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Teaching paradigm for decision making in facial skin defect reconstructions

K H Calhoun, H Seikaly, F B Quinn
Archives of Otolaryngology—Head & Neck Surgery 1998, 124 (1): 60-6

OBJECTIVE: To present a decision paradigm for facial defect reconstruction, and test the ability of this paradigm to improve resident performance.

DESIGN: A decision paradigm for reconstruction of facial skin defects is proposed and explained, with patient examples. The paradigm's usefulness is then tested with residents.

SETTING: Otolaryngology residency training program at a tertiary hospital.

STUDY PARTICIPANTS: Otolaryngology residents.

INTERVENTIONS: Twelve residents took a pretest wherein they were presented with drawings of skin defects and asked to choose the "best" (most aesthetically pleasing) type of reconstruction from a closed set. This paradigm was presented to these residents, and their posttest consisted of choosing again with the same defects and closed set of choices.

MAIN OUTCOME MEASURES: Cosmetic outcomes of reconstructive decisions on the pretest and posttest were rated on a scale of 0 to 5 (with 0 indicating poor; 5, excellent).

RESULTS: There was a significant improvement in reconstructive choices between the pretest and posttest (P<.001, Student t test).

CONCLUSION: This paradigm can be easily modified to accommodate different surgical approaches preferred by individual surgeons and is thus useful in almost any reconstructive teaching situation.

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