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State-of-the-Art Resources for Otolaryngology are MITIE at Houston Methodist

Houston Methodist Department of Otolaryngology – Head and Neck Surgery (OTO-HNS) physicians are dedicated to providing the best, innovative patient care experience while training students, residents, fellows and physician scientists. To this end, Department faculty utilize the Houston Methodist Institute for Technology, Innovation & Education, or MITIESM: a state-of-the-art virtual hospital and simulation training facility.
MITIE’s high-tech simulation spaces, access to a first clinical 7 Tesla MRI and integrated audiovisual and virtual reality capabilities encompass a comprehensive unique training system. Of even greater value is MITIE’s access to the combined expertise of professionals from across Houston Methodist. Building on its reputation as the gold standard for hands-on training, MITIE is further realizing its potential as a center of innovation, offering a wide spectrum of training, clinical research and industry development resources.
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Widely known for its hands-on learning opportunities, MITIE has attracted a growing number of trainees, physicians, researchers and clinical innovators from around the world. It hosted nearly 8,000 guest encounters in 2019. MITIE has become a center for innovative ideas and technological advances that offers an extensive array of resources for training, research and device development. Education Simulation at MITIE offers a procedural and clinical simulation environment for education and research, including a virtual hospital and procedural skills labs that support evidence-based practice. Physicians can use MITIE to maintain their finely-honed procedural skills or develop expertise in new techniques. Through ongoing training for healthcare professionals, research on skill acquisition and development of novel procedures, MITIE improves patient outcomes and safety. In addition, simulation training for new residents increases confidence and perceived ability – critical factors for success as a surgeon.
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In fact, research has shown that an otolaryngology-specific skills training is a valuable addition to improving proficiency. In one study1, six basic simulations were included in the first course in 2019: tracheostomy, flexible laryngoscopy, otomicroscopy, myringotomy and tube insertion, epistaxis and peritonsillar abscess management. In 2020, the course added three advanced simulations: ear foreign body extraction, tracheostomy complications, and “cannot intubate, cannot ventilate” situations. This study clearly supported the value of simulation sites such as MITIE as a resource for the head and neck surgery training interests and initiatives in the Houston Methodist Department of Otolaryngology – Head and Neck Surgery. Recently, the Houston Methodist Department of OTO-HNS invited 20 sleep surgeons from across the U.S. to train in MITIE on the single lead hypoglossal nerve stimulator for obstructive sleep apnea. Combining interactive lecture in the lecture hall and cadaveric lab teaching in the dissection lab, surgeons learned the technology and surgical implantation of the device. The dissection was live streamed into the lecture hall for sleep pulmonologists and for the study support team members to learn the applicable surgical technique. MITIE’s space allows this critical integration of technology and lecture hall approaches needed for the most effective training experience possible. Coming up in January, the Department of OTO-HNS is also leading a multi-institutional resident training cadaveric course schedule with faculty and residents from Baylor College of Medicine, University of Texas Health Science Center at Houston, and the University of Texas Medical Branch. Residents will have lecture and hands-on cadaveric sinus and facial plastics surgical training. MITIE’s facilities are also optimal for training residents in temporal bone surgery, laryngologic procedures, head and neck dissections, and sleep surgical procedures. A simulation training course is also planned for our residents in 2022. To further drive innovation and training objectives, MITIE is utilizing technologies such as the Oculus Quest for space orientation that could be used in various applications, including education, providing a virtual orientation of facilities for professionals. This is especially helpful during a pandemic when on-campus visits are not possible. Houston Methodist’s Department of OTO-HNS is also using virtual reality (VR) for surgical planning, loading patient’s CTs and MRIs into a system which can then render patient pathology in a VR environment, allowing a 3D immersive experience for the surgeon, depicting the pathology, vital structures adjacent to the area of interest and the surgical corridor. Another important consideration during a respiratory pathogen pandemic is physician safety. Continued training of core providers promotes vigilance in pandemic situations. Given the high risk of virus aerosolization during tracheostomy, simulation training focused on proper PPE donning and doffing is essential for these physicians. Studies have shown that standardized COVID-19 tracheostomy simulation training at facilities treating COVID-19 patients can increase physician safety and confidence in these procedures in real-life scenarios2. As a high-tech facility for education and research, MITIE has an enormous impact on otolaryngology patient care. In addition to training and practice, Houston Methodist ENT Specialists can utilize MITIE for procedural development, demonstrations, remote telementoring, image guidance for surgery and surgical robotics. As Chair of the Department of Otolaryngology – Head and Neck Surgery and Chair of Houston Methodist ENT Specialists, Dr. Mas Takashima, MD, FACS, had a vision when he toured surgical centers around the country to define exactly what Houston Methodist needed to best care for its patients, caregivers, students, and trainees. With MITIE, his vision is a reality.
Citations
  1. Keilin et al. Otolaryngology Curriculum During Residency Preparation Course Improves Preparedness for Internship. Comprehensive Otolaryngology. 10 February 2021
  2. LoSavio et al. Rapid implementation of COVID-19 tracheostomy simulation training to increase surgeon safety and confidence. American Journal of Otolaryngology. Volume 41, Issue 5, September–October 2020