Evaluating a specialized workshop on otorhinolaryngology emergencies for junior doctors: Empowering the next generation of healers
Otorhinolaryngology (ORL) emergencies encompass a wide variety of acute conditions that often require prompt medical intervention to prevent life-threatening complications. These include airway obstruction, epistaxis, foreign body aspiration, and severe laryngeal trauma. Such emergencies are time-sensitive, requiring rapid diagnosis and intervention to avoid significant morbidity or mortality. Junior doctors, particularly those in the early stages of their careers, often serve as the first point of contact for patients presenting with these urgent ORL conditions in emergency departments or other acute care settings. However, they may not always be adequately prepared due to limited exposure to otorhinolaryngology-specific training during their medical education and internship rotations.  While general medical education provides foundational knowledge, it often lacks the depth needed to manage complex and life-threatening ORL conditions, leaving many junior doctors feeling unprepared and lacking confidence.  This gap in training can lead to delays in diagnosis, suboptimal management, and poor patient outcomes.  Recent studies have highlighted the need for enhanced training in ORL emergencies for junior doctors, particularly in high-risk areas such as airway management and bleeding control.  Research indicates that when junior doctors are exposed to focused training programs–such as simulation-based learning, workshops, and hands-on clinical training–they experience significant improvements in both knowledge and confidence.  Moreover, such interventions have been shown to improve clinical performance, leading to more effective management of urgent conditions and a reduction in errors.  This underscores the growing recognition that specialized education in ORL emergencies is critical for improving both patient care and the safety of junior doctors as they navigate the challenges of their early medical careers. Given these findings, there has been increasing emphasis on incorporating focused educational initiatives, such as workshops dedicated to ORL emergencies, into the training of junior doctors. These initiatives aim to provide them with the necessary skills to confidently manage common but critical ORL conditions such as airway obstruction, severe epistaxis, and laryngeal trauma, all of which require immediate intervention to prevent life-threatening complications.  The present study seeks to evaluate the effectiveness of such a specialized workshop, designed to fill the gap in training and enhance the preparedness of junior doctors to handle ORL emergencies effectively. By measuring improvements in knowledge and confidence, this research aims to assess whether targeted interventions can positively influence the readiness of junior doctors in managing high-acuity ORL cases. 

2.1. Study participants and selection criteria The study targeted junior doctors who had recently completed their Bachelor of Medicine and Bachelor of Surgery (MBBS) final examinations and were undergoing a mandatory 1-year internship rotation. These participants were selected based on their registration for a specialized training program focusing on Essential otorhinolaryngology Emergencies, organized by the Department of otorhinolaryngology. This cohort represented a diverse group of medical professionals eager to enhance their skills in managing critical ENT conditions. 2.2. Inclusion criteria Participants were required to have successfully completed their MBBS final examinations and actively registered for the 1-day training session on otorhinolaryngology emergencies. This ensured that all participants possessed the foundational medical knowledge necessary to engage meaningfully with the training content. 2.3. Exclusion criteria Exclusion criteria encompassed individuals who did not complete their MBBS program or who did not formally register for the training program. Nonparticipation in the scheduled sessions also excluded interns from being included in the final analysis, ensuring data integrity and the effectiveness of the training evaluation. 2.4. Study duration and enrollment The training program, essential for advancing knowledge and practical skills in otorhinolaryngology emergencies, was meticulously designed to span a single intensive day. Initially, 50 interns demonstrated interest and registered for the program, highlighting the relevance and appeal of specialized training opportunities among early-career medical professionals. Ultimately, 41 interns actively participated in the structured training sessions, indicating a robust engagement and commitment to professional development. 2.5. Sample size calculation Given the comprehensive nature of the study and the invitation extended to all eligible interns, a formal sample size calculation was not necessary. The inclusion of all interested and qualified participants ensured a representative sample and minimized selection bias, reflecting the real-world context of medical education and training. 2.6. Ethical considerations Ethical considerations were paramount throughout the study process. Ethical clearance was taken from institutional review committee (IRC) of Birat Medical College Teaching Hospital. Further, informed consent was obtained from all participants, detailing the study objectives, procedures, potential risks, and benefits associated with participation. Strict protocols were in place to safeguard participant anonymity and confidentiality, protecting their identities and responses throughout data collection and analysis. Participants were assured that their involvement in the study would not result in any adverse consequences or impacts on their internship evaluations or professional standing. 2.7. Data collection and analysis Data collection commenced with the administration of a pretest questionnaire distributed via Google Forms, comprising 20 carefully crafted multiple-choice questions. The questionnaire covered a broad spectrum of otorhinolaryngology emergencies, including ear emergencies, vertigo management, tracheostomy indications, epistaxis, paranasal sinus emergencies, pharynx and neck space emergencies, anaphylaxis, drug-related emergencies, and traumatic ENT emergencies. Participants were allotted a defined time limit of 10 minutes to complete the questionnaire, ensuring consistency and efficiency in data gathering. 2.8. Statistical analysis Following the intensive training sessions, a post-training assessment using the identical 20-question format was administered to evaluate participants’ knowledge retention and performance improvement. Scores from both pretest and posttest assessments, along with the corresponding answer key, were promptly communicated to participants via email for transparency and self-assessment. The collected data from pre- and post-assessment questionnaires were meticulously compiled using Google Sheets and subjected to rigorous statistical analysis using SPSS 23 software. Descriptive statistics, including means, standard deviations, and frequency distributions, provided a comprehensive summary of participants’ scores. Inferential statistical techniques, such as paired t -tests, were employed to compare pretest and posttest scores, elucidating the statistical significance of learning outcomes and the program’s effectiveness in enhancing participants’ competency in managing critical ENT emergencies. 

