Assessment of Otolaryngology Residency Training Program in Iran: Perspectives of Faculty Members and Recently Graduated Medical Students

Document Type : Original

Authors

1 Department of Otolaryngology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

3 Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

4 Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

5 School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

6 Otolaryngology Research Center, Shahid Sadoughi University of Medical Sciences. Yazd, Iran.

7 School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

8 School of Medicine, Baqiyatallah Medical Sciences University, Tehran, Iran.

Abstract

Introduction
There is limited evidence regarding the quality of otolaryngology residency programs in Iran. Regarding this, the present study aimed to assess some aspects of otolaryngology residency program in the field of otology in Iran based on the perspectives of faculty members and graduates.
 
Materials and Methods:
This study was conducted on 105 recent graduates and 30 faculty members and/or program directors in otolaryngology using two self-administered questionnaires.
 
Results:
While the faculty members believed that a resident should work on at least 5.4 temporal bone surgeries on average, the actual number was 2.49. Tympanoplasty was assigned the highest rate of satisfaction by the recent graduates, whereas the lowest score belonged to middle ear exploration, ossiculoplasty, and stapes surgery. Only 53.6% of the graduates stated that there was an organized training curriculum in temporal laboratory. The recent graduates reported to have more frequent experiences of performing usual otology operations. However, they had fewer experiences of performing more advanced surgeries. The recently graduated subjects had a significantly low level of satisfaction with their competencies in carrying out more complex types of otology surgeries.
 
Conclusion:
High prevalence of otology surgeries in Iran provides valuable opportunities for training otolaryngology residents to achieve an acceptable level of competency. However, the results of this study strongly suggest the necessity of quality improvement both in teaching-learning and assessment processes in otolaryngology training programs.

