J Neurol Surg B Skull Base
DOI: 10.1055/a-2226-8294
Original Article

Residency Education Practices in Endoscopic Skull Base Surgery

Rose Dimitroyannis
1   Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, United States
,
Sharanya Thodupunoori
1   Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, United States
,
Sean P. Polster
2   Department of Neurological Surgery, The University of Chicago Medicine, Chicago, Illinois, United States
,
Paramita Das
2   Department of Neurological Surgery, The University of Chicago Medicine, Chicago, Illinois, United States
,
Christopher R. Roxbury
3   Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago Medicine, Chicago, Illinois, United States
› Author Affiliations

Abstract

Background There has been increased interest in how residents train in the subspecialty of skull base surgery. Examining which training methods are popular and effective to optimize residency learning is necessary, especially with new training adjuncts available to the modern trainee. In this study, we survey North American Skull Base Society (NASBS) members to analyze endoscopic skull base surgery education methods.

Methods The NASBS membership was surveyed regarding endoscopic skull base surgery teaching and feedback methods using a Likert scale via an anonymized REDCap form over 4 months.

Results With a response rate of 10.1%, we found that informal teaching methods and verbal qualitative feedback were rated significantly more effective than other teaching and feedback methods (p < 0.01). When comparing the opinions of otolaryngologists and neurosurgeons, otolaryngologists were less likely to believe feedback is most effective with a shared grading scale (p < 0.01). Physicians with more than 10 years of experience posttraining felt model- and rubric-based teaching were used more frequently (p < 0.01). Respondents indicated that standardization and use of simulation, artificial intelligence, and virtual reality should be at the forefront of educational practices used in the field in the coming 5 to 10 years.

Conclusion Despite the current emphasis on informal training, respondents pointed to standardization and simulation as methods of endoscopic skull base surgery education that should be used more in the future. These results indicate an unmet need in skull base education. Future multi-institutional initiatives with NASBS membership participation are warranted.

Future Presentation

The associated abstract was accepted and will be presented for the NASBS conference, which will be on February 16-18th, 2024.


Ethical Approval

This study was approved by the University of Chicago Institutional Review Board (IRB 22-0637).


Authors' Contributions

Conception and design: R.D., C.R.R.; data acquisition: R.D., C.R.R.; analysis and interpretation: R.D., S.T., S.P.P., P.D., C.R.R.; drafting the manuscript: R.D., S.T., S.P.P., P.D., C.R.R.; critical revision: R.D., S.T., S.P.P., P.D., C.R.R.; guarantor: C.R.R.


Data Availability Statement

Data collected for this study contain sensitive information on patients that make up the cohort and may be made available upon request from the corresponding author.




