Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.591
Filtrar
1.
Int J Pediatr Otorhinolaryngol ; 182: 112026, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38981300

RESUMO

OBJECTIVE: To evaluate the availability and breadth of information provided by program-created pediatric otolaryngology fellowship websites as well as the American Society of Pediatric Otolaryngology (ASPO) program directory. METHODS: Program-created pediatric otolaryngology fellowship websites and the ASPO directory were evaluated for 16 key criteria deemed to be relevant to fellowship applicants. RESULTS: All 36 ACGME-accredited pediatric otolaryngology fellowship programs had websites that were readily available by Google search, and the ASPO program directory contained direct links to 17 (47.2 %) program-created websites. On average, program-created websites fulfilled 6.9 (43.1 %, range 1-11) and the ASPO directory fulfilled 6.9 (43.1 %, range 3-11) of the 16 key criteria. When utilizing both resources, the average increased to 8.3 (51.2 %) - criteria included program description (94.4 %), location description (30.4 %), fellowship director contact information (94.4 %), program coordinator contact information (72.2 %), teaching responsibilities (68.6 %), call responsibilities/schedule (41.7 %), operative volume (80 %), breadth of surgical exposure (94.4 %), research opportunities (72.2 %), research expectations (63.9 %), current fellow(s) (42.9 %), post-fellowship placement (28.6 %), fellow clinic (28.6 %), medical missions/outreach (20 %), and resident coverage (36.1 %). CONCLUSION: Pediatric otolaryngology fellowship websites as well as program-specific data sheets from ASPO lack many key criteria that would otherwise be valuable to applicants. Inclusion of these criteria could help applicants make a more well-informed decision when applying into pediatric otolaryngology fellowship.


Assuntos
Bolsas de Estudo , Internet , Otolaringologia , Pediatria , Humanos , Otolaringologia/educação , Pediatria/educação , Estados Unidos , Educação de Pós-Graduação em Medicina , Internato e Residência
2.
FP Essent ; 542: 2, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39018124
3.
Glob Health Action ; 17(1): 2370102, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38932660

RESUMO

BACKGROUND: While ear, nose, and throat (ENT) diseases are a substantial threat to global health, comprehensive reviews of ENT services in Southern Africa remain scarce. OBJECTIVE: This scoping review provides a decade-long overview of ENT services in Southern Africa and identifies gaps in healthcare provision. From the current literature, we hope to provide evidence-based recommendations to mitigate the challenges faced by the resource-limited ENT service. DATA SOURCES: PubMed, Web of Science, EBSCOhost, Cochrane Library, Cochrane Library, and Scopus. REVIEW METHODS: On several databases, we conducted a comprehensive literature search on both quantitative and qualitative studies on ENT services in Southern Africa, published between 1 January 2014 and 27 February 2024. The extracted data from the analyzed studies was summarized into themes. RESULTS: Four themes in the fourteen studies included in the final analysis described the existing ENT services in Southern Africa: 1. Workforce scarcity and knowledge inadequacies, 2. Deficiencies in ENT infrastructure, equipment, and medication, 3. Inadequate ENT disease screening, management, and rehabilitation and 4. A lack of telehealth technology. CONCLUSION: The Southern African ENT health service faces many disease screening, treatment, and rehabilitation challenges, including critical shortages of workforce, equipment, and medication. These challenges, impeding patient access to ENT healthcare, could be effectively addressed by implementing deliberate policies to train a larger workforce, increase ENT funding for equipment and medication, promote telehealth, and reduce the patient cost of care.


Main findings: Ear, nose and throat (ENT) healthcare in Southern Africa faces critical shortages of workforce, equipment, and medication for disease screening, treatment and rehabilitation.Added knowledge: In this review, we identify challenges in the resource-limited Southern African ENT healthcare provision and provide evidence-based recommendations to mitigate these challenges.Global health impact for policy and action: Improving ENT service delivery in the resource-limited world requires deliberate policies that improve health worker training, expand financing and resource availability, incorporate new technology, and lower patient costs of care.


