ABSTRACT
OBJECTIVES: To determine how standard residency training and educational background affect otolaryngology resident auditory-perceptual judgments compared with inexperienced listeners. A secondary aim was to assess the impact of a brief training session on the reliability of judgments among otolaryngology residents. STUDY DESIGN: Mixed cross-sectional and cohort study. METHODS: Twenty adult dysphonic and four normal speaker samples were selected from a database. Fifteen listeners at various stages of residency in otolaryngology judged all samples for breathiness and roughness using visual analog scales. Fifteen inexperienced listeners judged the same samples. Subsequently, 12 otolaryngology residents underwent a brief training session. During training, listeners were provided definitions of rating dimensions and accuracy feedback while rating 20 novel (training) stimuli. The feedback included averaged responses from experienced clinicians who had previously evaluated the same speech samples. The residents then completed posttraining evaluations. RESULTS: As a group, otolaryngology resident listeners had significantly better interrater agreement for judgments of roughness compared with inexperienced listeners (P<0.05) and trended toward better interrater agreement for judgments of breathiness (P=0.058). Posttraining, no significant improvement in interrater agreement for judgments of roughness was observed; however, a significant improvement was found in interrater agreement of judgments of breathiness (P<0.05). CONCLUSIONS: Compared with inexperienced (untrained) listeners, otolaryngology resident listeners had better interrater agreement overall for judgments of dysphonia. A short training module was associated with improved reliability in resident evaluation of breathiness. Results have implications for improving and standardizing resident evaluation of dysphonia.
Subject(s)
Auditory Perception , Clinical Competence , Dysphonia/diagnosis , Education, Medical, Graduate , Internship and Residency , Judgment , Otolaryngology/education , Speech Production Measurement , Voice Quality , Adolescent , Adult , Aged , Aged, 80 and over , Clinical Competence/standards , Cross-Sectional Studies , Dysphonia/physiopathology , Dysphonia/psychology , Education, Medical, Graduate/standards , Feedback, Psychological , Female , Humans , Internship and Residency/standards , Male , Middle Aged , Observer Variation , Otolaryngology/standards , Reproducibility of Results , Speech Production Measurement/standards , Washington , Young AdultABSTRACT
OBJECTIVES: The patency and volume of the nasal cavity affect the acoustic characteristics of the voice. The aim of this study was to investigate the effect of a nasal decongestant on nasal volumes and nasalance scores, and to determine the relationship between these measures. METHODS: Acoustic rhinometry and nasometry were performed in a group of 21 adult volunteers both prior to and following application of a nasal decongestant. The relationship between changes in nasalance scores and acoustic rhinometric parameters was investigated. RESULTS: After the application of nasal decongestant, statistically significant increases were observed in nasalance scores and in all of the acoustic rhinometric parameters assessed (i.e. minimal cross-sectional area, three cross-sectional areas, three volumes and total volume). However, no significant correlation was found between the changes in nasalance scores and acoustic rhinometric parameters. CONCLUSIONS: Nasal decongestion causes an increase in nasalance scores and nasal cavity volumes. However, the findings of this study indicate that changes in nasalance scores may result from factors other than nasal cavity volume changes.
