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Evaluation of a 3-Dimensional–Printed Head Simulation Technique for Teaching Flexible Nasopharyngoscopy to Radiation Oncology Residents
International Journal of Radiation Oncology Biology Physics
  • Christopher D. Goodman, London Health Sciences Centre
  • Justin D. Pautler, London Regional Cancer Program
  • Christopher S. Balestrini, Western University
  • Santiago Cobos, Western University
  • Leah D'Souza, Rush University Medical Center
  • Paige Eansor, Western University
  • Jasbir Jaswal
  • Anthony Nichols, London Health Sciences Centre
  • Madeleine Norris, Western University
  • Manas Sharma, London Health Sciences Centre
  • Katherine Willmore, Western University
  • Andrew Warner, London Health Sciences Centre
  • Donna H. Murrell, London Regional Cancer Program
  • David A. Palma, London Health Sciences Centre
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© 2020 Elsevier Inc. Purpose: Simulation-based medical education is an effective tool for medical teaching, but simulation-based medical education deployment in radiation oncology (RO) is limited. Flexible nasopharyngoscopy (FNP), an essential skill for RO residents, requires practice that typically occurs on volunteer patients, introducing the potential for stress and discomfort. We sought to develop a high-fidelity simulator and intervention that provides RO residents the opportunity to develop FNP skills in a low-pressure environment. Methods and Materials: Computed tomography images were used to create an anatomically accurate 3-dimensional–printed model of the head and neck region. An intervention incorporating didactic instruction, multimedia content, and FNP practice on the model was designed and administered to RO residents attending the Anatomy and Radiology Contouring Bootcamp. Participants completed pre- and postintervention evaluations of the training session and model fidelity, and self-assessments of FNP skill and confidence performing FNP. Participants were video recorded performing FNP pre- and postintervention. Videos were scored by a blinded observer on a predefined rubric. Changes in scores were evaluated using the Wilcoxon signed-rank test. Results: Twenty-four participants from 17 institutions and 4 countries completed the intervention, 50% were women, and most were senior residents. Postintervention, FNP confidence and FNP performance improved significantly (mean ± standard deviation on a 10-point scale: 1.8 ± 1.8, P < .001; 2.2 ± 2.0, P < .001, respectively). Participants felt the model was helpful (mean ± standard deviation on a 5-point scale: 4.2 ± 0.6), anatomically correct (4.1 ± 0.9), and aided in spatial comprehension (4.3 ± 0.8). Overall satisfaction for the intervention was high (4.3 ± 0.8). Participants strongly agreed the intervention should be integrated into RO training programs (4.3 ± 0.8). Conclusions: A 3-dimensional–printed model and associated intervention were effective at improving FNP performance and the teaching method was rated highly by participants. RO residents may benefit from broader dissemination of this technique to improve trainee performance.


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Christopher D. Goodman, Justin D. Pautler, Christopher S. Balestrini, Santiago Cobos, et al.. "Evaluation of a 3-Dimensional–Printed Head Simulation Technique for Teaching Flexible Nasopharyngoscopy to Radiation Oncology Residents" International Journal of Radiation Oncology Biology Physics (2020)
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