Assuntos
Otorrinolaringopatias , Humanos , África Austral , Otorrinolaringopatias/terapia , Otolaringologia/organização & administração , Atenção à Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/organização & administração
4.
BMC Med Educ ; 24(1): 702, 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38937721

RESUMO

BACKGROUND: To assess changes in confidence and preparedness after conducting a 2-day induction bootcamp for novice Ear Nose and Throat (ENT) first year specialty trainee registrars (ST3s) in the United Kingdom (UK). The bootcamp covered common ENT presentations on the ward, and in the elective and emergency settings. METHODS: A total of 32 trainees (ST3 or research fellow) voluntarily registered via an online application form to the Southern ST3 accelerated learning course bootcamp through ENT UK. ENT UK is a membership body that supports ENT trainees throughout their careers. They completed a two-day bootcamp that was hosted at St Mary's Hospital, London and 10 skills sessions were delivered by either a senior ENT registrar or an ENT consultant. A pre-session questionnaire was distributed to all participants and a post-session questionnaire was provided that assessed the changes in confidence and preparedness of the participants, if any. The responses were scored by a 10-point Likert scale. Only participants who fully completed the pre and post questionnaire were included, which was 29 in total. RESULTS: Participants self-reported a significant increase in confidence (p < 0.001) and preparedness (p < 0.001) following the bootcamp course. The greatest improvements in comparison to all other stations were self-preparedness in the rigid bronchoscopy station and self-confidence in the sphenopalatine artery (SPA) ligation station. CONCLUSION: The use of a two-day bootcamp improved confidence and preparedness of managing common ENT presentations in the ward, elective and emergency settings for ENT ST3s. It provides a useful adjunct in the acquisition of technical and non-technical skills alongside the traditional surgical apprenticeship. In the future, more work is required to assess the impact of bootcamps on patient outcomes and long-term benefits on trainees' skill retention and clinical proficiency.


Assuntos
Competência Clínica , Corpo Clínico Hospitalar , Otolaringologia , Humanos , Otolaringologia/educação , Reino Unido , Corpo Clínico Hospitalar/educação , Inquéritos e Questionários , Feminino , Masculino , Educação de Pós-Graduação em Medicina
7.
Int J Pediatr Otorhinolaryngol ; 181: 111970, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38733945

RESUMO

OBJECTIVE: Infants and children diagnosed with a conductive hearing loss (CHL) are often referred for otolaryngology assessment. Although this is also a regular occurrence for infants diagnosed with a CHL through Universal Newborn Hearing Screening (UNHS), less is known about these infants and their outcomes. Using a cohort of infants diagnosed with CHL through UNHS and referred to otolaryngology, this study aimed to investigate the relationship between specific demographic or clinical characteristics and 1) triage category 2) middle ear diagnosis and intervention and, 3) service-related factors at otolaryngology. METHODS: Retrospective analysis through clinical chart review was performed on all infants born between January 2014 and December 2017 who referred on UNHS, diagnosed with a CHL and referred to the Queensland Children's Hospital. Descriptive analysis and Chi squared analysis was conducted on data from 95 records. RESULTS: Analysis between all infants referred from UNHS and those who referred, diagnosed with CHL and then referred to otolaryngology suggest that bilateral referrals/medical exclusion, preterm and infants with ≥1 risk factors are more readily associated with referral to otolaryngology for CHL. Nearly all (92.86 %) infants who were referred to otolaryngology had a primary diagnosis of OM and most infants (89.66 %) received grommets as an intervention. The average age of first appointment at otolaryngology was 427 days, the average age of intervention was 579 days and the average occasions of service at otolaryngology was 6.72. CONCLUSION: This paper provides a snapshot into the journey and outcomes of infants referred from UNHS, diagnosed with CHL, and referred to otolaryngology. Further investigation in both general and UNHS populations is needed to better understand and apply these findings.


