Some outcomes of this article were presented as a poster at the Triological Society 2011 Combined Sections Meeting, Scottsdale, AZ, USA, January 28th, 2011.
Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice
Version of Record online: 22 JUL 2013
Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 123, Issue 12, pages 3162–3167, December 2013
How to Cite
Malik, M. U., Diaz Voss Varela, D. A., Park, E., Masood, H., Laeeq, K., Bhatti, N. I. and Francis, H. W. (2013), Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice. The Laryngoscope, 123: 3162–3167. doi: 10.1002/lary.24179
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue online: 25 NOV 2013
- Version of Record online: 22 JUL 2013
- Manuscript Accepted: 4 APR 2013
- Manuscript Revised: 26 MAR 2013
- Manuscript Received: 7 DEC 2012
- Learning curve;
- surgical competency;
- skill acquisition;
- surgical learning
This study explores the influence of selected factors on achievement of competency in mastoid surgery.
A prospective study of surgical performance and a retrospective survey of learner and training factors.
The longitudinal performance of 15 residents was evaluated using the mastoidectomy task-based checklist (TBC). The influence of surgical experience, resident interest, and training factors (course attendance, voluntary use of simulation laboratory) was also examined and compared for the acquisition of distinct levels of technical skill difficulty (cortical mastoidectomy vs. facial recess).
Ninety-six observations made during the first otology rotation were analyzed. Cortical mastoidectomy tasks showed positive associations with cumulated case numbers (OR 1.13, CI 1.04–1.23, P = .003) and interest in otology (OR 3.86, CI 1.21–12.27, P = .022). Facial recess tasks showed a larger positive association with interest in otology (OR 10.38, CI 2.25–47.94, P = .003), and negative association with extra time spent in laboratory practice (OR .05, CI 0.011–0.23, P = .000).
Learning trajectory for cortical mastoidectomy and facial recess may be influenced by different factors. Interest in otology, in particular, may have a moderating effect on the acquisition of more complex skills in mastoid surgery. A negative association between self-directed laboratory simulation and performance may reflect the impact of assessment-guided feedback in promoting deliberate practice. Further investigations are suggested to explore the interactions between individual trainee differences, educational models, and learning outcomes.
Level of Evidence
N/A. Laryngoscope, 123:3162–3167, 2013