Simulation in Otolaryngology

  • Luv Javia
  • Maya G. Sardesai
  • Ellen S. DeutschEmail author
Part of the Comprehensive Healthcare Simulation book series (CHS)


Otolaryngologists have been at the forefront of creatively using simulation to enhance education, research, and system processes and are now at the forefront of developing simulators and expanding the field of simulation. Airway simulators have been used for almost 100 years, otology simulators for about 70 years, and soft tissue simulators for more than 30 years. Simulation has blossomed with a contemporary understanding of educational principles and quickly evolving methods of simulator fabrication. Simulators are being used in otology, sinus and rhinology, and airway and head and neck surgical skill development. Simulation is also being used to improve professionalism and teamwork skills and even to improve the systems we work within. This chapter provides a glimpse into the rapid growth of simulation in the field of otolaryngology and head and neck surgery.


Surgical simulation Airway task training Sinus task training Otology task training Otolaryngology education ENT simulation Interprofessional education Patient education 


  1. 1.
  2. 2.
    History: Jackson speaks Accessed 4/26/2012, 2012.
  3. 3.
    House ear institute: About.
  4. 4.
    Cook T, editor. Basic soft tissue surgery. Spokane: American Academy of Facial Plastic and Reconstructive Surgery; 1982.Google Scholar
  5. 5.
    Wiet GJ, Stredney D, Kerwin T, et al. Virtual temporal bone dissection system: OSU virtual temporal bone system: development and testing. Laryngoscope. 2012;122(Suppl 1):S1–12.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Fried MP, Sadoughi B, Gibber MJ, et al. From virtual reality to the operating room: the endoscopic sinus surgery simulator experiment. Otolaryngol Head Neck Surg. 2010;142(2):202–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Johnson K, Geis G, Oehler J, et al. Simulation to implement a novel system of care for pediatric critical airway obstruction. Arch Otolaryngol Head Neck Surg. 2012;138(10):907–11.CrossRefPubMedGoogle Scholar
  8. 8.
    Lee DJ, Fu TS, Carrillo B, Campisi P, Forte V, Chiodo A. Evaluation of an otoscopy simulator to teach otoscopy and normative anatomy to first year medical students. Laryngoscope. 2015;125(9):2159–62.CrossRefPubMedGoogle Scholar
  9. 9.
    Chiesa Estomba CM, Melendez Garcia JM, Hamdam Zavarce MI, Betances Reinoso FA. The vigo grommet trainer. Eur Ann Otorhinolaryngol Head Neck Dis. 2015;132(1):53–5.CrossRefPubMedGoogle Scholar
  10. 10.
    Volsky PG, Hughley BB, Peirce SM, Kesser BW. Construct validity of a simulator for myringotomy with ventilation tube insertion. Otolaryngol Head Neck Surg. 2009;141(5):603–8.e1.Google Scholar
  11. 11.
    Malekzadeh S, Hanna G, Wilson B, Pehlivanova M, Milmoe G. A model for training and evaluation of myringotomy and tube placement skills. Laryngoscope. 2011;121(7):1410–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Clark MPA, Westerberg BD, Mitchell JE. Development and validation of a low cost microsurgery ear trainer for low-resource settings. J Laryngol Otol. 2016;130:954–61.CrossRefPubMedGoogle Scholar
  13. 13.
    Wheeler B, Doyle PC, Chandarana S, Agrawal S, Husein M, Ladak HM. Interactive computer-based simulator for training in blade navigation and targeting in myringotomy. Comput Methods Prog Biomed. 2010;98(2):130–9.CrossRefGoogle Scholar
  14. 14.
    Sowerby LJ, Rehal G, Husein M, Doyle PC, Agrawal S, Ladak HM. Development and face validity testing of a three-dimensional myringotomy simulator with haptic feedback. J Otolaryngol Head Neck Surg. 2010;39(2):122–9.PubMedGoogle Scholar
  15. 15.
