Content validity evidence for a simulation-based test of handheld otoscopy skills
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OTOLOGY
Content validity evidence for a simulation‑based test of handheld otoscopy skills Josefine Hastrup von Buchwald1,2 · Martin Frendø1,2 · Mads J. Guldager1 · Jacob Melchiors1,2 · Steven Arild Wuyts Andersen1,2,3 Received: 9 June 2020 / Accepted: 28 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose At graduation from medical school, competency in otoscopy is often insufficient. Simulation-based training can be used to improve technical skills, but the suitability of the training model and assessment must be supported by validity evidence. The purpose of this study was to collect content validity evidence for a simulation-based test of handheld otoscopy skills. Methods First, a three-round Delphi study was conducted with a panel of nine clinical teachers in otorhinolaryngology (ORL) to determine the content requirements in our educational context. Next, the authenticity of relevant cases in a commercially available technology-enhanced simulator (Earsi, VR Magic, Germany) was evaluated by specialists in ORL. Finally, an integrated course was developed for the simulator based on these results. Results The Delphi study resulted in nine essential diagnoses of normal variations and pathologies that all junior doctors should be able to diagnose with a handheld otoscope. Twelve out of 15 tested simulator cases were correctly recognized by at least one ORL specialist. Fifteen cases from the simulator case library matched the essential diagnoses determined by the Delphi study and were integrated into the course. Conclusion Content validity evidence for a simulation-based test of handheld otoscopy skills was collected. This informed a simulation-based course that can be used for undergraduate training. The course needs to be further investigated in relation to other aspects of validity and for future self-directed training. Keywords Handheld otoscopy · Simulation-based training · Technical skills training · Evidence-based medical education · Otology
Introduction Handheld otoscopy is performed on a daily basis by a wide range of healthcare professionals including general practitioners, nurse practitioners, paediatricians, otorhinolaryngologists, and others. Otoscopy skills are important for accurate * Josefine Hastrup von Buchwald [email protected] 1
Department of Otorhinolaryngology‑Head and Neck Surgery, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
2
Copenhagen Academy for Medical Education and Simulation (CAMES), Center for HR and Education, The Capital Region of Denmark, Copenhagen, Denmark
3
Department of Otolaryngology, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA
diagnosis and treatment and have been identified as key to preventing inappropriate use of antibiotics [1]. Even though otoscopy is a very common diagnostic procedure, competency in otoscopy after pre-graduate training is often insufficient: In one study, otoscopy skills were ranked by junior doctors as the second lowest of skills they perceive
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