Assuntos
Perda Auditiva Condutiva , Testes Auditivos , Triagem Neonatal , Humanos , Recém-Nascido , Perda Auditiva Condutiva/diagnóstico , Estudos Retrospectivos , Masculino , Feminino , Lactente , Encaminhamento e Consulta/estatística & dados numéricos , Queensland , Otolaringologia , Fatores de Risco
9.
Am J Otolaryngol ; 45(4): 104344, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38701730

RESUMO

PURPOSE: To determine the characteristics of current US Otolaryngology-Head and Neck Surgery (Oto-HNS) residents and their medical school. METHODS: Data were manually collected between Dec 2022 and Jan 2023 for 1649 residents attending 163 US-based ACGME accredited Oto-HNS residency programs, reflecting the 2018-2022 cohort. All data were collected from publicly available sources including residency and medical school program websites, web of science, and professional networking sites (ex: LinkedIn, Doximity). Data were analyzed to determine the "feeder" schools which contributed the greatest number and percent of residents. Using univariable linear regression models, we characterized factors which were associated with feeder school status. RESULTS: Of 1649 residents analyzed, 364 (22 %) matched to their home program and 918 (56 %) stayed in the region of their medical school. The median [IQR] number of published papers and abstracts was 5 [3, 9] with an h-index of 2 [1,4]. Factors associated with producing a greater percent of Oto-HNS residents include presence of an interest group, presence of a home program, USNWR research rank of the medical school, Doximity reputation rank of the home residency program, average pre-residency h-index of the school's graduates, and total NIH research funding (each p < 0.001). CONCLUSIONS: In the changing landscape of residency applications after the USMLE Step 1 exam's transition in January 2022 to pass/fail scoring, it is important to objectively characterize current Oto-HNS residents. Findings from this study will inform prospective residents and residency programs seeking to improve access to Oto-HNS. Future small-scale studies may help further identify driving factors within medical school curricula.


Assuntos
Internato e Residência , Otolaringologia , Faculdades de Medicina , Humanos , Otolaringologia/educação , Estados Unidos , Masculino , Feminino
10.
Am J Otolaryngol ; 45(4): 104327, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38701731

RESUMO

OBJECTIVE: Residents are faced with ethical issues every day but most residency curriculums do not routinely include formal ethics skills training. In order to address this, a comprehensive curriculum on ethics and surgical palliative care was implemented for otolaryngology residents. METHODS: An 8-h ethics didactics curriculum was designed in collaboration with our institution's Institute of Ethics. Varied strategies were used to cover basic principles and practical skills. Anonymous assessments were completed by learners at 3 points during the curriculum on a 5-point scale. RESULTS: Nine residents were surveyed. Prior to the curriculum, a large majority of residents (85 %) expressed little to no familiarity with basic ethical principles. There was statistically significant improvement in understanding of and familiarity with bioethics topics, including the four principles of bioethics (Δ = 2.4, p = 0.004). There was also statistically significant improvement in comfort with the implementation of ethical decision making and palliative care skills, including with difficult conversations with patients (Δ = 1.3, p = 0.03). Participation in sessions was excellent with positive qualitative feedback. CONCLUSION: An interactive curriculum in ethics and palliative care can be engaging and practical for busy surgical residents, with measurable improvement in comfort with challenging cases and ethical, patient-centered care.


Assuntos
Currículo , Internato e Residência , Otolaringologia , Cuidados Paliativos , Otolaringologia/educação , Otolaringologia/ética , Cuidados Paliativos/ética , Humanos , Ética Médica/educação , Educação de Pós-Graduação em Medicina , Competência Clínica , Inquéritos e Questionários , Masculino
11.
Am J Otolaryngol ; 45(4): 104326, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38704948

