Volume 123, Issue 12 pp. 3162-3167

Otology/Neurotology

Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice

Mohammad U. Malik MD,

Mohammad U. Malik MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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David A. Diaz Voss Varela MD,

David A. Diaz Voss Varela MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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EunMi Park EdD,

EunMi Park EdD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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Hamid Masood MD,

Hamid Masood MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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Kulsoom Laeeq MD,

Kulsoom Laeeq MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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Nasir I. Bhatti MD,

Nasir I. Bhatti MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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Howard W. Francis MD, MBA,

Corresponding Author

Howard W. Francis MD, MBA

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

Send correspondence to Howard W. Francis M.D. MBA, 601 N. Caroline St. Suite 6251, Johns Hopkins Outpatient Center, Baltimore MD 21287. E-mail: [email protected]Search for more papers by this author

Mohammad U. Malik MD,

Mohammad U. Malik MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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David A. Diaz Voss Varela MD,

David A. Diaz Voss Varela MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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EunMi Park EdD,

EunMi Park EdD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

Search for more papers by this author

Hamid Masood MD,

Hamid Masood MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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Kulsoom Laeeq MD,

Kulsoom Laeeq MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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Nasir I. Bhatti MD,

Nasir I. Bhatti MD

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

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Howard W. Francis MD, MBA,

Corresponding Author

Howard W. Francis MD, MBA

Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A

Send correspondence to Howard W. Francis M.D. MBA, 601 N. Caroline St. Suite 6251, Johns Hopkins Outpatient Center, Baltimore MD 21287. E-mail: [email protected]Search for more papers by this author

First published: 22 July 2013

https://doi.org/10.1002/lary.24179

Citations: 22

Some outcomes of this article were presented as a poster at the Triological Society 2011 Combined Sections Meeting, Scottsdale, AZ, USA, January 28th, 2011.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

This study explores the influence of selected factors on achievement of competency in mastoid surgery.

Study Design

A prospective study of surgical performance and a retrospective survey of learner and training factors.

Methods

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).

Results

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).

Conclusions

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

BIBLIOGRAPHY

1Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation System—Rationale and benefits. N Engl J Med 2012; 366: 1051–1056. doi: 10.1056/NEJMsr1200117. Epub 2012.
10.1056/NEJMsr1200117
CAS PubMed Web of Science® Google Scholar
2Laeeq K, Bhatti N I, Carey J P, et al. Pilot testing of an assessment tool for competency in mastoidectomy. Laryngoscope 2009; 119: 2402–2410.
10.1002/lary.20678
CAS PubMed Web of Science® Google Scholar
3Francis HW, Masood H, Chaudhry KN, et al. Objective assessment of mastoidectomy skills in the operating room. Otol Neurotol 2010; 31: 759–765.
10.1097/MAO.0b013e3181e3d385
PubMed Web of Science® Google Scholar
4Francis HW, Masood H, Laeeq K, Bhatti NI. Defining milestones toward competency in mastoidectomy using a skills assessment paradigm. Laryngoscope 2010; 120: 1417–1421.
10.1002/lary.20953
PubMed Web of Science® Google Scholar
5Bandura A. Social Learning Theory. New York, NY: General Learning Press; 1977.
Web of Science® Google Scholar
6Bandura A. Social Foundations of Thought and Action. Englewood Cliffs, NJ: Prentice Hall; 1986.
Google Scholar
7Ainley M, Hidi S, Berndorff D. Interest, learning, and the psychological processes that mediate their relationship. J Educ Psychol 2002; 94: 545.
10.1037/0022-0663.94.3.545
Web of Science® Google Scholar
8Feldman LS, Cao J, Andalib A, Fraser S, Fried GM. A method to characterize the learning curve for performance of a fundamental laparoscopic simulator task: defining “learning plateau” and “learning rate”. Surgery 2009; 146: 381–386.
10.1016/j.surg.2009.02.021
PubMed Web of Science® Google Scholar
9 Using Delphi technique to achieve consensus. http://www.eagleforum.org/educate/1998/nov98/focus.html. Accessed October 15, 2012.
Google Scholar
10Diggle P, Heagerty P, Liang KY, Zeger S. L. Analysis of Longitudinal Data, 2nd ed. New York, NY: Oxford University Press; 2002.
10.1093/oso/9780198524847.001.0001
Google Scholar
11Barrick MR, Mount MK. The big five personality dimensions and job performance: a meta-analysis. Person Psychol 1991; 44: 1–26.
10.1111/j.1744-6570.1991.tb00688.x
PubMed Web of Science® Google Scholar
12Francis HW, Malik MU, Diaz Voss Varela DA, et al. Technical skills improve after practice on virtual-reality temporal bone simulator. Laryngoscope 2012; 122: 1385–91.
10.1002/lary.22378
PubMed Web of Science® Google Scholar
13Gauvin JM. How to promote medical student interest in surgery. Surgery 2003; 134: 407–408.
10.1067/S0039-6060(03)00110-7
PubMed Web of Science® Google Scholar
14Kirkham JC, Widmann WD, Leddy D, et al. Medical student entry into general surgery increases with early exposure to surgery and to surgeons. Curr Surg 2006; 63: 397–400.
10.1016/j.cursur.2006.05.005
PubMed Google Scholar
15Mitchell M, Srinivasan M, West DC, et al. Factors affecting resident performance: development of a theoretical model and a focused literature review. Acad Med 2005; 80: 376–389.
10.1097/00001888-200504000-00016
PubMed Web of Science® Google Scholar
16Godellas CV, Hauge LS, Huang R. Factors affecting improvement on the American Board of Surgery in-training exam (ABSITE). J Surg Res 2000; 91: 1–4.
10.1006/jsre.2000.5852
CAS PubMed Web of Science® Google Scholar
17Schueneman AL, Pickleman J, Hesslein R, Freeark RJ. Neuropsychologic predictors of operative skill among general surgery residents. Surgery 1984; 96: 288–295.
CAS PubMed Web of Science® Google Scholar
18Carr MM. Program directors' opinions about surgical competency in otolaryngology residents. Laryngoscope 2005; 115: 1208–1211.
10.1097/01.MLG.0000163101.12933.74
CAS PubMed Web of Science® Google Scholar

Citing Literature

Volume123, Issue12

December 2013

Pages 3162-3167

Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

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