The study targeted junior doctors who had recently completed their Bachelor of Medicine and Bachelor of Surgery (MBBS) final examinations and were undergoing a mandatory 1-year internship rotation. These participants were selected based on their registration for a specialized training program focusing on Essential otorhinolaryngology Emergencies, organized by the Department of otorhinolaryngology. This cohort represented a diverse group of medical professionals eager to enhance their skills in managing critical ENT conditions. 

Participants were required to have successfully completed their MBBS final examinations and actively registered for the 1-day training session on otorhinolaryngology emergencies. This ensured that all participants possessed the foundational medical knowledge necessary to engage meaningfully with the training content. 

Exclusion criteria encompassed individuals who did not complete their MBBS program or who did not formally register for the training program. Nonparticipation in the scheduled sessions also excluded interns from being included in the final analysis, ensuring data integrity and the effectiveness of the training evaluation. 

The training program, essential for advancing knowledge and practical skills in otorhinolaryngology emergencies, was meticulously designed to span a single intensive day. Initially, 50 interns demonstrated interest and registered for the program, highlighting the relevance and appeal of specialized training opportunities among early-career medical professionals. Ultimately, 41 interns actively participated in the structured training sessions, indicating a robust engagement and commitment to professional development. 

Given the comprehensive nature of the study and the invitation extended to all eligible interns, a formal sample size calculation was not necessary. The inclusion of all interested and qualified participants ensured a representative sample and minimized selection bias, reflecting the real-world context of medical education and training. 

Ethical considerations were paramount throughout the study process. Ethical clearance was taken from institutional review committee (IRC) of Birat Medical College Teaching Hospital. Further, informed consent was obtained from all participants, detailing the study objectives, procedures, potential risks, and benefits associated with participation. Strict protocols were in place to safeguard participant anonymity and confidentiality, protecting their identities and responses throughout data collection and analysis. Participants were assured that their involvement in the study would not result in any adverse consequences or impacts on their internship evaluations or professional standing. 

Data collection commenced with the administration of a pretest questionnaire distributed via Google Forms, comprising 20 carefully crafted multiple-choice questions. The questionnaire covered a broad spectrum of otorhinolaryngology emergencies, including ear emergencies, vertigo management, tracheostomy indications, epistaxis, paranasal sinus emergencies, pharynx and neck space emergencies, anaphylaxis, drug-related emergencies, and traumatic ENT emergencies. Participants were allotted a defined time limit of 10 minutes to complete the questionnaire, ensuring consistency and efficiency in data gathering. 

Following the intensive training sessions, a post-training assessment using the identical 20-question format was administered to evaluate participants’ knowledge retention and performance improvement. Scores from both pretest and posttest assessments, along with the corresponding answer key, were promptly communicated to participants via email for transparency and self-assessment. The collected data from pre- and post-assessment questionnaires were meticulously compiled using Google Sheets and subjected to rigorous statistical analysis using SPSS 23 software. Descriptive statistics, including means, standard deviations, and frequency distributions, provided a comprehensive summary of participants’ scores. Inferential statistical techniques, such as paired t -tests, were employed to compare pretest and posttest scores, elucidating the statistical significance of learning outcomes and the program’s effectiveness in enhancing participants’ competency in managing critical ENT emergencies. 

