Introduction: Nasal analysis is a challenging skill that otolaryngology trainees must demonstrate competency in on-board examinations. Study objective: To compare where experts and trainees focus their gaze when completing nasal analysis of a patient, as measured by eye tracking software. Methods: Participants of various training levels ( n = 27) were shown photographs of six faces from all standard angles for photographic nasal analysis. Eye-tracking data were collected. Heat and gaze maps, the time to first fixation on areas of interest, duration, and number of fixations were extracted. These metrics were compared between experts and trainees using t -tests and one-way ANOVA. Results: Qualitative comparisons of gaze patterns reveal a more comprehensive and organized approach among experts than trainees. However, quantitative measures of eye-tracking metrics, including the time to first fixations, duration, and number of fixations made by experts and trainees, were similar. Conclusions: Gaze tracking reveals more thorough and efficient eye movements among experts than trainees during nasal analysis. Further study may be useful in the development of learning tools to guide effective nasal analyses.
A New Diversity Strategy to Increase Latinx Representation in Otolaryngology: A Survey of Latinx Medical Students
Introduction: Despite ongoing diversity initiatives, Otolaryngology – Head and Neck surgery continues to face a widening representation gap as the Latinx population in the United States grows. To address this disparity, novel strategies for recruiting Latinx medical students into the specialty must be explored. Methods: A descriptive, cross-sectional survey was distributed to Latinx medical students in the United States via social media platforms (Facebook, Twitter, Instagram) and Latino Medical Student Association (LMSA) chapters. Results: Most respondents were unfamiliar with Otolaryngology-specific health disparities affecting Latinx communities and indicated an interest in learning more about these disparities. Most respondents indicated that early exposure to Otolaryngology disparities affecting Latinx communities could increase interest in exploring the specialty. Additionally, most participants deemed a department's commitment to diversity, equity and inclusion and opportunities to serve Latinx patients to be necessary residency program attributes when deciding between programs (69.2% and 66.7%, respectively). Conclusion: Integrating community outreach and education on Otolaryngology-related health disparities into undergraduate medical education may serve as a promising strategy to enhance Latinx recruitment and representation in the specialty.
Exploring Access to Care in Zimbabwe Using the 3‐Delay Model
ABSTRACTObjective(s)We aim to identify the diversity of barriers to care for otolaryngology‐head and neck surgery patients in Harare, Zimbabwe.MethodsInterviews were conducted at four general otolaryngology clinics in Harare in October 2022.The patient population included children and adults presenting to either government or private clinics. Via interpreter, six standardized questions were discussed with each patient. Survey responses were used to categorize patients into one or more of three types of delays: (1) deciding to seek care, (2) reaching the appropriate healthcare facility, and (3) receiving adequate care after reaching that facility.ResultsForty‐six patients participated in this survey. The average time from problem presentation to treatment in this population was 16.3 months. Twenty‐six percent of patients experienced more than one type of delay. The most common type of delay was Type 3 (67%). Many of these patients reached appropriate facilities but could not receive timely treatment due to lengthy wait times. Type 1 delays affected 35% of patients. Notable causes were fear of doctors, preference for traditional healing, or ignorance to a treatable problem. Type 2 delays were also reported in 37%, commonly due to long distance and time to travel and insufficient finances for these journeys.ConclusionsENT patients in Zimbabwe experience a myriad of delays to receiving appropriate care. Systemic issues, including backlogged surgical lists, convoluted referral patterns, and poor transportation infrastructure, are significant contributors to patient delays. The 3‐delay model is useful for identifying barriers to care for future efforts to improve patient access to safe and affordable surgical care.Level of EvidenceLevel VI.
Otolaryngology - Head and Neck Surgery in Post-War Mekele, Ethiopia: An Application of the Three Delay Model to Explore Barriers to Care
Abstract Background: The three delays model, identifies three key stages to delays in care that can contribute to adverse outcomes: decision-making to seek care, accessing healthcare facilities, and receiving appropriate medical care. However, the application of this model in otolaryngology-head and neck surgery (OHNS) and in a human conflict environment has not been examined. This study aims to explore the impact of each delay type within the OHNS population in post-war Mekelle, Ethiopia. By investigating these delays, the study seeks to uncover strategies for reducing delays and improving outcomes in the management of OHNS pathology for this and similar environments. Methods: This study was conducted during a 3-week short term OHNS surgical trip in Mekele, Ethiopia, following a 2 year war. A total of 105 patients attending the OHNS clinic were identified and given verbal interviews and semi-structured questionnaires. The three delays model was applied to analyze the data collected, focusing on the following aspects: 1) decision to seek care, 2) reaching care, and 3) receiving care. Results: A total of 105 patients were included in the analysis, with 100% (105/105) experiencing type 1 delays (decision to seek care), 75% experiencing type 2 delays (75/105) and an additional 77% (77/105) facing type 3 delays (receiving appropriate care after reaching health care facility). More than half of the patients encountered delays in all three types. Various factors contributed to type 3 delays, including multiple delays at the time of admission, drug shortages, non-availability of skilled staff, and incompetence. Cost of transportation emerged as the primary factor contributing to type 2 delays. Conclusion: The findings provide valuable insights into the specific delays experienced by patients seeking OHNS services in a post-war setting and inform potential strategies for improving healthcare delivery in similar contexts.