    Ho AK, Alsaffar H, Doyle PC, Ladak HM, Agrawal SK. Virtual reality myringotomy simulation with real-time deformation: development and validity testing. Laryngoscope. 2012;122(8):1844–51.CrossRefPubMedGoogle Scholar
  16. 16.
    Monfared A, Mitteramskogler G, Gruber S, Salisbury JK Jr, Stampfl J, Blevins NH. High-fidelity, inexpensive surgical middle ear simulator. Otol Neurotol. 2012;33(9):1573–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Barber SR, Kozin ED, Dedmon M, et al. 3D-printed pediatric endoscopic ear surgery simulator for surgical training. Int J Pediatr Otorhinolaryngol. 2016;90:113–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Anschuetz L, Bonali M, Ghirelli M, et al. An ovine model for exclusive endoscopic ear surgery. JAMA Otolaryngol Head Neck Surg. 2017;143(3):247–52.Google Scholar
  19. 19.
    Awad Z, Ahmed S, Taghi AS, et al. Feasibility of a synthetic temporal bone for training in mastoidectomy: face, content, and concurrent validity. Otol Neurotol. 2014;35(10):1813–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Da Cruz MJ, Francis HW. Face and content validation of a novel three-dimensional printed temporal bone for surgical skills development. J Laryngol Otol. 2015;129(Suppl 3):S23–9.CrossRefPubMedGoogle Scholar
  21. 21.
    Mick PT, Arnoldner C, Mainprize JG, Symons SP, Chen JM. Face validity study of an artificial temporal bone for simulation surgery. Otol Neurotol. 2013;34(7):1305–10.CrossRefPubMedGoogle Scholar
  22. 22.
    Mowry SE, Jammal H, Myer C, Solares CA, Weinberger P. A novel temporal bone simulation model using 3D printing techniques. Otol Neurotol. 2015;36(9):1562–5.CrossRefPubMedGoogle Scholar
  23. 23.
    Hochman JB, Rhodes C, Wong D, Kraut J, Pisa J, Unger B. Comparison of cadaveric and isomorphic three-dimensional printed models in temporal bone education. Laryngoscope. 2015;125(10):2353–7.CrossRefPubMedGoogle Scholar
  24. 24.
    Rose AS, Kimbell JS, Webster CE, Harrysson OLA, Formeister EJ, Buchman CA. Multi-material 3D models for temporal bone surgical simulation. Ann Otol Rhinol Laryngol. 2015;124(7):528–36.CrossRefPubMedGoogle Scholar
  25. 25.
    Andersen SAW, Caye-Thomasen P, Sorensen MS. Mastoidectomy performance assessment of virtual simulation training using final-product analysis. Laryngoscope. 2015;125(2):431–5.CrossRefPubMedGoogle Scholar
  26. 26.
    Zirkle M, Roberson DW, Leuwer R, Dubrowski A. Using a virtual reality temporal bone simulator to assess otolaryngology trainees. Laryngoscope. 2007;117(2):258–63.CrossRefPubMedGoogle Scholar
  27. 27.
    Wiet GJ, Stredney D, Sessanna D, Bryan JA, Bradley Welling D, Schmalbrock P. Virtual temporal bone dissection: an interactive surgical simulator. Otolaryngol Head Neck Surg. 2002;127(1):79–83.CrossRefPubMedGoogle Scholar
  28. 28.
    Sewell C, Morris D, Blevins NH, et al. Providing metrics and performance feedback in a surgical simulator. Comput Aided Surg. 2008;13(2):63–81.CrossRefPubMedGoogle Scholar
  29. 29.
    Zhao YC, Kennedy G, Yukawa K, Pyman B, O’Leary S. Can virtual reality simulator be used as a training aid to improve cadaver temporal bone dissection? results of a randomized blinded control trial. Laryngoscope. 2011;121(4):831–7.CrossRefPubMedGoogle Scholar
  30. 30.