Keywords

Main Subjects

References

1. Burford B, Whittle V, Vance GH. The relationship between medical student learning opportunities and preparedness for practice: a questionnaire study. BMC medical education. 2014;14(1):223.
2. Illing JC, Morrow GM, nee Kergon CRR, Burford BC, Baldauf BK, Davies CL, et al. Perceptions of UK medical graduates’ preparedness for practice: a multi-centre qualitative study reflecting the importance of learning on the job. BMC medical education. 2013;13(1):34.
3. de Jong J, Visser M, Van Dijk N, van der Vleuten C, Wieringa-de Waard M. A systematic review of the relationship between patient mix and learning in work-based clinical settings. A BEME systematic review: BEME Guide No. 24. Medical teacher. 2013;35(6):e1181-e96.
4. Memon MA, Brigden D, Subramanya MS, Memon B. Assessing the surgeon's technical skills: analysis of the available tools. Academic Medicine. 2010;85(5):869-80.
5. Naples JG. Education, Health Care Economics, and the Resident in the Middle. Otolaryngology--Head and Neck Surgery. 2016;155(3):542-.
6. Kim YJ, Park EW, Cheong YS, Choi EY, Baek KH, Sung HY, et al. Residents' expectation of family medicine-specific training program and its current state. Korean journal of family medicine. 2011;32(7):390-8.
7. Bath A, Wilson T. Objective assessment of surgical competency–ENT trainees. Clinical Otolaryngology. 2007;32(6):475-9.
8. Georgalas C, Hadjihannas E, Ghufoor K, Pracy P, Papesch M. Operative training in otolaryngology in the United Kingdom: a specialist registrar survey. The Journal of Laryngology & Otology. 2005;119(5):356-61.
9. Carr MM. Program directors' opinions about surgical competency in otolaryngology residents. The Laryngoscope. 2005;115(7): 1208-11.
10. Komiya K, Saito M, Sakurai Y, Kojima H, Takase K. Effectiveness of setting numerical targets in the surgical training of residents: A trial to achieve an optimal balance. Journal of medical and dental sciences. 2013;60(4):
93-101.
11. Abadel FT, Hattab AS. How does the medical graduates' self-assessment of their clinical competency differ from experts' assessment? BMC medical education. 2013;13(1):24.
12. Geoffrion R, Choi JW, Lentz GM. Training surgical residents: the current Canadian perspective. Journal of surgical education. 2011;68(6):547-59.
13. Dent J, Harden RM, Hunt D. A practical guide for medical teachers: Elsevier Health Sciences; 2017.
14. Modi JN, Gupta P, Singh T. Competency-based medical education, entrustment and assessment. Indian pediatrics. 2015;52(5):
413-20.
15. Broughan TA, Crosby ME, Trickey AW, Ma A, Bratzler DW. Implications of Medicare procedure volumes on resident education. The American Journal of Surgery. 2013; 205(6): 737-44.
16. Wijnen-Meijer M, Kilminster S, Van Der Schaaf M, Cate OT. The impact of various transitions in the medical education continuum on perceived readiness of trainees to be entrusted with professional tasks. Medical teacher. 2012;34(11):929-35.
17. Fronza JS, Prystowsky JP, DaRosa D, Fryer JP. Surgical residents' perception of competence and relevance of the clinical curriculum to future practice. Journal of surgical education. 2012;69(6):792-7.
18. Chadwick KA, Dodson KM, Wan W, Reiter ER. Attainment of surgical competence in otolaryngology training. The Laryngoscope. 2015;125(2):331-6.
19. Cave J, Woolf K, Jones A, Dacre J. Easing the transition from student to doctor: how can medical schools help prepare their graduates for starting work? Medical teacher. 2009; 31(5): 403-8.
20. Peyre SE, MacDonald H, Al-Marayati L, Templeman C, Muderspach LI. Resident self-assessment versus faculty assessment of laparoscopic technical skills using a global rating scale. International Journal of Medical Education. 2010;1:37.
21. Lee LC, Reines HD, Domanski M, Zapanta P, Robinson L. General surgery and otolaryngology resident perspectives on obtaining competency in thyroid surgery. Journal of surgical education. 2012;69(5):
593-8.
22. Pandey V, Wolfe J, Liapis C, Bergqvist D. The examination assessment of technical competence in vascular surgery. British journal of surgery. 2006;93(9):1132-8.
23. Clark M, White J, King S, Carbonaro M. Exploring Surgeons' Perceptions of the Role of Simulation in Surgical Education: A Needs Assessment. Canadian Medical Education Journal. 2011;2(2):44-52.
24. AOA. Basic Standards for Residency Training in Otolaryngology / Facial Plastic Surgery: American Osteopathic Association; 2017.
25. Gocer C, Eryilmaz A, Genc U, Dagli M, Karabulut H, Iriz A. An alternative model for stapedectomy training in residency program: sheep cadaver ear. European Archives of Oto-Rhino-Laryngology. 2007;264(12):1409-12.
26. Matsumoto ED. Perfect practice makes perfect. Canadian Urological Association Journal. 2015;9(9-10):336.
27. Andersen SAW, Konge L, Cayé-Thomasen P, Sørensen MS. Retention of mastoidectomy skills after virtual reality simulation training. JAMA Otolaryngology–Head & Neck Surgery. 2016;142(7):635-40.
28. Ruckenstein MJ, Staab JP. Who is performing stapedectomy surgery? Implications for residency and fellowship training. The Laryngoscope. 2008;118(7): 1224-7.
29. Harris JP, Osborne E. A survey of otologic training in US residency programs. Archives of Otolaryngology–Head & Neck Surgery. 1990;116(3):342-4.
30. Mathews SB, Rasgon BM, Byl FM. Stapes surgery in a residency training program. The Laryngoscope. 1999;109(1):52-3.
31. Burns JA, Lambert PR. Stapedectomy in residency training. Otology & Neurotology. 1996;17(2):210-3.
32. Handley GH, Hicks JN. Stapedectomy In Residency-The Uab Experience. Otology & Neurotology. 1990;11(2):128-30.
33. Vrabec JT, Coker NJ. Stapes surgery in the United States. Otology & Neurotology. 2004;25(4):465-9.
34. Statham MM, Pensak ML. Who should be a stapes surgeon? An otologist or a generalist? Current opinion in otolaryngology & head and neck surgery. 2006;14(5):319-22.
35. Watson GJ, Byth K, da Cruz M. Outcomes in stapedotomy surgery: The learning curve redefined. Otology & Neurotology. 2015;36 (10):1601-3.
36. Yung M, Oates J, Vowler S. The learning curve in stapes surgery and its implication to training. The Laryngoscope. 2006;116(1):
67-71.
37. Caughey RJ, Pitzer GB, Kesser BW. Stapedectomy: demographics in 2006. Otology & Neurotology. 2006;27(6):769-75.
38. McMains KC, Peel J. Dedicated training in adult education among otolaryngology faculty. The Laryngoscope. 2014;124(12):2693-5.
39. Önerci M, Orhan M, Öğretmenoğlu O, İrkeç M. Long-term results and reasons for failure of intranasal endoscopic dacryocystorhinostomy. Acta otolaryngologica.  2000;120(2):319-22.
40. Carraccio CL, Benson BJ, Nixon LJ, Derstine PL. From the educational bench to the clinical bedside: translating the Dreyfus developmental model to the learning of clinical skills. Academic Medicine. 2008; 83(8):761-7.
41. Ericsson KA. Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains. Academic medicine. 2004;79(10):S70-S81.
42. Reznick RK, MacRae H. Teaching surgical skills-changes in the wind. New England Journal of Medicine. 2006;355(25):2664-9.
43. Wagner N, Fahim C, Dunn K, Reid D, Sonnadara R. Otolaryngology residency education: a scoping review on the shift towards competency‐based medical education. Clinical Otolaryngology. 2017; 42(3): 564-72.
44. Roberson DW, Kentala E, Forbes P. Development and validation of an objective instrument to measure surgical performance at tonsillectomy. The Laryngoscope.  2005; 115 (12): 2127-37.
Iranian Journal of Otorhinolaryngology
Volume 31, Issue 1
January and February 2019
Pages 25-34

Files

Share

How to cite

Statistics