Publication History

Received: 02 October 2023

Accepted: 10 December 2023

Accepted Manuscript online:
12 December 2023

Article published online:
23 January 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Becker S, Gonser P, Haas M. et al. ENT residents benefit from a structured operation planning approach in the training of functional endoscopic sinus surgery. Medicina (Kaunas) 2021; 57 (10) 1062
  • 2 Kapoor D, Ramavat AS, Mehndiratta M, Agrawal A, Arora V, Goel A. Impact of coronavirus disease 2019 on ENT clinical practice and training: the resident's perspective. J Laryngol Otol 2021; 135 (12) 1-5
  • 3 Linke J, Eichhorn T, Kemper M, Zahnert T, Neudert M. [The situation of education in ENT-residency-training in Germany]. HNO 2021; 69 (07) 534-543
  • 4 Favier V, Ayad T, Blanc F, Fakhry N, Andersen SAW. Use of simulation-based training of surgical technical skills among ENTs: an international YO-IFOS survey. Eur Arch Otorhinolaryngol 2021; 278 (12) 5043-5050
  • 5 Fieux M, Gavoille A, Subtil F, Bartier S, Tringali S. Otoskills training during COVID-19 pandemic: a before-after study. BMC Med Educ 2021; 21 (01) 284
  • 6 Gonzalo JD, Wolpaw DR, Krok KL, Pfeiffer MP, McCall-Hosenfeld JS. A developmental approach to internal medicine residency education: lessons learned from the design and implementation of a novel longitudinal coaching program. Med Educ Online 2019; 24 (01) 1591256
  • 7 Purdy AC, Smith BR, Amersi F. et al. Characteristics associated with outstanding general surgery residency graduate performance, as rated by surgical educators. JAMA Surg 2022; 157 (10) 918-924
  • 8 Martin II RCG, Kehdy FJ, Allen JW. Formal training in advanced surgical technologies enhances the surgical residency. Am J Surg 2005; 190 (02) 244-248
  • 9 Howard F, McKneally MF, Upshur RE, Levin AV. The formal and informal surgical ethics curriculum: views of resident and staff surgeons in Toronto. Am J Surg 2012; 203 (02) 258-265
  • 10 Clark JA, Volchok JA, Hazey JW, Sadighi PJ, Fanelli RD. Initial experience using an endoscopic simulator to train surgical residents in flexible endoscopy in a community medical center residency program. Curr Surg 2005; 62 (01) 59-63
  • 11 Toprak A, Luhanga U, Jones S, Winthrop A, McEwen L. Validation of a novel intraoperative assessment tool: the surgical procedure feedback rubric. Am J Surg 2016; 211 (02) 369-376
  • 12 R Core Team. (2022). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, Vienna, Austria.
  • 13 StataCorp. 2021. Stata Statistical Software: Release 17. College Station, TX: StataCorp LLC;
  • 14 Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res 2007; 42 (04) 1758-1772
  • 15 Swing SR, Beeson MS, Carraccio C. et al. Educational milestone development in the first 7 specialties to enter the next accreditation system. J Grad Med Educ 2013; 5 (01) 98-106
  • 16 Yaeger KA, Munich SA, Byrne RW, Germano IM. Trends in United States neurosurgery residency education and training over the last decade (2009-2019). Neurosurg Focus 2020; 48 (03) E6
  • 17 Dell'Era V, Garzaro M, Carenzo L, Ingrassia PL, Aluffi Valletti P. An innovative and safe way to train novice ear nose and throat residents through simulation: the SimORL experience. Acta Otorhinolaryngol Ital 2020; 40 (01) 19-25
  • 18 Kim SC, Fisher JG, Delman KA, Hinman JM, Srinivasan JK. Cadaver-based simulation increases resident confidence, initial exposure to fundamental techniques, and may augment operative autonomy. J Surg Educ 2016; 73 (06) e33-e41
  • 19 Sikder S, Tuwairqi K, Al-Kahtani E, Myers WG, Banerjee P. Surgical simulators in cataract surgery training. Br J Ophthalmol 2014; 98 (02) 154-158
  • 20 Zarei-Ghanavati M, Ghassemi H, Salabati M. et al. A surgical skills assessment rubric for pterygium surgery. Ocul Surf 2020; 18 (03) 494-498
  • 21 Ophthalmic Educators - International Council of Ophthalmology. Accessed May 9, 2023 at: https://icoph.org/education/ophthalmic-educators/
  • 22 Qiu M, Avdagic E, Ramulu PY, Golnik K, Boland MV. Ophthalmology surgical assessment of tube shunt glaucoma surgery. Ophthalmol Glaucoma 2023; 6 (01) 100-105
  • 23 Sigmon D, Dumon K, Hoeltzel G. et al. Comparison of nontechnical skills grading rubrics for OR in situ simulation for general surgery and obstetrician/gynecologist residents. Surgery 2020; 168 (05) 898-903
  • 24 Patel NS, Gompel JJV, Tombers NM, Link MJ, Carlson ML. A cross-sectional survey of the North American Skull Base Society part 3: the state of lateral skull base surgery training in North America. J Neurol Surg B Skull Base 2019; 80 (04) 399-415
  • 25 Rimmer RA, Chitguppi C, D'Souza G. et al. Preoperative screening for obstructive sleep apnea prior to endoscopic skull base surgery: a survey of the North American Skull Base Society. Allergy Rhinol (Providence) 2020; 11: 2152656720968801
  • 26 White AJ, Paulo AJ, Petitt JC, Morren Y, Recinos PF, Kshettry VR. Significant variability in postoperative thromboprophylaxis in Cushing's disease patients: a survey of the North American Skull Base Society and the AANS/CNS Joint Tumor Section. J Neurol Surg B Skull Base 2023; . Epub ahead of print. DOI: 10.1055/s-0043-1772698.