Quality-assured training in the evaluation of cochlear implant electrode position: a prospective experimental study

BMC Med Educ. 2022 May 20;22(1):386. doi: 10.1186/s12909-022-03464-x.

Abstract

Background: The objective of this study was to demonstrate the utility of an approach in training predoctoral medical students, to enable them to measure electrode-to-modiolus distances (EMDs) and insertion-depth angles (aDOIs) in cochlear implant (CI) imaging at the performance level of a single senior rater.

Methods: This prospective experimental study was conducted on a clinical training dataset comprising patients undergoing cochlear implantation with a Nucleus® CI532 Slim Modiolar electrode (N = 20) or a CI512 Contour Advance electrode (N = 10). To assess the learning curves of a single medical student in measuring EMD and aDOI, interrater differences (senior-student) were compared with the intrarater differences of a single senior rater (test-retest). The interrater and intrarater range were both calculated as the distance between the 0.1th and 99.9th percentiles. A "deliberate practice" training approach was used to teach knowledge and skills, while correctives were applied to minimize faulty data-gathering and data synthesis.

Results: Intrarater differences of the senior rater ranged from - 0.5 to 0.5 mm for EMD and - 14° to 16° for aDOI (respective medians: 0 mm and 0°). Use of the training approach led to interrater differences that matched this after the 4th (EMD) and 3rd (aDOI) feedback/measurement series had been provided to the student.

Conclusions: The training approach enabled the student to evaluate the CI electrode position at the performance level of a senior rater. This finding may offer a basis for ongoing clinical quality assurance for the assessment of CI electrode position.

Keywords: Angular depth of insertion; Cochlear implant; Electrode position; Electrode-to-modiolus distance; Quality assurance.

MeSH terms

  • Cochlea / surgery
  • Cochlear Implantation* / methods
  • Cochlear Implants*
  • Electrodes, Implanted
  • Humans
  • Prospective Studies