    Tolisano AM, Justin GA, Ruhl DS, Cable BB. Rhinology and medical malpractice: an update of the medicolegal landscape of the last ten years. Laryngoscope. 2016;126(1):14–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Gross RD, Sheridan MF, Burgess LP. Endoscopic sinus surgery complications in residency. Laryngoscope. 1997;107(8):1080–5.CrossRefPubMedGoogle Scholar
  32. 32.
    Awad Z, Touska P, Arora A, Ziprin P, Darzi A, Tolley NS. Face and content validity of sheep heads in endoscopic rhinology training. Int Forum Allergy Rhinol. 2014;4(10):851–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Ianacone DC, Gnadt BJ, Isaacson G. Ex vivo ovine model for head and neck surgical simulation. Am J Otolaryngol Head Neck Med Surg. 2016;37:272–8.Google Scholar
  34. 34.
    Edmond CV Jr. Impact of the endoscopic sinus surgical simulator on operating room performance. Laryngoscope. 2002;112(7 I):1148–58.CrossRefPubMedGoogle Scholar
  35. 35.
    Agbetoba A, Luong A, Siow JK, et al. Educational utility of advanced three-dimensional virtual imaging in evaluating the anatomical configuration of the frontal recess. Int Forum Allergy Rhinol. 2016;
  36. 36.
    Glaser AY, Hall CB, Uribe SJI, Fried MP. Medical students’ attitudes toward the use of an endoscopic sinus surgery simulator as a training tool. Am J Rhinol. 2006;20(2):177–9.CrossRefPubMedGoogle Scholar
  37. 37.
    Solyar A, Cuellar H, Sadoughi B, Olson TR, Fried MP. Endoscopic sinus surgery simulator as a teaching tool for anatomy education. Am J Surg. 2008;196(1):120–4.CrossRefPubMedGoogle Scholar
  38. 38.
    Ecke U, Klimek L, Muller W, Ziegler R, Mann W. Virtual reality: preparation and execution of sinus surgery. Comput Aided Surg. 1998;3(1):45–50.CrossRefPubMedGoogle Scholar
  39. 39.
    Caversaccio M, Eichenberger A, Hausler R. Virtual simulator as a training tool for endonasal surgery. Am J Rhinol. 2003;17(5):283–90.CrossRefPubMedGoogle Scholar
  40. 40.
    Tolsdorff B, Pommert A, Hohne KH, et al. Virtual reality: a new paranasal sinus surgery simulator. Laryngoscope. 2010;120(2):420–6.PubMedGoogle Scholar
  41. 41.
    Arora A, Lau LYM, Awad Z, Darzi A, Singh A, Tolley N. Virtual reality simulation training in otolaryngology. Int J Surg. 2014;12(2):87–94.CrossRefPubMedGoogle Scholar
  42. 42.
    Fried MP, Sadoughi B, Weghorst SJ, et al. Construct validity of the endoscopic sinus surgery simulator: II. Assessment of discriminant validity and expert benchmarking. Arch Otolaryngol Head Neck Surg. 2007;133(4):350–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Satava RM, Fried MP. A methodology for objective assessment of errors: an example using an endoscopic sinus surgery simulator. Otolaryngol Clin N Am. 2002;35(6):1289–301.CrossRefGoogle Scholar
  44. 44.
    Arora H, Uribe J, Ralph W, et al. Assessment of construct validity of the endoscopic sinus surgery simulator. Arch Otolaryngol Head Neck Surg. 2005;131(3):217–21.CrossRefPubMedGoogle Scholar
  45. 45.
    Gallagher AG, Cowie R, Crothers I, Jordan-Black J, Satava RM. PicSOr: an objective test of perceptual skill that predicts laparoscopic technical skill in three initial studies of laparoscopic performance. Surg Endosc. 2003;17(9):1468–71.CrossRefPubMedGoogle Scholar
  46. 46.
    Fried MP, Satava R, Weghorst S, et al. Identifying and reducing errors with surgical simulation. Qual Saf Health Care. 2004;13(Suppl 1):19–26.CrossRefGoogle Scholar
  47. 47.
