Ear examination skills: a cross-sectional survey study of Australian junior doctors

Background: Ear pathology is a common presentation to the emergency department and primary care practitioner. This survey study assesses the confidence of Australian junior doctors to perform an ear exam and interpret basic audiometric testing. Methods: A cross-sectional study was conducted for junior doctors across New South Wales (NSW) and Australian Capital Territory (ACT) public hospitals. The survey assessed ability to identify anatomical landmarks, pathology and interpret tuning fork tests and audiograms. Results: A total of 83 junior doctors responded. Half of the respondents could correctly identify pathology on otoscopy and interpret tuning fork tests correctly. Ten percent correctly identified relevant anatomical landmarks. Respondents with any post-graduate Ear Nose and Throat (ENT) surgery exposure were three-times more likely to correctly identify pathology (P=0.05). Almost all junior doctors surveyed agreed or strongly agreed that more ENT exposure during medical school was required. Conclusions: This sample demonstrates the value of formal ENT exposure in the confidence and competence of junior doctors in identifying common ENT pathology. Given the prevalence of otologic issues in primary care and emergency department settings, junior doctors should be equipped with basic competency in performing otoscopy and accurately describing findings. Consideration of this data would suggest incorporating such experience into curricula.