RESUMO

BACKGROUND: Many students have limited exposure to otolaryngology-head and neck surgery (OTOHNS) throughout medical school, limiting recruitment of medical students early in their medical careers. OBJECTIVE: To assess the association between otolaryngology interest groups (OIGs) at medical schools and percentage of students matching into OTOHNS residency programs. To characterize specific aspects of OIGs that may impact the percentage of students matching into OTOHNS residency programs from a given medical school. METHODS: Data was obtained from web searches of 141 accredited U.S. allopathic medical schools to see if they possessed OIGs. Information on the various activities and opportunities that OIGs participated in was collected through medical school websites. 2020 NRMP® match results data were obtained. RESULTS: Web searches found that 73 % (103 out of 141) of U.S. allopathic medical schools have OIGs. Medical schools with OIGs were associated with a 35 % increase in the median percentage of OTOHNS matches (P = 0.022). Of the 103 medical schools with OIGs, 53 % (55) of the schools had information on their websites describing activities and opportunities that their OIGs participate in. OIGs with research and/or mentorship opportunities were associated with increases in OTOHNS matches by 32 % (P = 0.043) and 83 % (P = 0.012), respectively. CONCLUSION: The presence of an OIG at a medical school is associated with an increased percentage of students matching into OTOHNS from that medical school. OIGs that provide research or mentorship opportunities are associated with an increased percentage of students matching into OTOHNS from those medical schools.


Assuntos
Escolha da Profissão , Internato e Residência , Otolaringologia , Otolaringologia/educação , Internato e Residência/estatística & dados numéricos , Humanos , Estados Unidos , Estudantes de Medicina/estatística & dados numéricos , Estudantes de Medicina/psicologia , Faculdades de Medicina/estatística & dados numéricos , Seleção de Pessoal
12.
Acta Otorhinolaryngol Ital ; 44(3): 161-168, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38712520

RESUMO

Objective: The primary focus of this study was to analyze the adoption of ChatGPT among Ear, Nose, and Throat (ENT) trainees, encompassing its role in scientific research and personal study. We examined in which year ENT trainees become involved in clinical research and how many scientific investigations they have been engaged in. Methods: An online survey was distributed to ENT residents employed in Italian University Hospitals. Results: Out of 609 Italian ENT trainees, 181 (29.7%) responded to the survey. Among these, 67.4% were familiar with ChatGPT, and 18.9% of them used artificial intelligence as a tool for research and study. In all, 32.6% were not familiar with ChatGPT and its functions. Within our sample, there was an increasing trend of participation by ENT trainees in scientific publications throughout their training. Conclusions: ChatGPT remains relatively unfamiliar and underutilised in Italy, even though it could be a valuable and efficient tool for ENT trainees, providing quick access for study and research through both personal computers and smartphones.


Assuntos
Inteligência Artificial , Internato e Residência , Otolaringologia , Otolaringologia/educação , Humanos , Itália , Inquéritos e Questionários , Masculino , Feminino , Adulto
15.
Laryngoscope ; 134(8): 3698-3705, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38727412

RESUMO

OBJECTIVE: Care of patients with dysphagia occurs at the intersection of several different medical specialties. Otolaryngologists are uniquely equipped to diagnose dysphagia given their specialized training, yet the extent to which otolaryngologists perform diagnostic procedures for dysphagia is unknown. The objective of this study was to characterize the specialty-level variation among providers performing diagnostic assessments for dysphagia. METHODS: We performed a retrospective, cross-sectional analysis of dysphagia care utilization among Medicare beneficiaries from 2013 to 2021 using the CMS Physician & Other Practitioners by Provider and Service dataset. American Association of Medical Colleges (AAMC) data reports were used to determine the total number of providers per specialty. For each procedure and specialty, the percentage of providers performing >10 procedures annually and the average annual number of procedures per performing provider (non-radiology) were calculated. RESULTS: We analyzed nine common dysphagia diagnostic procedures, including manometry, 24-h pH testing, flexible endoscopic evaluation of swallowing (FEES), and modified barium swallow study (MBSS). Mean 3.7 (SD 1.4) otolaryngologists (0.04% of practicing) performed manometry testing annually, compared to 493 (69.3) gastroenterologists (3.3%). Less than 1% of practicing otolaryngologists (37.8 (8.0) (0.04%)) and gastroenterologists (51.6 (8.4), 0.35%) performed 24-h pH testing annually. FEES testing was most commonly performed by otolaryngologists; however, only 48 (6.3) providers (0.51% of practicing) performed these procedures annually. For MBSS, fewer otolaryngologists (5.2 (1.0), 0.05%) perform these assessments than other medical specialties. Each otolaryngologist performed 110.7 (52.5) studies annually, compared to 200.1 (68.0) per gastroenterologist. CONCLUSION: Otolaryngologists represent a small fraction of providers performing dysphagia-related diagnostic procedures despite a unique training within our specialty to comprehensively diagnose and manage this condition. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:3698-3705, 2024.


