IS OTOSCOPY RELIABLE - A STRUCTURED TEACHING-METHOD TO IMPROVE OTOSCOPIC ACCURACY IN TRAINEES

Otoscopy is an important skill for primary care physicians and otologi sts. Until now, training has been by repeated exposure to patients wit h ear disease. Structured instruction in how to assess an ear has not previously been reported. Not-diseased ears and those with varying typ es of chronic (suppurative) otitis media were chosen to be photographe d as this is an important condition to be able to diagnose and in whic h pneumatic otoscopy has no role. Two sets of 30 slides of equal diffi culty were shown to 10 trainees, one before and one after structured t eaching. The overall error rate fell from 44 to 21% (P < 0.001). Most importantly, the error rate in assessing ear activity fell from 35 to 17% (P < 0.05). In conclusion, a structured approach to otoscopy has b een shown to improve the diagnostic ability of trainess tested with ph otographs of ears with chronic otitis media. Such a teaching approach is likely to be equally beneficial to other otological conditions and to live otoscopy.