Competency-Based Otolaryngology Training Is Becoming More of a Fixture, But Needs to Be Fully Developed

As for the cost to residents for this type of education, Dr. Malekzadeh believed that it might ultimately be mandated by overseeing and regulatory organizations. Dr. Smith added that the amount that students and institutions are willing to spend in terms of resources for EPA and CBME is variable and depends upon the assessment method and its level of engagement.

“Residents and fellows are often eager to participate in simulation exercises, which can be incredibly effective at teaching interpersonal skills and teamwork and provide a valuable tool for competency assessments,” said Dr. Smith. “Too often, people focus on the ‘task trainer’ side of simulation, which is very important in teaching particular technical skills. However, situational simulation is also an extremely valuable tool to teach and assess teamwork and interpersonal skills in critical and difficult clinical scenarios, particularly when multiple specialties are involved.” He added that the resources are often related to time—for faculty to teach and assess and for residents and fellows to learn. “It’s generally agreed upon that text-based teaching is less effective than when text is combined with experience, which will prompt the learner to a greater depth of understanding by providing relevance,” he said. “Over time, we have addressed this by extending training duration (including fellowships), to allow for increased clinical exposure and to satisfy numerical constructs for surgical experience, and by expanding faculty numbers to provide more clinical opportunities.

“In my opinion,” Dr. Smith continued, “an optimal resident training program in the future would use simulation and competency-based assessment extensively during the PGY-1 [postgraduate year 1] to ensure equivalent training to all learners of the critical and key facets of otolaryngology practice. Additional simulations and assessment would take place annually to build upon the essentials and ensure equal exposure to all trainees of an agreed-upon curriculum, minimizing the variability based upon which patients present to the practice or the hospital.”

Katie Robinson is a freelance medical writer based in New York.