Evaluation of a low-fidelity ear surgery simulator in a low-resource setting

J Laryngol Otol. 2017 Nov;131(11):1010-1016. doi: 10.1017/S002221511700216X. Epub 2017 Oct 30.


Objective: The provision of healthcare education in developing countries is a complex problem that simulation has the potential to help. This study aimed to evaluate the effectiveness of a low-cost ear surgery simulator, the Ear Trainer.

Methods: The Ear Trainer was assessed in two low-resource environments in Cambodia and Uganda. Participants were video-recorded performing four specific middle-ear procedures, and blindly scored using a validated measurement tool. Face validity, construct validity and objective learning were assessed.

Results: The Ear Trainer provides a realistic representation of the ear. Construct validity assessment confirmed that experts performed better than novices. Participants displayed improvement in all tasks except foreign body removal, likely because of a ceiling effect.

Conclusion: This study validates the Ear Trainer as a useful training tool for otological microsurgical skills in developing world settings.

Keywords: Education; Foreign Bodies; Global Health; Medical; Middle Ear Ventilation; Teaching; Tympanic Membrane.

MeSH terms

  • Cambodia
  • Clinical Competence
  • Developing Countries
  • Ear Canal / anatomy & histology
  • Ear Canal / surgery
  • Ear, Middle / anatomy & histology
  • Ear, Middle / surgery
  • Female
  • Foreign Bodies / surgery
  • Humans
  • Male
  • Models, Anatomic*
  • Otologic Surgical Procedures / education*
  • Reproducibility of Results
  • Uganda