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Medical Graduate's Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship.

ABSTRACT: Exposure to otorhinolaryngology in India has been shadowed by an inadequate curriculum. Our study brings forth the lacunae in medical education setup related to ENT. We introspect why the subject is not a first choice for specialization. 100 medical graduates were assessed at the end of internship postings for: (1) subject knowledge, (2) basic and emergency procedures, (3) diagnosis and investigation of common and emergency conditions. 84% take ENT as a minor subject. Least awareness is seen regarding its relation with skull base, head and neck and plastic surgery. Very few knew about advanced surgeries and instruments in the field. Majority rejected ENT as a primary choice and its upgradation as major subject. Routine and emergency procedures based on ENT were not a matter of ease by majority of subjects. Post internship doctors lagged in doing basic clinical and diagnostic steps. Diagnosis of various pathologies was not a skill of majority of subjects under study. A lack of basic knowledge of important emergency conditions in ENT was noticed. Our study points at inadequate training in ENT and under estimation of its scope. The outcome raises a need to revise the curriculum and methodology to come at par with world standards, reflecting its true expanse and tremendous scope.

SUBMITTER: Qadri H

PROVIDER: S-EPMC6848343 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Medical Graduate's Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship.

Qadri Haris H Andrabi Danish Zamir DZ Nemade Sanjana Vijay SV Shinde Kiran Jaywant KJ Naik Chetna C Yeolekar Aditya A Kahane Kaustubh K

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India 20170719 Suppl 1

Exposure to otorhinolaryngology in India has been shadowed by an inadequate curriculum. Our study brings forth the lacunae in medical education setup related to ENT. We introspect why the subject is not a first choice for specialization. 100 medical graduates were assessed at the end of internship postings for: (1) subject knowledge, (2) basic and emergency procedures, (3) diagnosis and investigation of common and emergency conditions. 84% take ENT as a minor subject. Least awareness is seen reg ...[more]

PMID: 31741953

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Project description:Retention of resuscitation skills is usually assessed at a predefined moment, which enables participants to prepare themselves, possibly introducing bias. In this multicenter study, we evaluated the retention of knowledge and skills in pediatric basic life support (PBLS) amongst 58 pediatricians and pediatric residents with an unannounced examination. Practical PBLS skills were assessed with a validated scoring instrument, theoretical knowledge with a 10-item multiple-choice test (MCQ). Participants self-assessed their PBLS capabilities using five-point Likert scales. Background data were collected with a questionnaire. Of our participants, 21% passed the practical PBLS exam: 29% failed on compressions/ventilations, 31% on other parts of the algorithm, 19% on both. Sixty-nine percent passed the theoretical test. Participants who more recently completed a PBLS course performed significantly better on the MCQ (p = 0.03). This association was less clear-cut for performance on the practical exam (p = 0.11). Older, attending pediatricians with more years of experience in pediatrics performed less well than their younger colleagues (p < 0.05). Fifty-one percent of the participants considered themselves competent in PBLS. No correlation was found between self-assessed PBLS capabilities and actual performance on the practical exam (p = 0.25).ConclusionRetention of PBLS skills appears to be poor amongst pediatricians and residents, whereas PBLS knowledge is retained somewhat better. What is Known: • Pediatricians and pediatric residents are not always competent in pediatric basic life support (PBLS) in daily practice. Poor retention of skills supposedly accounts for this incompetence. Without regular exposure, resuscitation skills usually deteriorate within 3 to 6 months after training. • Examination of resuscitation skills usually takes place after training. Also, in most studies evaluating retention of skills, participants are tested at a predefined moment. Inasmuch as participants are able to prepare themselves, these assessments do not reflect the ad hoc resuscitation capabilities of pediatricians and residents. What is New: • In this study, pediatricians and pediatric residents had to complete an unannounced PBLS exam at variable time intervals from last certification. Retention of PBLS skills was rather poor (pass rate 21%). • The PBLS skills of older, attending pediatricians with many working years in pediatrics appeared to be inferior to those of their younger colleagues.

Project description:BackgroundUsing a validated, objective, and standardised assessment tool to assess progression and competency is essential for basic robotic surgical training programmes. Objective clinical human reliability analysis (OCHRA) is an error-based assessment tool that provides in-depth analysis of individual technical errors. We conducted a feasibility study to assess the concurrent validity and reliability of OCHRA when applied to basic, generic robotic technical skills assessment.MethodsSelected basic robotic surgical skill tasks, in virtual reality (VR) and dry lab equivalent, were performed by novice robotic surgeons during an intensive 5-day robotic surgical skills course on da Vinci® X and Xi surgical systems. For each task, we described a hierarchical task analysis. Our developed robotic surgical-specific OCHRA methodology was applied to error events in recorded videos with a standardised definition. Statistical analysis to assess concurrent validity with existing tools and inter-rater reliability were performed.ResultsOCHRA methodology was applied to 272 basic robotic surgical skills tasks performed by 20 novice robotic surgeons. Performance scores improved from the start of the course to the end using all three assessment tools; Global Evaluative Assessment of Robotic Skills (GEARS) [VR: t(19) = - 9.33, p < 0.001] [dry lab: t(19) = - 10.17, p < 0.001], OCHRA [VR: t(19) = 6.33, p < 0.001] [dry lab: t(19) = 10.69, p < 0.001] and automated VR [VR: t(19) = - 8.26, p < 0.001]. Correlation analysis, for OCHRA compared to GEARS and automated VR scores, shows a significant and strong inverse correlation in every VR and dry lab task; OCHRA vs GEARS [VR: mean r = - 0.78, p < 0.001] [dry lab: mean r = - 0.82, p < 0.001] and OCHRA vs automated VR [VR: mean r = - 0.77, p < 0.001]. There is very strong and significant inter-rater reliability between two independent reviewers (r = 0.926, p < 0.001).ConclusionOCHRA methodology provides a detailed error analysis tool in basic robotic surgical skills with high reliability and concurrent validity with existing tools. OCHRA requires further evaluation in more advanced robotic surgical procedures.

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Medical Graduate's Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship.

Publications

Medical Graduate's Basic Knowledge and Clinical Skills Assessment in Otorhinolaryngology Post Internship.

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