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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(04): e556-e560
DOI: 10.1055/s-0041-1740162
Original Research

Comparison of Summative Temporal Bone Dissection Scales Demonstrate Equivalence

Jordan B. Hochman
1   Division of Neurotologic Surgery, Department of Otolaryngology Head and Neck Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
,
Justyn Pisa 
2   Department of Otolaryngology Head and Neck Surgery, Health Sciences Centre, Winnipeg, Manitoba, Canada
,
Shubhi Singh
2   Department of Otolaryngology Head and Neck Surgery, Health Sciences Centre, Winnipeg, Manitoba, Canada
,
Michael Gousseau
3   Department of General Otolaryngology, Dr. Michael Gousseau Medical Corporation, Portage La Prairie, Manitoba, Canada
,
Bert Unger
1   Division of Neurotologic Surgery, Department of Otolaryngology Head and Neck Surgery, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
4   Laboratory for Surgical Modeling, Simulation and Robotics, University of Manitoba, Manitoba, Canada
› Author Affiliations Disclosure/Funding Annual research funding from Advanced Bionics. No direct financial support was provided for this research.
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Abstract

Introduction Temporal bone surgery is a unique and complicated surgical skill that requires extensive training. There is an educational requirement to maximize trainee experience and provide effective feedback.

Objective We evaluate three temporal bone dissection scales for efficacy, reliability, and accuracy in identifying resident skill during temporal bone surgery.

Methods Residents of various skill levels performed a mastoidectomy with posterior tympanotomy on identic 3D-printed temporal bone models. Four blinded otologic surgeons evaluated each specimen at two separate intervals using three separate dissection scales: the Welling Scale (WS), the Iowa Temporal Bone Assessment Tool (ITBAT), and the CanadaWest Scale (CWS). Scores from each scale were compared in their ability to accurately separate residents by skill level, inter- and intrarater reliability, and efficiency in application.

Results Nineteen residents from 9 postgraduate programs participated. Assessment was clustered into junior (postgraduate year or PGY 1, 2), intermediate (PGY 3) and senior resident (PGY 4, 5) cohorts. Analysis of variance (ANOVA) found significant differences between cohort performance (p < 0.05) for all 3 scales considering the PGY level and the subjective account of temporal bone surgical experience. The inter-rater reliability was consistent across each scale. The intrarater reliability was comparable between the CWS (0.711) and the WS (0.713), but not the ITBAT (0.289). Time (in seconds) to complete scoring for each scale was also comparable between the CWS (42.7 ± 16.8), the WS (76.6 ± 14.5), and the ITBAT (105.6 ± 38.9).

Conclusion All three scales demonstrated construct validity and consistency in performance, and consideration should be given to judicious use in training.

Keywords

temporal - bone - training - dissection - scales

Declarations

Study supported by:


1. Stryker Canada


2. Dept. of Otolaryngology Head and Neck Surgery, University of Manitoba




Publication History

Received: 22 February 2021

Accepted: 11 September 2021

Article published online:
28 January 2022

© 2022. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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