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

Abstract

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

• Cochlear implant
• Quality assurance
• Electrode position
• Electrode-to-modiolus distance
• Angular depth of insertion