Microsurgical skills training with a new tympanoplasty model: learning curve and motivational impact.

ABSTRACT

OBJECTIVES: To evaluate the microsurgical skills training on a tympanoplasty model with regard to the learning curve and the participants' motivation for a surgical specialty. STUDY DESIGN: Randomized controlled prospective study. SETTING: Department of Otolaryngology, Head and Neck Surgery, Medical Campus Carl Gustav Carus at the Technische Universität Dresden, Germany. SUBJECTS: Thirty randomly chosen fifth-year medical students divided into 2 groups. INTERVENTIONS: Group 2 (n = 16) had to perform an ossicular and tympanic membrane reconstruction on a tympanoplasty model on Days 1, 7, 14, and 21 and Group 1 (n = 14) on Days 1 and 21, while observing the procedure at Days 7 and 14. Six otosurgeons served as gold standard. Attempts and time of prosthesis placement and time for tympanic membrane reconstruction were recorded. Tremor frequency and amplitude were obtained at the same time points. An adjusted study interest questionnaire was used to assess students' motivation. RESULTS: Students in Group 2 showed a significant improvement in all reconstruction parameters over the study period compared with both, baseline measurement on first day and Group 1. However, the obtained learning curve did not reach the experts level. Tremor indices and students' motivation showed no correlation with the reconstruction parameters, whereas the training itself had a positive impact on students' interest in the surgical specialty. CONCLUSION: Training with the tympanoplasty model is suitable to acquire first microsurgical motor skills in otolaryngology and to arouse students' interest in the surgical field and otorhinolaryngology.