ENT training program; participants were divided into 5 teams and rotated around 10 different simulation stations over two days. Stations included: high-fidelity, skill trainer, computer based, wet lab and dissection. Stations were: virtual otoscopy (OtoSim(®)), simulated clinical cases with high-fidelity mannequin (e.g. epistaxis) or standardised patients (e.g. vestibular neuronitis), robotic surgery (Da Vinci(®)), human anatomy (zSPACE AIO(®)), surgical tracheostomy (wet model), cadaveric sino-nasal endoscopy (wet model), crisis resource management (team exercise), surgical sutures (Limbs&Things SkinPad(®)), surgical set station and team building exercises. Participants were asked to complete a pre- and post-test that queried previous experience and confidence using 10-item unanchored semantic scales. Results are presented as median (25-75 percentile). Satisfaction was assessed by a validated 5-item Likert Simulation Experience Scale (SSES). Twenty-three ENT trainees attended SimORL 2018. Only 3 participants reported limited previous simulation experience. Pre-post confidence significantly improved between before and after the event. Overall satisfaction with Simulation Experience Scale (SSES) was very high with a median of 4.5 of 5. Regarding simulation evaluation, the most appreciated station was nasal endoscopy (10/10), while the least appreciated was otoscopy (6/10). SimORL proved to be a highly rated and useful educational tool to improve junior ENT trainees’ confidence in performing basic ENT procedures.