New Standardized Otolaryngology Curriculum Launching July 1 Should Be Valuable Resource For Physicians Around The World

After fielding requests for it for years, the Education Committee of the American Academy of  Otolaryngology–Head and Neck Surgery (AAO-HNS), the Otolaryngology Program Directors Organization (OPDO), and the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) will debut a new Otolaryngology Core Curriculum (OCC) for residents this July. The initiative is aimed at otolaryngology residents, program directors, and others.

“The goal is to deliver a compre-hensive and appropriately detailed curriculum that will help direct self-learning and serve as a jumping-off point for residency programs’ didactic learning,” said Meredith Merz Lind, MD, the coordinator for education at AAO-HNS, surgical operations officer, and pediatric otolaryngology fellowship program director at Nationwide Children’s Hospital and Otolaryngology Residency Associate Program Director at The Ohio State University College of Medicine in Columbus. The OCC will provide “a standardized and unified curriculum for otolaryngology trainees across the country, [as well as] a valuable resource for physicians and practitioners outside of residency and across the world,” she said.

The goal is to deliver a comprehensive and appropriately detailed curriculum that will help direct self-learning and serve as a jumping-off point for residency programs’ didactic learning.“ — Meredith Merz Lind, MD

What Is It? Why Now?

The AAO-HNS has created other educational otolaryngology curricula materials, including Curriculum Learning through Interactive Approach (COCLIA), OTOSource (comprehensive curriculum developed by the AAO-HNSF and otolaryngology specialty societies), and Focused Lifelong Education Xperience (FLEX) for mid-career learning. But OCC is the first structured weekly curriculum designed for junior and senior residents.

“The impetus for the curriculum stems from a general frustration of many program directors and academic faculty who are seeking a standardized and systemic approach to teaching the core of otolaryngology,” said Sonya Malekzadeh, MD, who spoke in an online presentation introducing the curriculum on the AAO-HNS website (www.entnet.org/education/otolaryngology-core-curriculum). She is the residency program director and professor of otolaryngology–head and neck surgery at MedStar Georgetown University Hospital in Washington, D.C., the former education coordinator for AAO-HNS whose committee helped develop OTOSource, and the Triological Society’s COSM program chair. “The requisite knowledge, skills, and behaviors continue to grow, making it challenging to fit all the content in an organized fashion during the limited time we have with the residents,” she said.

Program directors have wanted a unified otolaryngology curriculum for years, said Eric Dobratz, MD, professor and vice chair of education at the Eastern Virginia Medical School in Norfolk, Va. The OCC “will provide all residency training programs with comprehensive and consistent educational content for their trainees,” he said. “We are fortunate to have excellent training programs across the board in otolaryngology; however, there is still a disparity in some of the resources that various programs are able to provide for in didactics/curriculum.”

Having a core standardized curriculum helps provide a fundamental set of knowledge and information for all residents regardless of what program they are in, noted Jeffrey P. Simons, MD, MMM, professor of otolaryngology at the University of Pittsburgh School of Medicine and director of the Otolaryngology Core Curriculum for the AAO-HNS. “Some residency programs are very large, with many educational resources, while other programs may have one or two residents a year. It may be more of a challenge for smaller programs with fewer faculty members to cover all of these core topics thoughtfully,” he said.

Historically, residency programs have educated residents via textbooks, didactic lectures, and practice board-style questions to try to cover as much of that material as possible. Implementing the OCC follows the trend of formalizing curriculum for all residents so that everyone has the same fundamental knowledge, he added. Other medical specialties, including general surgery, orthopedic surgery, and oral-maxillofacial surgery, have also implemented standardized curricula.

It’s not only residents who can benefit. Having a core curriculum backed by clinical experts and updated regularly can help those beyond their residency years. “Long term, the goal is to have this incredibly robust program that offers the comprehensive educational experience for all of our residents and beyond, including Academy members, practicing otolaryngologists, and hopefully the global community,” said Dr. Merz Lind, speaking in an AAO-HNS video explaining the OCC (www.entnet.org/education/otolaryngology-core-curriculum).

How OCC Will Work

Through collaboration between the AAO-HNSF’s Education committees and OPDO, the OCC has designed around 100 core otolaryngology topics to be covered over two years; each week is dedicated to a specific topic, said Dr. Malekzadeh. Each weekly module will include specific objectives, an outline, and a variety of supplemental resources such as radiographs, pathology slides, surgical videos, and pre-recorded lectures. Also, each topic will have weekly questions embedded to facilitate resident self-assessment and to provide the program directors with objective data on the learners’ progress. Residents and program directors will be able to track progress and comparative data via an embedded dashboard, she said.

The first 25 modules will be introduced on July 1, 2024; every six months, another 25 modules will be released, through January 1, 2026. The topics will be listed as a weekly curriculum. “We are hopeful that most programs will follow along with this schedule, as it will allow for us to get more consistent feedback from users so we can continue to improve the curriculum with each new release of topics,” said Dr. Dobratz.

The new curriculum is based on 21st-century adult education learning principles, said Dr. Simons. The multi-modality formats, including videos, webinars, podcasts, key articles, questions, and case-based learning, all reflect the reality that adults have various learning styles and preferences, he said. All instruction is available online via mobile devices, desktop, and laptop computers.

