Optimizing Otoscopy Competency in Audiology Students through Supplementary Otoscopy Training

Abstract

Background: Scope of practice in audiology encompasses proficiency in visual inspection of ear canal and tympanic membrane (TM) as well as otoscopy interpretation skills to determine normal versus abnormal conditions of outer and middle ear. Audiology students can develop skills in otoscopy through education and supervised training. Studies have shown that additional otoscopy training increased skills in medical students and general practitioners. However, educational and supervised practices targeting otoscopy competency during audiology graduate coursework are lacking. Also, no studies have attempted to determine otoscopy skills among audiology students. Purpose: To determine the effectiveness of the otoscopy training model on clinical competency and confidence level of audiology students in performing and interpreting otoscopy. Research Design: A combination of experimental treatment design with random assignment of treatment and control groups and delayed treatment for control group. Study Sample: Thirty-two first- and second-year audiology graduate students who were enrolled in a pediatric audiology class participated in this study. Students were randomly assigned to the control (n = 16, 14 females) or experimental (n = 16, 14 females) group. Intervention: Participants in the experimental group received supplementary otoscopy training including didactic otoscopy lectures as well as clinical training using manikin ears. The control group received the same pretest and posttest and then completed a third assessment (posttest 2) after receiving the same training. Data Collection and Analysis: An evaluation of knowledge and skills regarding otoscopy between groups and time was conducted at three times: (a) pretraining, (b) upon completion of training for the experimental group, (c) upon completion of training by the control group. The evaluation consisted of a written exam, a clinical exam, and a self-perception rating of confidence. Both written exam scores and clinical exam scores (otoscopy manikin) were analyzed via two-way analyses of variance (ANOVAs), whereas chi-square (χ2) statistic was conducted to evaluate the effects of training on the confidence level of students of both groups. Results: Experimental and control groups demonstrated significant increased overall competency in otoscopy following the otoscopy training model with didactic and laboratory components. Posttest confidence ratings showed increases in all groups, and there were no significant differences between groups. Conclusions: The need for supplementary otoscopy training was warranted by low knowledge and clinical competency in otoscopy skills of audiology students as measured by pretest mean scores. After completing the training, both experimental and control groups showed significant improvement in knowledge and competency. Results also suggest that perceived confidence ratings may be misleading in determining students' clinical otoscopy skills.