***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND the diagnostic accuracy of otitis media with effusion ( OME ) has been shown to be poor among medical students , residents , and practicing physicians . OBJECTIVE to determine if the use of pneumatic video-otoendoscopic examination ( VOE ) improves the diagnostic accuracy of OME  among residents . METHODS pediatric residents were r and omized into a " pneumatic " examination group ( intervention ) and a " still " examination group ( control ) . The control group viewed a set of 25 still VOE images of the tympanic membranes of both normal and OME ears . The intervention group viewed the same still images but with the addition of pneumatic VOE assessment s. Each resident documented each of his or her diagnoses as normal or OME . The accuracy of assessment for both the static and the pneumatic methods was compared . RESULTS twenty-nine pediatric residents participated in this study : 15 in the intervention group and 14 in the control group . The overall diagnostic accuracy was 91 % for the intervention group versus 78 % for the control group ( p = .0003 ) . CONCLUSION pneumatic video-otoscopy teaching improves the diagnostic accuracy of OME among residents Background Recently , medical education in surgery has experienced several modifications . We have implemented a blended learning module in our teaching curriculum to evaluate its effectiveness , applicability , and acceptance in surgical education . Methods In this prospect i ve study , the traditional face-to-face learning of our teaching curriculum for fourth-year medical students ( n = 116 ) was augmented by the Inmedea Simulator , a web-based E-learning system , with six virtual patient cases . Student results were documented by the system and learning success was determined by comparing patient cases with comparable diseases ( second and sixth case ) . The acceptance among the students was evaluated with a question naire . Results After using the Inmedea Simulator , correct diagnoses were found significantly ( P < 0.05 ) more often , while an incomplete diagnostic was seen significantly ( P < 0.05 ) less often . Significant overall improvement ( P < 0.05 ) was seen in sixth case ( 62.3 ± 5.6 % ) vs. second case ( 53.9 ± 5.6 % ) . The question naire revealed that our students enjoyed the surgical seminar ( score 2.1 ± 1.5 ) and preferred blended learning ( score 2.5 ± 1.2 ) to conventional teaching . Conclusion The blended learning approach using the Inmedea Simulator was highly appreciated by our medical students and result ed in a significant learning success . Blended learning appears to be a suitable tool to complement traditional teaching in surgery Introduction Video teaching modules are proven effective tools for enhancing student competencies and technical skills in the operating room . Integration into post-graduate surgical curricula , however , continues to pose a challenge in modern surgical education . To date , video teaching modules for neck dissection have yet to be described in the literature . Purpose To develop and vali date an HD video-based teaching module ( HDVM ) to help instruct post-graduate otolaryngology trainees in performing neck dissection . Methods This prospect i ve study included 6 intermediate to senior otolaryngology residents . All consented subjects first performed a control selective neck dissection . Subjects were then exposed to the video teaching module . Following a washout period , a repeat procedure was performed . Recordings of the both sets of neck dissections were de-identified and review ed by an independent evaluator and scored using the Observational Clinical Human Reliability Assessment ( OCHRA ) system . Results In total 91 surgical errors were made prior to the HDVM and 41 after exposure , representing a 55 % decrease in error occurrence . The two groups were found to be significantly different . Similarly , 66 and 24 staff takeover events occurred pre and post HDVM exposure , respectively , representing a statistically significant 64 % decrease . Conclusion HDVM is a useful adjunct to classical surgical training . Residents performed significantly less errors following exposure to the HD-video module . Similarly , significantly less staff takeover events occurred following exposure to the HDVM OBJECTIVE To evaluate students '  overall assessment and effectiveness of the web-based blended learning conception " Unified Patient Project " ( UPP ) for medical students rotating on their otolaryngology internship ( ear , nose , and throat [ ENT ] tertiary ) . DESIGN Prospect i ve comparison group design of the quasiexperimental type . SETTING Medical education . SUBJECTS The experimental group ( preintervention test [ pretest ] , intervention , and postintervention test [ posttest ] ) comprised 117 students , and the comparison group ( pretest , alternative intervention , and posttest ) , 119 . INTERVENTIONS In the experimental group , lecturing of case studies was replaced by the