Digital otoscopy
"He wouldn't let me get a good ear exam..." We've all heard it. The 2-year-old bested the resident, yet again. How can we better teach, and minimize the trauma, for both the learners and patients? This article looked primarily at whether or not using digital otoscopy (DO; ie: with a camera) can reduce repeat exams, but secondarily evaluated trainees' confidence, satisfaction, and knowledge when using DO.
What did they do? Children aged 6 months-5 years presenting with URI-like symptoms, fever or ear pain were enrolled. Trainees obtained a single video clip of each ear with what they determined to be the best possible view of the TM. This was then reviewed by the supervising doctor with the trainee. Peds and EM residents as well as pediatric NPs were supervised by PEM attendings and fellows. They enrolled 368 patients in total, median age 24 months.
What did they find? In 75% of cases, no repeat exam was required. Older patients, higher level of training, and >50% visualization of the TM all made it less likely to require a repeat exam. Trainees reported improved confidence in performing the exam, improved confidence in making the diagnosis, and satisfaction with DO as an educational tool and a diagnostic tool at the end of the study.
Bottom Line: digital otoscopy is effective as both a teaching tool and a diagnostic tool, allowing for immediate feedback for the learner, and less repeat, potentially traumatic exams for the patient.
What did they do? Children aged 6 months-5 years presenting with URI-like symptoms, fever or ear pain were enrolled. Trainees obtained a single video clip of each ear with what they determined to be the best possible view of the TM. This was then reviewed by the supervising doctor with the trainee. Peds and EM residents as well as pediatric NPs were supervised by PEM attendings and fellows. They enrolled 368 patients in total, median age 24 months.
What did they find? In 75% of cases, no repeat exam was required. Older patients, higher level of training, and >50% visualization of the TM all made it less likely to require a repeat exam. Trainees reported improved confidence in performing the exam, improved confidence in making the diagnosis, and satisfaction with DO as an educational tool and a diagnostic tool at the end of the study.
Bottom Line: digital otoscopy is effective as both a teaching tool and a diagnostic tool, allowing for immediate feedback for the learner, and less repeat, potentially traumatic exams for the patient.