    Uribe JI, Ralph WMJ, Glaser AY, Fried MP. Learning curves, acquisition, and retention of skills trained with the endoscopic sinus surgery simulator. Am J Rhinol. 2004;18(2):87–92.CrossRefPubMedGoogle Scholar
  48. 48.
    Malekzadeh S, Pfisterer MJ, Wilson B, Na H, Steehler MK. A novel low-cost sinus surgery task trainer. Otolaryngol Head Neck Surg. 2011;145(4):530–3.CrossRefPubMedGoogle Scholar
  49. 49.
    Steehler MK, Chu EE, Na H, Pfisterer MJ, Hesham HN, Malekzadeh S. Teaching and assessing endoscopic sinus surgery skills on a validated low-cost task trainer. Laryngoscope. 2013;123(4):841–4.CrossRefPubMedGoogle Scholar
  50. 50.
    Harbison RA, Johnson K, Miller C, Sardesai M, Davis GE. Face, content, and construct validation of a low-cost, non-biologic, sinus surgery task trainer and knowledge-based curriculum. Int Forum Allergy Rhinol. 2016;
  51. 51.
    Deutsch ES, Christenson T, Curry J, Hossain J, Zur K, Jacobs I. Multimodality education for airway endoscopy skill development. Ann Otol Rhinol Laryngol. 2009;118(2):81–6.CrossRefPubMedGoogle Scholar
  52. 52.
    Tompkins JJ. Use of simulation boot camps to train junior otolaryngology residents: a resident’s testimonial. JAMA Otolaryngol Head Neck Surg. 2014;140(5):1–2.CrossRefPubMedGoogle Scholar
  53. 53.
    Howells TH, Emery FM, Twentyman JE. Endotracheal intubation training using a simulator. An evaluation of the Laerdal adult intubation model in the teaching of endotracheal intubation. Br J Anaesth. 1973;45(4):400–2.CrossRefPubMedGoogle Scholar
  54. 54.
    Sawyer T, Strandjord TP, Johnson K, Low D. Neonatal airway simulators, how good are they? A comparative study of physical and functional fidelity. J Perinatol. 2016;36(2):151–6.CrossRefPubMedGoogle Scholar
  55. 55.
    Hesselfeldt R, Kristensen MS, Rasmussen LS. Evaluation of the airway of the SimMan full-scale patient simulator. Acta Anaesthesiol Scand. 2005;49(9):1339–45.CrossRefPubMedGoogle Scholar
  56. 56.
    Schebesta K, Hupfl M, Ringl H, Machata A, Chiari A, Kimberger O. A comparison of paediatric airway anatomy with the SimBaby high-fidelity patient simulator. Resuscitation. 2011;82(4):468–72.CrossRefPubMedGoogle Scholar
  57. 57.
    Dedmon MM, Paddle PM, Phillips J, Kobayashi L, Franco RA, Song PC. Development and validation of a high-fidelity porcine laryngeal surgical simulator. Otolaryngol Head Neck Surg. 2015;153(3):420–6.CrossRefPubMedGoogle Scholar
  58. 58.
    Amin M, Rosen CA, Simpson CB, Postma GN. Hands-on training methods for vocal fold injection education. Ann Otol Rhinol Laryngol. 2007;116(1):1–6.CrossRefPubMedGoogle Scholar
  59. 59.
    Fleming J, Kapoor K, Sevdalis N, Harries M. Validation of an operating room immersive microlaryngoscopy simulator. Laryngoscope. 2012;122(5):1099–103.CrossRefPubMedGoogle Scholar
  60. 60.
    Ross PD, Steven R, Zhang D, Li H, Abel EW. Computer-assessed performance of psychomotor skills in endoscopic otolaryngology surgery: construct validity of the Dundee endoscopic psychomotor otolaryngology surgery trainer (DEPOST). Surg Endosc. 2015;29(11):3125–31.CrossRefPubMedGoogle Scholar
  61. 61.