blended learning concept UPP . A st and ardized question naire evaluated  students  ' overall assessment of teaching otolaryngology . A pretest and posttest using multiple choice questions was administered to clarify whether the UPP has led to a knowledge gain . RESULTS The comparison group was more satisfied with their teaching ; however , this was not statistically significant ( P = .26 ) compared with the UPP . Students with higher preknowledge benefitted from the UPP , while students with lower preknowledge did not ( P = .01 ) . On average , posttest results in the experimental group exceeded those of the comparison group by 8.7 percentage points for a 75 % preknowledge of the maximum attainable score , while they fell below those of the comparison group by 8.1 percentage points for a 25 % preknowledge . CONCLUSIONS Students ' satisfaction with the blended learning concept UPP was lower than in the face-to-face teaching , although this was not statistically significant . The new web-based UPP leads to an improved knowledge in clinical otolaryngology for all students . Students with lower preknowledge benefitted more from face-to-face teaching than from the UPP , while students with higher preknowledge benefitted more from the UPP . This implies students with poor preknowledge need special promotion programs INTRODUCTION The use of computer-generated 3-dimensional ( 3-D ) anatomical models to teach anatomy has proliferated . However , there is little evidence that these models are educationally effective . The purpose of this study was to test the educational effectiveness of a computer-generated 3-D model of the middle and inner ear . METHODS We reconstructed a fully interactive model of the middle and inner ear from a magnetic resonance imaging scan of a human cadaver ear . To test the model 's educational usefulness , we conducted a r and omised controlled study in which 28 medical students completed a Web-based tutorial on ear anatomy that included the interactive model , while a control group of 29 students took the tutorial without exposure to the model .  At the end of the tutorials , both groups were asked a series of 15 quiz questions to evaluate their knowledge of 3-D relationships within the ear . RESULTS The intervention group 's mean score on the quiz was 83 % , while that of the control group was 65 % . This difference in means was highly significant ( P < 0.001 ) . DISCUSSION Our findings st and in contrast to the h and ful of previous r and omised controlled trials that evaluated the effects of computer-generated 3-D anatomical models on learning . The equivocal and negative results of these previous studies may be due to the limitations of these studies ( such as small sample size ) as well as the limitations of the models that were studied ( such as a lack of full interactivity ) . Given our positive results , we believe that further research is warranted concerning the educational effectiveness of computer-generated anatomical models BACKGROUND Mannequin and computer-based simulators are useful for the practice of patient management , physical procedures , and competency . However , they are ineffective in teaching clinical medicine . StepStone Interactive Medical Software ( SS ) is a web-based medical learning modality that provides the user with a highly focused set of evaluative and interventional tasks to treat memorable virtual patients in a visual case-based format . OBJECTIVE To determine whether the SS learning modality is superior to traditional lecture format in medical student learning and retention . METHODS After Institutional Review Board ( IRB ) approval was obtained and the consents were signed , 30 third-year medical students were assigned r and omly to 2 groups of 15 students each : The control group received two 30-minute PowerPoint lectures ( Microsoft Corporation , Redmond , Washington ) about torsades de pointes ( TdP ) and pulseless electrical activity ( PEA ) , and the SS group was given 1 hour to review 2 SS cases teaching TdP and PEA . A preintervention test was given to assess their baseline knowledge . An immediate postintervention test was given to both groups . Twenty-two days later , a long-term retention test was administered . The results were analyzed using a Student t test for continuous variables . RESULTS The mean scores for the preintervention test in the control and SS groups were 44.9 ± 3 % and 44.1 ± 2 % , respectively ( p = 0.41 ) . The mean scores for the postintervention test in the control and SS groups were 61.7 ± 2 % and 86.7 ± 2 % , respectively ( p < 0.001 ) . Improvement from baseline knowledge was calculated , and the mean improvement was 16.8 ± 3 % in the control group and 42.5 ± 2 % in the SS group ( p < 0.001 ) . The long-term retention test revealed the mean scores of 55.8 ± 3 % in the control group and 70.1 ± 3 % in the SS group ( p < 0.001 ) . Long-term improvement from baseline knowledge was calculated and the control group improved by 10.9 ± 4 % , whereas the SS