A survey of Queensland medical education in otolaryngology

Abstract

Background: Little literature exists examining the effectiveness and adequacy of otolaryngology teaching during undergraduate training within Australia. This education influences preparedness of interns particularly during their emergency terms but may also contribute to career choices later in professional life. This study used a questionnaire to examine interns' perceptions of previous teaching opportunities and correlates this with their perceived knowledge of otolaryngology. Methods: The study was designed as a prospective cohort study. A survey of Queensland Health sites with medical interns was conducted from the second half of 2019 to the first half of 2020. Data were collected regarding exposure to otolaryngology in medical school and self-reported competence across several domains of clinical knowledge and skills. The statistical analysis included calculation of observational statistics and secondary analysis using 2-sample t-tests. Results: There were 106 respondents across 6 hospitals, with 97 interns included in the final sample. A majority of interns (88%) had one week or less of otolaryngology teaching during medical school. As few as 31% of interns spent time attached to a specialist otolaryngology service in medical school, and within this cohort the duration of placement was typically between 1-4 weeks. At baseline, interns self-reported low competence in clinical skills, diagnosis and management of otolaryngology conditions. Interns who had received more otolaryngology teaching self-reported higher levels of competence in clinical skills compared to those who did not (P=0.017). Those who had placement with a specialist otolaryngology service also self-reported better clinical skills compared to those who did not (P=0.008). For self-reported competence in diagnosis and management no significant difference was observed between groups according to amount of teaching received (P=0.123), or placement attached to a specialist otolaryngology service (P=0.321). Conclusions: In spite of the high prevalence of otolaryngology presentations in the emergency department (ED) and general practice, interns report low competence in their clinical skills, diagnosis and management. More otolaryngology teaching and an attachment to a specialist otolaryngology service during medical school are associated with improved self-rated competence in clinical skills.