    Ainsworth TA, Kobler JB, Loan GJ, Burns JA. Simulation model for transcervical laryngeal injection providing real-time feedback. Ann Otol Rhinol Laryngol. 2014;123(12):881–6.CrossRefPubMedGoogle Scholar
  62. 62.
    Contag SP, Klein AM, Blount AC, Johns MM III. Validation of a laryngeal dissection module for phonomicrosurgical training. Laryngoscope. 2009;119(1):211–5.CrossRefPubMedGoogle Scholar
  63. 63.
    Holliday MA, Bones VM, Malekzadeh S, Grant NN. Low-cost modular phonosurgery training station: development and validation. Laryngoscope. 2015;125(6):1409–13.CrossRefPubMedGoogle Scholar
  64. 64.
    Cabrera-Muffly C, Clary MS, Abaza M. A low-cost transcervical laryngeal injection trainer. Laryngoscope. 2016;126(4):901–5.CrossRefPubMedGoogle Scholar
  65. 65.
    Broadhurst MS, Kobler JB, Burns JA, Anderson RR, Zeitels SM. Chick chorioallantoic membrane as a model for simulating human true vocal folds. Ann Otol Rhinol Laryngol. 2007;116(12):917–21.CrossRefPubMedGoogle Scholar
  66. 66.
    Rowe R, Cohen RA. An evaluation of a virtual reality airway simulator. Anesth Analg. 2002;95(1):62–6.CrossRefPubMedGoogle Scholar
  67. 67.
    Mandal S, Patel ARC, Goldring JJP. A simulated bronchoscopy course for new specialist trainees. Thorax. 2010;65:A117.CrossRefGoogle Scholar
  68. 68.
    Patel ARC, Mandal S, Goldring JJP. Simulated bronchoscopy training delivered by experienced peers improves confidence of new trainees. Thorax. 2010;65:A116.CrossRefGoogle Scholar
  69. 69.
    Pastis NJ, Vanderbilt AA, Tanner NT, et al. Construct validity of the simbionix bronch mentor simulator for essential bronchoscopic skills. J Bronchology Interv Pulmonol. 2014;21(4):314–21.CrossRefPubMedGoogle Scholar
  70. 70.
    Vaidyanath C, Sharma M, Mistry V, Mendonca C. ORSIM bronchoscopy simulator improves psychomotor skills for fibreoptic intubation amongst novices. Br J Anaesth. 2013;111(4):684–91.CrossRefGoogle Scholar
  71. 71.
    Bronchoscopy simulator. Updated 2016.
  72. 72.
    Scott GM, Roth K, Rotenberg B, Sommer DD, Sowerby L, Fung K. Evaluation of a novel high-fidelity epistaxis task trainer. Laryngoscope. 2016;126(7):1501–3.CrossRefPubMedGoogle Scholar
  73. 73.
    Pettineo CM, Vozenilek JA, Kharasch M, Wang E, Aitchison P. Epistaxis simulator. Simul Healthc. 2008;3(4):239–41.CrossRefPubMedGoogle Scholar
  74. 74.
    Pearson CR, Wallace HC. The tonsil cup: a simple teaching aid for tonsillectomy. J Laryngol Otol. 1997;111(11):1064–5.CrossRefPubMedGoogle Scholar
  75. 75.
    Duodu J, Lesser THJ. Tonsil tie simulator. J Laryngol Otol. 2013;127(9):924–6.CrossRefPubMedGoogle Scholar
  76. 76.
    Street I, Beech T, Jennings C. The Birmingham trainer: a simulator for ligating the lower tonsillar pole. Clin Otolaryngol. 2006;31(1):79.CrossRefPubMedGoogle Scholar
  77. 77.
    Raja MK, Haneefa MA, Chidambaram A. Yorick’s skull model for tonsillectomy tie training. Clin Otolaryngol. 2008;33(2):187–8.CrossRefPubMedGoogle Scholar
  78. 78.
