Effect of Simulation-Based Training on Final-Year Medical Students' Self-Reported Confidence in Recognising and Managing Acute ENT Emergencies.

BACKGROUND

Undergraduate exposure to ear, nose and throat (ENT) emergencies is limited, and newly qualified doctors may encounter acute ENT presentations despite feeling underprepared. Simulation-based education provides a structured environment in which learners can practise emergency assessment and management.

AIM: To evaluate the immediate impact of a dedicated ENT emergency simulation session on final-year medical students' self-reported confidence in recognising and managing acute ENT emergencies.

METHODS

A prospective pre- and post-intervention evaluation was conducted over 16 weeks involving 110 final-year medical students undertaking an ENT placement. Students participated in three simulated emergency scenarios: epistaxis, supraglottitis and post-tonsillectomy haemorrhage. Self-reported confidence was assessed immediately before and after the intervention using individual five-point Likert items. As questionnaires were anonymous and responses could not be matched at participant level, pre- and post-intervention response distributions were compared using the Mann-Whitney U-test. Holm adjustment was applied for multiple comparisons, and rank-biserial correlation was calculated as an effect-size measure.

RESULTS

Post-intervention self-reported confidence was higher across all three scenarios. Median confidence scores increased from 3 (MAD 1) to 4 (MAD 0) for post-tonsillectomy haemorrhage, from 2 (MAD 1) to 4 (MAD 0) for epistaxis, and from 2 (MAD 0) to 4 (MAD 0) for supraglottitis. All comparisons remained statistically significant after Holm adjustment, with large rank-biserial effect sizes: post-tonsillectomy haemorrhage r_rb=0.849 (95% CI 0.785-0.898), epistaxis r_rb=0.940 (95% CI 0.891-0.970), and supraglottitis r_rb=0.948 (95% CI 0.899-0.975).

CONCLUSIONS

A structured ENT emergency simulation session was associated with higher immediate self-reported confidence in recognising and initiating management of three acute ENT presentations. Further studies incorporating objective performance measures, comparator groups and longitudinal follow-up are required to determine whether these findings translate into sustained improvements in clinical competence.