While many residency program directors have requested a standardized curriculum, they will have options on how to use it. “It is available to all who will subscribe to it, and it is expected to be of high interest,” said Dr. Simons. “We will not legislate how people use it, but we suggest that residents spend one to two hours a week outside of the classroom completing the curriculum module learning.”

Pricing, membership, subscription, and other fee information are online at the AAO-HNS website.

OCC Implementation

As the OCC is being implemented, the AAO-HNS Education Committee will present webinars to help explain how the platform, created by the scholarly and academic technology company Silverchair, works and how people can use it effectively. The webinars will be for program directors, chairs, program coordinators, and residents. Program directors and faculty will be able to access the modules to be able to monitor their content as well as their residents’ progress, said Dr. Merz Lind. Also, the AAO-HNSF staff will provide support to programs and residents as needed.

OPDO has developed a 14-member board that will help the Education Committee to develop topics and review modules “to ensure that the content is meeting the needs of the residency programs,” said Dr. Dobratz.

Alignment with Current Trends, Best Practices, and Existing Training

The curriculum will be “high quality, up-to-date, and comprehensive material for otolaryngology trainees and other interested parties,” said Dr. Merz Lind. “It is multifaceted, which allows for those with various learning styles to choose those modalities that work best for them. It will allow for frequent review, revisions, and updates, which allows us to respond quickly to feedback and to incorporate the most up-to-date information about any topic.”

The flipped classroom model, which is discussion-based and less focused on traditional lectures, is employed because “It is well known at this point that adult learners benefit most from in-person learning sessions,” said Dr. Dobratz. “Best practices for adult learners have changed drastically over the years. We believe that providing residents with self-directed learning options through a structured curriculum with defined tasks will allow them to review a manageable volume of material each week and will allow for programs to develop discussion-based sessions to further review the topic on a higher and more in-depth level.”

With the flipped classroom concept, residents will prepare for the weekly conference sessions by completing pre-assigned modules, said Dr. Malekzadeh. Case-based scenarios will be offered to further apply the knowledge under

the direction of an assigned expert faculty member.

Different programs will likely integrate the new curriculum in different ways, said Dr. Dobratz. “There are no requirements on how this curriculum should be utilized by each program. Our goal is to provide a consistent and structured curriculum that programs may employ and use in a fashion that suits their individual program.”

Dr. Merz Lind agreed.

“We know that different programs have varying support and resources available for resident teaching,” she said. “We believe that there are many ways that the OCC can be used as the central part of resident teaching, or as a supplement to programs’ existing didactic programming.”

Technology and Innovative Teaching Help Deliver the New Curriculum

The online format, available on various devices, means that leaders can respond quickly to feedback and update modules as needed, said Dr. Merz Lind.

“Our goal is to use alternative teaching methods—such as webinars, podcasts, etc.—as additional resources to complement the information provided with each module,” said Dr. Dobratz. “There are also case discussion examples provided to assist programs that are having in-person didactics that cover the associated topics.”

Collecting Feedback

Both Dr. Malekzadeh and Dr. Merz Lind emphasized how ongoing assessment and evaluation will improve and strengthen the curriculum.

“Continuous feedback from learners and faculty is imperative to the success of the program,” Dr. Malekzadeh said. “The curriculum will be an iterative process. We will actively seek feedback from all stakeholders to continuously improve access, platform, and content.”

Because the OCC is so new, “early and frequent feedback will be critical to creating a product that will be useful to trainees across healthcare settings,” said Dr. Merz Lind. “We plan to obtain feedback from a selection of programs and faculty prior to the official launch, and to collect and incorporate feedback on a continuous, formative basis for both existing modules and modules being created.”

To ensure the OCC’s effectiveness is properly evaluated, “we plan to study how the curriculum impacts outcomes, including such factors as otolaryngology training exam scores, resident well-being, and faculty satisfaction with teaching, among other” aspects, she added. “There is a huge opportunity to study how this intervention impacts otolaryngology trainee education and how this translates into measurable outcomes.”

Because the modules will be repeated every two years, such feedback “will help guide changes for the next time that topic is released,” said Dr. Dobratz. “The additional resources will be reviewed and updated as well.”

Final Thoughts

“As a program director, I am excited to be able to provide my residents with a resource that will provide a clearly defined and manageable volume of content each week that will cover 100 topics in otolaryngology,” said Dr. Dobratz. “There is such a large volume of information available to residents, including textbooks, review books, journal articles, review articles, webinars, podcasts, etc. It can be overwhelming. This curriculum will provide a clear and manageable process to gain the necessary knowledge base, as well as clearly defined and vetted resources to access more information on each topic.”

It’s hoped that the OCC will help physicians not just as residents, but beyond.

“It is our goal that this curriculum will help provide everyone an even playing field to help them be successful not just during residency and preparing for board examinations, but as practicing otolaryngologists,” said Dr. Simons. “We also anticipate that the OCC will be able to be disseminated internationally in the future, to help other countries with otolaryngology education.”

“We welcome anyone interested in learning more about the OCC to regularly visit the webpage at www.entnet.org/education/otolaryngology-core-curriculum for updated information and to reach out to our team with any questions or ideas,” said Dr Merz Lind.    

Cheryl Alkon is a freelance medical writer based in Massachusetts.