Literature Review: A Roundup of Important Recent Studies

Study design: Prospective randomized controlled study.

Setting: Military tertiary referral hospital.

Synopsis: Forty-five parents were asked to remember nine risks of adenotonsillectomy, and scores were compared after counseling alone (C), counseling with a handout (CH) and counseling plus a video (CV). Before surgery, parents remembered an average of 6.8, 7.3 and 6.6 risks in the C, CH and CV groups, respectively. After surgery, parents remembered an average of 5.8, 6.5 and 5.2, respectively, with no significant difference between groups. The length of time to surgery was inversely correlated with retention of surgical risks (P=0.02). Despite the fact that there was no significant improvement in parental understanding through use of videos or handouts, 90 percent of the parents felt that these modalities added to their understanding. In addition, these interventions reduced counseling time by 2.9 to 5.4 minutes.

Previous studies have found the use of handouts to improve procedure risk retention, which was not demonstrated here. Limitations include the fact that most of the parents had at least some secondary education and the sample size was small. However, the use of handouts or videos may allow for decreased face-to-face counseling time without reducing parental understanding of surgical risks.

Bottom line: Parents are not able to retain all of the nine common surgical risks of adenotonsillectomy, and the addition of a handout or video did not add any significant benefit when combined with counseling. Longer times between surgery counseling and the procedure itself may contribute to a reduction in retention of risks.

Reference: Adams MT, Chen B, Makowski R, Bevans S, Boseley M. Multimedia approach to preoperative adenotonsillectomy couselling. Otolaryngol Head Neck Surg. 2012;146(3):461-466.

—Reviewed by Stacey L. Ishman, MD

Resident Facebook Postings Impact Professionalism

What portion of otolaryngology applicants for residency at a single institution had Facebook profiles that would be considered unprofessional?

Background: Increased Internet-based social networking and connectivity have resulted in increased exposure for physicians who post personal information on websites such as Facebook. Patients routinely search for information on their doctors via the internet. Professionalism is one of the six core competencies stressed by the Accreditation Council of Graduate Medical Education (ACGME) and could be impacted by what is posted on a physician’s publically accessible website.

Study design: Case series.

Setting: Division of Otolaryngology-Head and Neck Surgery, University of Alabama, Birmingham.

Synopsis: Of 234 residency applicants to the otolaryngology program, 119 had Facebook profiles. Of these, 85 profiles contained information beyond simple demographics: 11 percent contained pictures or text that at least one reviewer felt could be perceived as unprofessional, six profiles contained content considered “concerning” and one profile contained clear violations of professional boundaries.