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Design and Validation of a Practical Simulator for the Development of Basic Nasal Endoscopy Skills in Otolaryngology – Head and Neck Surgery Open Access


Other title
Type of item
Degree grantor
University of Alberta
Author or creator
Steen, Laila H
Supervisor and department
Hodgetts, Bill (Rehabilitation Medicine)
Wolfaardt, Johan (Surgery)
Examining committee member and department
Boulanger, Pierre (Computing Science)
Zheng, Bin (Surgery)
Wright, Erin (Surgery)
Faculty of Rehabilitation Medicine
Rehabilitation Science
Date accepted
Graduation date
Master of Science
Degree level
Diagnostic nasal endoscopy is the standard procedure used by Otolaryngology – Head and Neck (OHNS) surgeons in detecting and treating conditions of the nose and sinuses. Due to a reduction in time resources towards surgical residency programs, OHNS residents have less access to hands-on patient based training in the clinic and operating room (OR) to develop the basic skills required to perform this procedure. Simulation training has been established as an accessible, safe and more ethical alternative to practicing on patients. There are currently no available simulators for practicing basic diagnostic nasal endoscopy skills. The goal of the present research project was to develop a practical simulator for training basic nasal endoscopy skills in OHNS residency programs. A needs analysis was conducted by interviewing experts in OHNS to help inform the design of the simulator and detect potential barriers to adoption. The simulator was developed using additive manufacturing (AM) technology at the Institute for Reconstructive Sciences in Medicine (iRSM), Edmonton, Alberta. The simulator model was made based on computerized tomography (CT) data to closely resemble human anatomy and incorporated force sensors to function as an objective measure of performance. The model was validated through an experimental study involving novice medical students, residents, and staff from the Department of Otolaryngology – Head and Neck Surgery at the University of Alberta, Edmonton, Alberta. The model showed good face validity by the participants rating its overall utility and effectiveness as high. The model showed good construct validity with a strong correlation between the participants’ performance rated on the Objective Structured Assessment of Technical Skills (OSATS) rating scale and surgical experience when performing a set of basic nasal endoscopic tasks on the model. The model failed to show construct validity as an objective measure of performance with no correlation between force measured by the force sensors in the ii model and surgical experience. The simulator model developed is a practical and readily available alternative for OHNS residents to practice their diagnostic nasal endoscopy skills before they go on to practice on patients. The simulator model can help accelerate learning and improve patient safety and the overall quality of patient care.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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