{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:21:09Z","timestamp":1785324069464,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,4,26]],"date-time":"2019-04-26T00:00:00Z","timestamp":1556236800000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2019,4,1]],"date-time":"2019-04-01T00:00:00Z","timestamp":1554076800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 DC005356"],"award-info":[{"award-number":["T32 DC005356"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"national institutes of health","doi-asserted-by":"publisher","award":["T32 DC005356"],"award-info":[{"award-number":["T32 DC005356"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Appropriate timing of subspecialty simulation is critical to maximize learner benefit and guide resource utilization. We aimed to determine optimal timing of a simulation\u2010based curriculum designed to teach entry\u2010level procedural skills for otolaryngology residency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Simulation curriculum intervention tested among 3 comparison groups of varying clinical levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic otolaryngology training program and medical school.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>We developed a simulation\u2010based technical skills curriculum incorporating the following task trainers: flexible laryngoscopy, peritonsillar abscess drainage, and myringotomy and tube insertion. Preclinical medical students (n = 40), subintern rotators (n = 35), and midyear interns (n = 8) completed the simulation\u2010based curriculum. Pre\u2010 and postintervention knowledge\/confidence and \u201clevel appropriateness\u201d were rated on a 5\u2010point Likert scale, and effect size was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall self\u2010reported knowledge\/confidence levels improved in all 3\u00a0groups preintervention (1.05, 2.15, 3.17) to postintervention (2.79, 3.45, 4.38, respectively; all <jats:italic>P<\/jats:italic> &lt;. 01). Preclinical medical students uniformly reported very little to no familiarity with the procedures prior to the curriculum, while interns approached independence following the intervention. Large effect sizes were seen in all tasks for preclinical students (<jats:italic>d<\/jats:italic> = 3.13), subinterns (<jats:italic>d<\/jats:italic> = 1.46), and interns (<jats:italic>d<\/jats:italic> = 2.14). Five\u2010point Likert scale measures of level appropriateness (1 = too challenging, 5 = too easy) for preclinical students, subinterns, and interns were 2.70 (95% CI, 2.56\u20102.84), 3.11 (95% CI, 2.97\u20103.25), and 3.75 (95% CI, 3.35\u20104.15), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Subinternship may represent the optimal timing for entry\u2010level skills simulation training. The proposed curriculum shows utility for clinical levels ranging from medical students to postgraduate year 1 resident levels, with large effect sizes for all tested groups.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2473974x19845851","type":"journal-article","created":{"date-parts":[[2019,4,26]],"date-time":"2019-04-26T20:58:29Z","timestamp":1556312309000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Optimal Timing of Entry\u2010Level Otolaryngology Simulation"],"prefix":"10.1002","volume":"3","author":[{"given":"Kevin J.","family":"Kovatch","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aileen P.","family":"Wertz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology\u2013Head and Neck Surgery Children\u2019s Hospital of Philadelphia Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor R.","family":"Carle","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren A.","family":"Bohm","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc C.","family":"Thorne","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M.","family":"Malloy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,4,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3402\/meo.v17i0.18398"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/msj.20301"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12391"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG-D-14-00004.1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2017.05.012"},{"key":"e_1_2_9_7_1","unstructured":"Accreditation Council for Graduate Medical Education.ACGME program requirements for graduate medical education in otolaryngology.https:\/\/www.acgme.org\/Portals\/0\/280_otolaryngology_PRs_RC.pdf. 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