Comparative validity of three simulation platforms for objective
assessment of otoscopy skills
Abstract
Introduction Otoscopy is a key clinical skill which following the
introduction of the Medical Licensing Assessment all newly qualified
doctors in the United Kingdom will be required to be able to perform
independently. At present there is no consensus on a standardised method
for objectively assessing otoscopy skills. Methods Prospective mixed
methods study comparing face, content and construct validity of three
different platforms for otoscopy skills assessment, using a traditional
otoscope with manikin, digital otoscope (Tympahealth) with manikin, and
traditional otoscope with a low-cost model ear (SimEar). Skills were
assessed using a standardised mark scheme, and five expert assessors and
twelve participants who rotated through three Objective Structured
Clinical Examination (OSCE) stations representing each model. Assessors
numerically ranked validity of each model, and participated in a
semi-structured interview of opinion. Results Each platform differed in
face, construct and content validity scores, with no one platform
consistently outperforming others. Three main themes were identified
during thematic analysis of expert assessor interviews: ability to
assess what is seen, anatomical reality, and ease of use. The low-cost
model showed greatest potential, where modification to include a
silicone ear could lead to high validity with marginal increase in cost.
Conclusion Several modalities for assessing otoscopy skills exist, each
with advantages and disadvantages. Modifications to a low-cost model,
for use with either a traditional or digital otoscope, could prove to be
the best model.