Assuntos
Transtornos de Deglutição , Padrões de Prática Médica , Transtornos de Deglutição/diagnóstico , Humanos , Estados Unidos , Estudos Transversais , Estudos Retrospectivos , Padrões de Prática Médica/estatística & dados numéricos , Otorrinolaringologistas/estatística & dados numéricos , Masculino , Feminino , Medicare/estatística & dados numéricos , Otolaringologia/estatística & dados numéricos
16.
Curr Opin Otolaryngol Head Neck Surg ; 32(3): 186-187, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38690639
17.
J Surg Educ ; 81(8): 1057-1065, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38796361

RESUMO

OBJECTIVE: Fit is a crucial factor in surgical residency selection, but how this abstract concept is applied in practice is poorly understood. Person-environment (PE) fit theory suggests that there are multiple fit domains that can clarify usage: person-job, person-organization, and person-workgroup fit. We used PE fit theory to explore how otolaryngology residency selection committee (RSC) members operationalize the concept of fit. DESIGN: One-hour focus groups were conducted in November 2022. Interview questions explored participants' definitions and uses of fit in the resident selection process. Transcripts were analyzed using directed qualitative content analysis to generate themes and evaluate how these align with PE fit domains. SETTING: Society of University Otolaryngologists Annual Meeting breakout session in November 2022. PARTICIPANTS: 21 RSC members from 20 different otolaryngology-head and neck surgery departments participated in three seven-person focus groups. RESULTS: Participants described aspects of fit that aligned with PE fit domains. Person-job included how applicants fit as both surgeons and residents. Person-organization included how applicants fit with the program's characteristics, program's mission, and the local community. Person-workgroup emphasized how applicants fit with current residents. Various challenges in the selection process limited the extent to which PE fit was operationalized, including 1) ambiguous uses of fit, 2) unique features of the match process, 3) lack of outcomes data for selection decisions, and 4) interactions with diversity, equity, and inclusion goals. CONCLUSIONS: Fit manifests in various ways during the surgical residency selection process that parallel domains of PE fit theory. Recommendations are made to assist programs in using fit in resident selection, including clearly articulating definitions of fit to increase transparency in conversations. Further work on selection challenges is needed to maximize the utility of fit in practice.


Assuntos
Grupos Focais , Internato e Residência , Otolaringologia , Seleção de Pessoal , Otolaringologia/educação , Humanos , Feminino , Masculino
18.
Laryngorhinootologie ; 103(S 01): S1-S2, 2024 May.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-38697140

RESUMO

Dear colleagues,Dear readers,We are constantly developing innovative solutions and treatment concepts for our patients in our discipline. In this context, interdisciplinary collaboration is essential. The conference motto "Crossing Borders: interdisciplinary, international, interactive" of the 95th Annual Meeting of the German Society of Otorhinolaryngology, Head and Neck Surgery emphasizes the relevance of interdisciplinary cooperation and global exchange. This year, joint meetings with the European Laryngological Society (ELS) and the Rhinoplasty Society of Europe (RSE) will take place for the first time. The American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) and the Confederation of European Otorhinolaryngology - Head and Neck Surgery (CEORL-HNS) are also involved in the scientific program. The interdisciplinary presentations offer insights into the most recent developments in the fields of head and neck oncology, skull base and orbital surgery, among others. They are a great opportunity to expand your own knowledge and exchange the latest research findings.