    Ruthenbeck GS, Tan SB, Carney AS, Hobson JC, Reynolds KJ. A virtual-reality subtotal tonsillectomy simulator. J Laryngol Otol. 2012;126(Suppl 2):S8–13.CrossRefPubMedGoogle Scholar
  79. 79.
    Bunting H, Wilson BM, Malloy KM, Malekzadeh S. A novel peritonsillar abscess simulator. Simul Healthc. 2015;10(5):320–5.CrossRefPubMedGoogle Scholar
  80. 80.
    Taylor SR, Chang CWD. Gelatin facial skin simulator for cutaneous reconstruction. Otolaryngol Head Neck Surg. 2016;154(2):279–81.CrossRefPubMedGoogle Scholar
  81. 81.
    Giblett N, Hari C. Introducing a realistic and reusable quinsy simulator. J Laryngol Otol. 2016;130(2):201–3.CrossRefPubMedGoogle Scholar
  82. 82.
    Walliczek U, Förtsch A, Dworschak P, et al. Effect of training frequency on the learning curve on the da Vinci skills simulator. Head Neck. 2016;38(S1):E1762–9.CrossRefPubMedGoogle Scholar
  83. 83.
    Walliczek-Dworschak U, Mandapathil M, Förtsch A, et al. Structured training on the da Vinci skills simulator leads to improvement in technical performance of robotic novices. Clin Otolaryngol. 2016;42(1).
  84. 84.
    Zhang N, Sumer BD. Transoral robotic surgery: simulation-based standardized training. JAMA Otolaryngol Head Neck Surg. 2013;139(11):1111–7.CrossRefPubMedGoogle Scholar
  85. 85.
    Sperry SM, O'Malley BWJ, Weinstein GS. The university of Pennsylvania curriculum for training otorhinolaryngology residents in transoral robotic surgery. ORL J Otorhinolaryngol Relat Spec. 2014;76(6):342–52.CrossRefPubMedGoogle Scholar
  86. 86.
    Janus JR, Hamilton GS. The use of open-cell foam and elastic foam tape as an affordable skin simulator for teaching suture technique. JAMA Facial Plast Surg. 2013;15(5):385–7.CrossRefPubMedGoogle Scholar
  87. 87.
    Gilmour A, Taghizadeh R, Payne CE. The educational hand and head: novel teaching tools in the design and execution of local flaps. J Plast Reconstr Aesthet Surg. 2012;65(7):981–2.CrossRefPubMedGoogle Scholar
  88. 88.
    Souza IA, Sanches CJ, Zuffo MK. A virtual reality simulator for training of needle biopsy of thyroid gland nodules. Stud Health Technol Inform. 2009;142:352–7.PubMedGoogle Scholar
  89. 89.
    Griffin GR, Rosenbaum S, Hecht S, Sun GH. Development of a moderate fidelity neck-dissection simulator. Laryngoscope. 2013;123(7):1682–5.CrossRefPubMedGoogle Scholar
  90. 90.
    Allak A, Liu YE, Oliynyk MS, Weng KH, Jameson MJ, Shonka DCJ. Development and evaluation of a rigid esophagoscopy simulator for residency training. Laryngoscope. 2016;126(3):616–9.CrossRefPubMedGoogle Scholar
  91. 91.
  92. 92.
    Burke CS, Salas E, Wilson-Donnelly K, Priest H. How to turn a team of experts into an expert medical team: guidance from the aviation and military communities. Qual Saf Health Care. 2004;13(Suppl 1):96–104.CrossRefGoogle Scholar
  93. 93.
    Weller J, Boyd M, Cumin D. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgrad Med J. 2014;90(1061):149–54.CrossRefPubMedGoogle Scholar
  94. 94.
    Endsley MR. Toward a theory of situation awareness in dynamic systems. Hum Factors. 1995;37(1):32–64.CrossRefGoogle Scholar
  95. 95.