group improved by 26 ± 3 % ( p = 0.002 ) . CONCLUSIONS The SS learning modality demonstrated a significant improvement in student learning retention compared to traditional didactic lecture format . SS is an effective web-based medical education tool Introduction : Plastic surgery training has traditionally been modeled as an “ apprenticeship , ” where faculty teach surgical skills to residents on live patients . Although this is a well-established process , the dem and by the public and healthcare agencies for improved patient care , outcomes , and patient safety has led to the development of adjunct methods of teaching . The goal of this project is to assess the effectiveness of a web-based microsurgical curriculum . Methods : We developed an interactive Web site to teach essential microsurgical competencies . Residents were r and omly divided into 2 cohorts : one experimental group completed this online re source and the other control group did not . Pre- and post assessment s were administered , consisting of a written test and a recorded microsurgery skills session . Results : A total of 17 plastic surgery residents of various training levels participated in the study . Residents who completed the web-based curriculum showed dramatic improvement in their knowledge and skills , with a 17-percentage point increase in their test scores ( P = 0.01 ) compared with controls ( P = 0.80 ) . The experimental group was more likely to perform microanastomoses faster with an average of 4.5-minute improvement compared with 1.25-minute change among the control group . Residents performed self- assessment s , and those who rated themselves as “ very confident ” had higher overall test scores ( 85 % test score vs. 59 % , P = 0.004 ) , as well as shorter times to complete the microsurgical task ( 7.5 minutes vs. 13.6 minutes , P = 0.007 ) . Overall , 62 % of residents rated the online webpage as extremely valuable . The majority of residents reported the webpage improved their knowledge and markedly improved their microsurgical technique , which was confirmed by faculty experts . Conclusions : Our interactive Web-based curriculum is a novel re source , teaching microsurgery in an organized , competency-based manner , which we believe is the first Web site of this nature . An individualized , self-paced Web site is ideal for plastic surgery trainees of all levels . Overall , the widespread implementation of our proposed curriculum — online self-directed training combined with regular practice sessions — will establish a strong foundation of microsurgery knowledge and skills acquisition for all plastic surgery residents OBJECTIVES To establish discriminant validity of the endoscopic sinus surgery simulator ( ES3 ) ( Lockheed Martin , Akron , Ohio ) between various health care provider experience levels and to define benchmarking criteria for skills assessment . DESIGN Prospect i ve multi-institutional comparison study . SETTING University-based tertiary care institution . PARTICIPANTS Ten expert otolaryngologists , 14 otolaryngology residents , and 10 medical students . INTERVENTIONS Subjects completed the ES3 's virtual reality curriculum ( 10 novice mode , 10 intermediate mode , and 3 advanced mode trials ) . Performance scores were recorded on each trial . Performance differences were analyzed using analysis of variance for repeated measures ( experience level as between-subjects factor ) . MAIN OUTCOME MEASURES Simulator performance scores , accuracy , time to completion , and hazard disruption . RESULTS The novice mode accurately distinguished the 3 groups , particularly at the onset of training ( mean scores : senior otolaryngologists , 66.0 ; residents , 42.7 ; students , 18.3 ; for the paired comparisons between groups 1 and 2 and groups 1 and 3 , P = .04 and .03 , respectively ) . Subjects were not distinguished beyond trial 5 . The intermediate mode only discriminated students from other subjects ( P = .008 ) . The advanced mode did not show performance differences between groups . Scores on the novice mode predicted those on the intermediate mode , which predicted advanced mode scores ( r = 0.687 ) , but no relationship was found between novice and advanced scores . All groups performed equally well and with comparable consistency at the outset of training . Expert scores were used to define benchmark criteria of optimal performance . CONCLUSIONS This study completes the construct validity assessment of the ES3 by demonstrating its discriminant capabilities . It establishes expert surgeon benchmark performance criteria and shows that the ES3 can train novice subjects to attain those . The refined analysis of trial performance scores could serve educational and skills assessment purpose s. Current studies are evaluating the transfer of surgical skills acquired on the ES3 to the 
    Output:
    
E-learning proves to be a powerful alternative to st and ard teaching techniques within otolaryngology education for both residents and medical students .