Assuntos
Otolaringologia , Humanos , Alemanha , Comunicação Interdisciplinar , Rinoplastia/métodos , Sociedades Médicas
19.
Acta Otolaryngol ; 144(3): 237-242, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38781053

RESUMO

BACKGROUND: Large Language Models (LLMs) might offer a solution for the lack of trained health personnel, particularly in low- and middle-income countries. However, their strengths and weaknesses remain unclear. AIMS/OBJECTIVES: Here we benchmark different LLMs (Bard 2023.07.13, Claude 2, ChatGPT 4) against six consultants in otorhinolaryngology (ORL). MATERIAL AND METHODS: Case-based questions were extracted from literature and German state examinations. Answers from Bard 2023.07.13, Claude 2, ChatGPT 4, and six ORL consultants were rated blindly on a 6-point Likert-scale for medical adequacy, comprehensibility, coherence, and conciseness. Given answers were compared to validated answers and evaluated for hazards. A modified Turing test was performed and character counts were compared. RESULTS: LLMs answers ranked inferior to consultants in all categories. Yet, the difference between consultants and LLMs was marginal, with the clearest disparity in conciseness and the smallest in comprehensibility. Among LLMs Claude 2 was rated best in medical adequacy and conciseness. Consultants' answers matched the validated solution in 93% (228/246), ChatGPT 4 in 85% (35/41), Claude 2 in 78% (32/41), and Bard 2023.07.13 in 59% (24/41). Answers were rated as potentially hazardous in 10% (24/246) for ChatGPT 4, 14% (34/246) for Claude 2, 19% (46/264) for Bard 2023.07.13, and 6% (71/1230) for consultants. CONCLUSIONS AND SIGNIFICANCE: Despite consultants superior performance, LLMs show potential for clinical application in ORL. Future studies should assess their performance on larger scale.


Assuntos
Otolaringologia , Humanos , Alemanha , Idioma , Competência Clínica , Benchmarking
20.
Am J Otolaryngol ; 45(4): 104322, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38692073

RESUMO

OBJECTIVE: Pediatric patients and their caregivers may receive information from their primary care physician (PCP) that does not match current American Academy of Otolaryngology (AAO) guidelines. The purpose of this study is to evaluate the frequency of parents deciding to seek a second opinion based on the demographics of pediatric otolaryngologists who deliver guideline supported advice, contrary to advice from their child's PCP. METHODS: A survey was distributed to parents in a pediatric otolaryngology clinic between June 2021 and July 2023. Demographics included parent age category, gender, race, and age of youngest child. The survey included a scenario depicting recurrent otitis media with clear ears and a suggestion to defer tympanostomy tube insertion per AAO guidelines after their child's PCP recommended tubes. Thirteen variations of otolaryngologist photos were used in the case, including a control case with no picture. RESULTS: Of the 658 participants, 460 (69.9 %) were female. 551 (83.7 %) were aged 30-49 years, 70 (10.7 %) were younger, and 37 (5.6 %) were older. 545 (82.8 %) were White, 30 (4.6 %) were Black, 20 (3.0 %) were Asian, and 31 (4.7 %) were Hispanic. 39.9 % of parents would seek a second opinion if an otolaryngologist recommended watchful waiting following evaluation of their child's otitis media. Participants given the control case were 2.23 times more likely to listen to the otolaryngologist's advice (p = .025). If a picture was provided, respondents were more likely to follow advice given if the pictured otolaryngologist was female (p = .025, OR = 1.47) or Asian (p = .042, OR = 1.53). CONCLUSION: In this group, there is evidence that physician race and gender may influence decision making when considering action versus monitoring in the context of recurrent otitis media.


Assuntos
Otorrinolaringologistas , Pais , Encaminhamento e Consulta , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Encaminhamento e Consulta/estatística & dados numéricos , Otorrinolaringologistas/estatística & dados numéricos , Criança , Pais/psicologia , Pré-Escolar , Inquéritos e Questionários , Otite Média , Otolaringologia , Adolescente , Guias de Prática Clínica como Assunto , Lactente
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA