A low-cost otoscopy simulator increased confidence in mechanical otoscopy skills and tympanic membrane pathology identification among preclinical medical students during the COVID-19 pandemic

Abstract

Background: Diagnostic evaluation of otologic diseases often requires otoscopy to visualize the tympanic membrane. The fundamentals of otoscopy include both learning the mechanics of using an otoscope and accurately identifying ear pathologies. During the COVID-19 pandemic, there was limited peer-to-peer physical exam practice for preclinical medical students. We developed a low-cost 3D-printed otoscopy simulator to teach the otoscopic exam to small groups of medical students. Methods: A modified open-source 3-dimensional (3D) head was printed, and a silicone ear was attached. A user interface was created to display one normal tympanic membrane and four pathologies. Preclinical medical students attended a didactic lecture on common otologic pathologies and on how to perform otoscopy. Students then practiced otoscopy and pathology identification on the simulator in small groups. After the session, students were provided an optional survey to evaluate their confidence in otoscopy skills and pathology identification. Results: A total of 47 out of 134 (35%) medical students completed the survey, of whom 60% reported that training with the 3D printed otoscopy simulator was at least moderately effective in learning the mechanical techniques of otoscopy, and 66% found the simulator to be at least moderately effective in helping them learn to identify pathology. The majority (57%) of students reported that the otoscopy simulator was more effective than practicing otoscopy on their peers. Conclusions: We demonstrate the utility of a novel low-cost 3D printed otoscopy simulator to teach both the mechanical skills and pathology identification necessary in performing an otoscopic exam to preclinical medical students.