    Geis GL, Pio B, Pendergrass TL, Moyer MR, Patterson MD. Simulation to assess the safety of new healthcare teams and new facilities. Simul Healthc. 2011;6(3):125–33.CrossRefPubMedGoogle Scholar
  96. 96.
    Volk MS, Ward J, Irias N, Navedo A, Pollart J, Weinstock PH. Using medical simulation to teach crisis resource management and decision-making skills to otolaryngology housestaff. Otolaryngol Head Neck Surg. 2011;145(1):35–42.CrossRefPubMedGoogle Scholar
  97. 97.
    Weintraub AY, Deutsch ES, Hales RL, Buchanan NA, Rock WL, Rehman MA. Using high-technology simulators to prepare anesthesia providers before implementation of a new electronic health record module: a technical report. Anesth Analg. 2017;124(6):1815–9.CrossRefPubMedGoogle Scholar
  98. 98.
    Guise J, Mladenovic J. In situ simulation: identification of systems issues. Semin Perinatol. 2013;37(3):161–5.CrossRefPubMedGoogle Scholar
  99. 99.
    Mark LJ, Herzer KR, Cover R, et al. Difficult airway response team: a novel quality improvement program for managing hospital-wide airway emergencies. Anesth Analg. 2015;121(1):127–39.CrossRefPubMedPubMedCentralGoogle Scholar
  100. 100.
    Jones CE, Hollis RH, Wahl TS, et al. Transitional care interventions and hospital readmissions in surgical populations: a systematic review. Am J Surgery. 2016;212(2):327–35.CrossRefGoogle Scholar
  101. 101.
    The affordable care act: helping providers help patients. A menu of options for improving care.
  102. 102.
    Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Acad Med. 2003;78(8):783–8.CrossRefPubMedGoogle Scholar
  103. 103.
    Deutsch ES. High-fidelity patient simulation manniquins to facilitate aerodigestive endoscopy training. Arch Otolaryngol Head Neck Surg. 2008;134(6):625–9.Google Scholar
  104. 104.
    Deutsch ES, Malloy KM, Malekzadeh S. Simulation-based otorhinolaryngology emergencies boot camp: part 3: complex teamwork scenarios and conclusions. Laryngoscope. 2014;124(7):1570–2.CrossRefPubMedGoogle Scholar
  105. 105.
    Malekzadeh S, Deutsch ES, Malloy KM. Simulation-based otorhinolaryngology emergencies boot camp: part 2: special skills using task trainers. Laryngoscope. 2014;124(7):1566–9.CrossRefPubMedGoogle Scholar
  106. 106.
    Malloy KM, Malekzadeh S, Deutsch ES. Simulation-based otorhinolaryngology emergencies boot camp: part 1: curriculum design and airway skills. Laryngoscope. 2014;124(7):1562–5.CrossRefPubMedGoogle Scholar
  107. 107.
    Deutsch ES, Orioles A, Kreicher K, Malloy KM, Rodgers DL. A qualitative analysis of faculty motivation to participate in otolaryngology simulation boot camps. Laryngoscope. 2013;123(4):890–7.CrossRefPubMedGoogle Scholar
  108. 108.
    ACGME program requirements for graduate medical education in otolaryngology.
  109. 109.
    The otolaryngology milestone project. Updated 2013.
  110. 110.
    Javia L, Deutsch ES. A systematic review of simulators in otolaryngology. Otolaryngol Head Neck Surg. 2012;147(6):999–1011.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Luv Javia
    • 1
  • Maya G. Sardesai
    • 2
  • Ellen S. Deutsch
    • 3
    Email author
  1. 1.Department of OtorhinolaryngologyClinical Otorhinolaryngology/Head and Neck Surgery at the Perelman School of Medicine at the University of Pennsylvania, Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Department of Otolaryngology – Head & Neck SurgeryUniversity of WashingtonSeattleUSA
  3. 3.PA Patient Safety Authority and ECRI InstituteThe Children’s Hospital of PhiladelphiaPlymouth MeetingUSA

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