Virtual Resident Mentorship Groups for Fourth Year Medical Students Applying into Otolaryngology-Head and Neck Surgery.

OBJECTIVE: To create a longitudinal near-peer mentorship program for medical students applying to otolaryngology. METHODS: A program for longitudinal near-peer mentorship was designed based on a needs analysis of senior medical students. Program objectives were to (1) provide didactic education on common otolaryngology consults, (2) facilitate resident-student networking, and (3) enable applicants to meet other students. Senior otolaryngology residents were matched with medical students from across the United States applying to otolaryngology for a series of online small group meetings. Sessions included resident-designed didactics covering high-yield clinical scenarios and a mentorship component focused on transition to residency topics. Program evaluation included anonymized pre- and post-tests for each didactic session and an anonymous post-program participant survey. RESULTS: There were 40 student participants from across the United States, with an average attendance of 73% of sessions per participant. Performance on didactic testing improved for 2 of the 3 sessions. Participants stated they would be very likely to recommend each session to another student in the future (4.96/5.00, obs = 155). Participants stated the most valuable part of the program was interacting with residents (82% of responses), transition to residency advice (28%), and learning about otolaryngology consults (28%). Suggestions for improvement included expanding content, increasing the number of sessions, and involving additional faculty and residents. CONCLUSION: A longitudinal virtual experience can be valuable for near-peer mentorship for medical students applying to otolaryngology.

Hearing Loss and Healthcare Access among Adults.

Hearing loss (HL) is common among individuals aged 50 and older and is associated with increased healthcare costs. Whether HL is associated with less access to healthcare is unclear. In this study, we examined the association between HL and access to medical care and prescription drugs among individuals 50+ with and without HL. We used nationally representative 2013-2014 Medical Expenditure Panel Survey data, consisting of 1,977 adults with HL and 17,399 without. We applied an inverse propensity score weighting and regression modeling to adjust for any potential differences in health and socioeconomic conditions between the two groups. Adults with HL were more likely to be white, less educated, poorer, and with public insurance ( p < 0.001). They were also likely to have hypertension, heart disease, stroke, emphysema, high cholesterol, diabetes, joint pain, and arthritis ( p < 0.001). The odds of reporting unmet medical needs (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 1.29-2.66), delay in getting medical needs met (OR = 1.37; 95% CI = 1.00-1.87), and having unfilled prescriptions (OR = 1.81; 95% CI = 1.27-2.59) were higher among individuals with HL compared with their counterparts without HL. Individuals with HL have less access to care and prescription drugs. To ensure equitability in access, public health policies should address specific needs of people with HL.

Development of a 60/60 Guideline for Referring Adults for a Traditional Cochlear Implant Candidacy Evaluation.

OBJECTIVE: To evaluate the effectiveness of a 60/60 referral guideline for identifying patients who should be referred for a cochlear implant candidacy evaluation (CICE), which states patients should be referred if they demonstrate a best ear unaided monosyllabic word score less than or equal to 60% correct and if they demonstrate an unaided pure-tone average in their better ear that is greater than or equal to 60 dB HL. STUDY DESIGN: Retrospective review of data from adults who participated in a CICE. SETTING: A single tertiary medical facility. PATIENTS: Five hundred twenty-nine patients who participated in a CICE. INTERVENTION: CICEs included unaided threshold assessment, unaided speech recognition, and aided word and sentence testing. MAIN OUTCOME MEASURE: Ninety-five percent of patients who met traditional indications for a cochlear implant (n = 250) had a pure-tone average that was greater than or equal to 60 dB, while 92% had a better ear unaided monosyllabic word score that was less than or equal to 60%. RESULTS: If used as a screening measure, the 60/60 measure resulted in a 96% detection rate and a 34% false-positive rate for identifying adults who would meet traditional indications for a cochlear implant. CONCLUSIONS: Hearing professionals should consider referring patients for a CICE when they meet the 60/60 guideline. It is hoped that provision of this guideline will result in greater numbers of adults being referred for CICEs, improving access to cochlear implants for patients who may benefit from this important technology.