P0305 - Can a Smartphone Digital Otoscope Improve Anatomical Recognition of the Inner Ear Landmarks, Comfort and Confidence in First Year Medical Students?

Examination of the tympanic membrane with manual otoscopy instrumentation is an essential skill for medical providers. Advances in technology have led to the development of cost effective otoscopic digital image capture and videography. Additionally, DVO skills training has not been evaluated in undergraduate medical education neither for physical examination of the middle ear nor for assessment of the external auditory canal.

The purpose of the study is to identify whether including training in digital video otoscopy (DVO), in addition to training in manual otoscopy examination (MOE), improves ease and accuracy of anatomical recognition in comparison to MOE training alone. We would like to test the hypothesis that first year osteopathic medical students are better able to recognize important anatomical landmarks, feel more comfortable and confident with DVO than with MOE alone.

The participants received a lecture from faculty on how to use the DVO. The participants then took turns as the examiner and examinee. First, the examiner utilized the MOE and then the DVO on the examinee to locate inner ear landmarks and then rate their confidence in locating these landmarks as well as their confidence in using the DVO. Before the examination, participants were randomly assigned to positions of examiner and examinee.

We assessed examinee comfort, examiner comfort, examiner confidence and anatomical landmarks recognition scores in both MOE and DVO in undergraduate medical education (UME). In first year medical students with 3 months prior experience with MOE and minimal experience with DVO, examiner comfort and examiner anatomy recognition scores are significantly higher with DVO. Examiner confidence and examinee comfort scores trended higher with DVO than MOE but this was not found to be statistically significant in this cohort.

DVO was preferred for anatomical recognition of the middle ear, examinees comfort, examiner’s comfort, and for examiners’ confidence. However, examiner confidence and examinee comfort scores were not significant. In this cohort, DVO training was conducted one hour before study intervention. Proper and timely training of DVO may affect these results and increase student comfort and confidence with DVO.