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

Satia Babu,1 Katharine Fray,2 Kapil Sugand31Department of Oral and Maxillofacial Surgery, Whipps Cross Hospital, Barts Health NHS Trust, London, UK; 2Department of Geriatric Medicine, Stepping Hill Hospital, Stockport NHS Foundation Trust, Stockport, UK; 3Faculty of Surgery and Cancer, Imperial College London, London, UKCorrespondence: Katharine Fray, Email k.fray@nhs.netBackground: 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.Keywords: otolaryngology, simulation, education, undergraduate, emergency