Safe surgical training: evaluation of a national functional endoscopic sinus surgery model simulation course using the Kirkpatrick evaluation model.

BACKGROUND: Simulation is a rapidly developing field in modern undergraduate skills education and postgraduate surgical training. AIM: We aim to evaluate simulation training as a tool for higher surgical training in functional endoscopic sinus surgery (FESS) using the Kirkpatrick evaluation model. METHODS: This was a prospective cohort study in which a qualitative survey and multiple-choice questionnaire were distributed to otolaryngology trainees pre- and post-FESS training course using simulation models. Participants' reactions and interpretations of the models were assessed. Pre- and post-simulation knowledge and subjective skills were assessed. RESULTS: A total of 21 trainees completed the course. Trainees reported simulation models to be accurate representations of human anatomy 95% and easy to use 90%. There was an improvement in anatomical 54 to 62% (Z = 76, p0.03) and procedural 65 to 72% (Z = 87, p0.03) knowledge overall. CONCLUSION: Simulation training is an effective method of postgraduate education. This has been particularly useful following reduced operative exposure in the COVID-19 era.

The Effect of the 2021 Irish Cyber-Attack on Otolaryngology Outpatient Non-attendance at a Model 4 Hospital in the Post-COVID Era.

Aim This study investigates the rate of non-attendance at ENT outpatient appointments in the post-COVID era and the effect of the 2021 Irish cyber-attack on non-attendance. Methods A retrospective review of the rates of non-attendance in a post-COVID pre-cyber-attack era wherein patients received an automated text message reminder about their appointment was compared to a post-cyber-attack era wherein the text message reminder system was disabled. In addition, these were compared with rates of non-attendance prior to when the reminder system was introduced. Three periods were compared, two weeks prior to the introduction of the text reminder system, two weeks pre-cyber-attack, and two weeks post-cyber-attack. Results Period 1 measured rates of non-attendance prior to the introduction of the text reminder system. Period 2 measured rates of non-attendance at outpatient appointments and consisted of nine clinic days, with two clinics per day. Period 3 similarly measured rates of non-attendance at outpatient appointments and consisted of 10 clinic days, with two clinics per day. The text reminder service was disabled during this collection period because of the cyber-attack. The average non-attendance rate was 16.99% for period 1, 13.00% for period 2, and 16.13% for period 3. A Fisher Exact Test was carried out on data with a p-value set at <0.05. Results reached statistical significance. Conclusion Our data shows non-attendance at ENT outpatient appointments increased without the text reminder system. Over two weeks after the attack, non-attendance increased by approximately 3%, which was statistically significant.

COVID-19 pandemic: Effects and evidence-based recommendations for otolaryngology and head and neck surgery practice.

The 2019 novel coronavirus disease (COVID-19) is a highly contagious zoonosis produced by SARS-CoV-2 that is spread human-to-human by respiratory secretions. It was declared by the WHO as a public health emergency. The most susceptible populations, needing mechanical ventilation, are the elderly and people with associated comorbidities. There is an important risk of contagion for anesthetists, dentists, head and neck surgeons, maxillofacial surgeons, ophthalmologists, and otolaryngologists. Health workers represent between 3.8% and 20% of the infected population; some 15% will develop severe complaints and among them, many will lose their lives. A large number of patients do not have overt signs and symptoms (fever/respiratory), yet pose a real risk to surgeons (who should know this fact and must therefore apply respiratory protective strategies for all patients they encounter). All interventions that have the potential to aerosolize aerodigestive secretions should be avoided or used only when mandatory. Health workers who are: pregnant, over 55 to 65 years of age, with a history of chronic diseases (uncontrolled hypertension, diabetes mellitus, chronic obstructive pulmonary diseases, and all clinical scenarios where immunosuppression is feasible, including that induced to treat chronic inflammatory conditions and organ transplants) should avoid the clinical attention of a potentially infected patient. Health care facilities should prioritize urgent and emergency visits and procedures until the present condition stabilizes; truly elective care should cease and discussed on a case-by-case basis for patients with cancer. For those who are working with COVID-19 infected patients' isolation is compulsory in the following settings: (a) unprotected close contact with COVID-19 pneumonia patients; (b) onset of fever, cough, shortness of breath, and other symptoms (gastrointestinal complaints, anosmia, and dysgeusia have been reported in a minority of cases). For any care or intervention in the upper aerodigestive tract region, irrespective of the setting and a confirmed diagnosis (eg, rhinoscopy or flexible laryngoscopy in the outpatient setting and tracheostomy or rigid endoscopy under anesthesia), it is strongly recommended that all health care personnel wear personal protective equipment such as N95, gown, cap, eye protection, and gloves. The procedures described are essential in trying to maintain safety of health care workers during COVID-19 pandemic. In particular, otolaryngologists, head and neck, and maxillofacial surgeons are per se exposed to the greatest risk of infection while caring for COVID-19 positive subjects, and their protection should be considered a priority in the present circumstances.