Rosalind Di Traglia

Objective: Ear, nose and throat (ENT) is often underrepresented in undergraduate medical curricula. E‐learning has emerged as a promising strategy to address this gap. This mixed‐methods systematic review aimed to evaluate the effectiveness of e‐learning in undergraduate ENT education. Data Sources: MEDLINE, Embase, Education Research Complete, and Web of Science were searched. Review Methods: The PRISMA guidelines were followed. Quantitative data were synthesized with a meta‐analysis of normalized gain scores to assess knowledge improvement. Qualitative findings were analyzed using thematic synthesis. Due to substantial heterogeneity, a narrative synthesis was performed for skills and confidence. Results: Twenty‐nine studies fulfilled the inclusion criteria. Knowledge scores improved by 26.8% (95% CI 23.7%–30.0%, n = 13), which was considered low gain. Skill improvement was variable ( n = 6), while confidence consistently improved ( n = 5). Thematic synthesis identified four themes: (1) multimedia resources, (2) learner autonomy and self‐directed engagement, (3) technical barriers, and (4) blended learning models. Conclusion: Knowledge and learner confidence improved with e‐learning. However, its impact on practical skills was limited. These findings support the integration of e‐learning as a complementary adjunct to clinical teaching.

Purpose: Retraction is the removal of published material due to flaws in research that cannot be corrected. Our aim was to perform a systematic review of all retracted literature in Ear Nose and Throat to understand the characteristics of retraction and the citations of retracted literature. Methods: The Retraction Watch, EMBASE and MEDLINE databases were systematically searched to yield relevant retractions. Two independent authors performed abstract and full-text screening. Non-relevant texts, articles in non-English languages, and articles that were neither published (protocols) or retracted (expression of concern) were excluded. Results: We found 225 retractions in Ear Nose and Throat literature from 1992 to 2023. The number of retractions increased with time, and the average time-to-retraction was 1 year (range 0–29). Most articles were retracted due to misconduct (72%). In total, 191/225 of retractions were signposted with a retraction notice; 90.6% of notices were linked to the original manuscript; 96.9% specified the reason for retraction and 100% were freely accessible. Publications were cited more after retraction (median 2, range 0–215 vs median 0, range 0–78, Z –1.78, p = 0.075), however this was not significant, and appeared to improve with a shorter retraction time (RS 0.67, p < 0.001). Conclusion: Retractions, although rare, are increasing across all scientific disciplines. Our data suggests that retractions are both efficiently and transparently publicised in the Ear Nose and Throat Literature. Investigators should be veracious when conducting their own research and regularly appraise manuscripts to ensure that misinformation is not perpetuated, remaining aware that retracted articles continue to be cited.

Background: Otitis externa is a condition causing inflammation of the outer ear canal, which presents with itching, discharge and pain. Most cases of acute otitis externa are caused by bacterial infection and are thus treated with antibiotics.This systematic review and meta‐analysis of randomised controlled trials aims to assess the effectiveness of topical non‐antibiotic treatments compared to topical antibiotic treatment for the treatment of acute otitis externa.Methods: Systematic review and meta‐analysis databases searched: Cochrane Library including ClinicalTrials.gov; MEDLINE; World Health Organisation International Clinical Trials Registry Platform and Web of Science to identify randomised clinical trials evaluating topical antibiotics and topical non‐antibiotic agents in adults and children with acute otitis externa. Non‐antibiotic therapeutics for comparison with topical antibiotics included antiseptics, steroids, non‐pharmaceuticals and astringents.Results: Seventeen trials were eligible for inclusion, with 10 combined in meta‐analysis. Data could be pooled comparing antiseptic and steroid monotherapies with topical antibiotic agents. There were no significant differences in cure rates in any pairwise comparisons. Individually, the majority of studies favoured topical antiseptics or steroids over antibiotics, however these differences were not significant when pooled in meta‐analysis.Conclusion: Antiseptic, steroid and antibiotic monotherapies are all effective for the management of acute otitis externa. There is insufficient evidence to suggest that topical antiseptic or steroid agents are superior or inferior to topical antibiotics.

Introduction: Virtual teaching has proven effective for medical students during the COVID-19 pandemic. This study is the first to describe an undergraduate orthopaedic teaching strategy in the format of virtual trauma meetings (VTM). Methods: Clinical medical students from the Universities of Bristol and Cardiff were invited to attend five VTM between October and November 2020. These were delivered by consultants and speciality doctors via Zoom software. An 11-item feedback form was distributed after each session to assess the relevance of teaching material, student confidence in asking and answering questions, and if students would benefit from further sessions. Several open-ended questions were designed to evaluate aspects of the session that were most useful, which orthopaedic topics were of high priority and if they had any suggestions for improvement. Our initial aim was to assess student acceptance of the virtual format. Several months later pre-recorded material was uploaded onto YouTube and post hoc questionnaires were analysed. Results: A total of 50 students attended, with a median of 11±6 attending per session, producing a total of 26 feedback responses. Among the responders, there were 10 males and nine females and 63% of the students were in their third year. 100% of students felt comfortable asking questions and 96% felt comfortable answering questions. X-ray interpretation and management of fractures were the highest priority subjects. The majority of students considered the interaction between senior and junior doctors most valuable, and the most common improvement suggested was the inclusion of polls or OSCE-styled questions. Conclusions: VTM could be a useful resource to enhance undergraduate trauma and orthopaedic (T&O) education by providing student-focused material in an open learning environment.