The study cohort comprised 41 junior doctors who actively participated in a specialized workshop focused on Essential otorhinolaryngology Emergencies, organized by the Department of otorhinolaryngology. The mean age of the participants was 24.73 years, with a standard deviation of ±1.30 years, indicating a relatively narrow age distribution among the attendees, reflective of the cohort’s early-career stage in medicine. Gender distribution among the participants was nearly balanced, with 21 female and 20 male doctors attending the workshop. This gender parity reflects the growing diversity within the medical profession and underscores the inclusive nature of the training initiative. In terms of internship experience, 31 candidates had completed 6 months of their mandatory internship period, while 10 candidates had completed the full 12-month internship requirement. This variation in internship duration provided a spectrum of clinical exposure among the participants, with some having completed a significant portion of their internship training and others nearing its completion. Regarding clinical exposure specifically related to otorhinolaryngology specialties, 25 candidates had already undergone an otorhinolaryngology posting as part of their internship rotations. This subgroup had prior exposure to otorhinolaryngology -related conditions and procedures, potentially influencing their baseline knowledge and readiness to engage with the workshop content. In contrast, 16 candidates had not yet embarked on an otorhinolaryngology posting, indicating a lack of prior specialized training in otorhinolaryngology emergencies prior to the workshop (Table ). Similarly, the mean and standard deviation of pretest score and posttest score were 9.95 and 2.97 and 12.78 and 2.73 respectively. It was found statistically significant ( P < .0001) (Table ). An important aspect highlighted was the participants’ lack of prior attendance at seminars, webinars, or workshops specifically focused on otorhinolaryngology emergencies. None of the participants had previously engaged in formalized educational sessions dedicated to otorhinolaryngology emergencies, emphasizing the workshop’s novelty and the unique educational opportunity it provided for enhancing participants’ knowledge and skills in this critical area of medical practice. Overall, the demographic and training background of the participants underscored the workshop’s relevance and potential impact in filling educational gaps and equipping junior doctors with essential competencies for managing otorhinolaryngology emergencies effectively. By targeting a diverse group of early-career doctors with varying levels of clinical exposure and prior otorhinolaryngology training, the workshop aimed to standardize and elevate the participants’ proficiency in handling urgent otorhinolaryngology conditions, thereby enhancing overall patient care and safety in emergency settings. 

The management of otorhinolaryngology (ORL) emergencies is a critical aspect of acute medical care. Early-career doctors, particularly those in internship or junior doctor roles, are often the first responders to these emergencies in emergency departments or general hospital settings. However, as demonstrated by this study and supported by previous research, junior doctors often lack the specific training and preparedness required to manage such cases effectively. The results of this study underscore the value of targeted educational interventions, such as specialized workshops, in improving knowledge, skills, and confidence in handling ORL emergencies. The findings from this study corroborate those of previous research, which has highlighted significant gaps in the training of junior doctors regarding ORL emergencies. A large proportion of the participants in this study had limited or no prior exposure to ORL-specific emergencies, with many not having participated in any formal ORL-focused training programs before attending the workshop. This lack of specialized training is consistent with the findings of Nair et al, who noted that junior doctors often report feeling underprepared for ORL emergencies due to insufficient exposure during their medical education and clinical rotations.  In many medical schools, the focus of undergraduate training remains on general medicine and surgery, with specialties like otorhinolaryngology receiving less emphasis, which can contribute to significant knowledge gaps.  These gaps are particularly concerning given that ORL emergencies often require rapid and specialized interventions, such as airway management in cases of laryngeal obstruction or the control of severe epistaxis, where delays in treatment can lead to life-threatening outcomes.  The results from this study indicate a significant improvement in both the theoretical knowledge and practical confidence of junior doctors following the ORL emergency workshop. The pre- and posttest scores showed a marked increase, suggesting that the targeted training had a positive impact on participants’ understanding of ORL emergency management. These findings are in line with those of previous studies, revealing that focused educational workshops for junior doctors in ORL significantly enhanced their clinical knowledge and skills in managing emergencies.  Workshops like the 1 described in this study are valuable not only in providing theoretical knowledge but also in offering hands-on experience and practical training. Participants who engage in such training are often more confident and capable when faced with real-life emergencies, as evidenced by the improvements in their post-workshop self-assessment and performance.  Simulation-based training has been particularly effective in teaching skills for emergency care, as it allows junior doctors to practice in a low-risk environment. Simulation-based workshops provide a platform for learners to rehearse emergency procedures and decision-making processes without jeopardizing patient safety.  This approach enhances the ability of junior doctors to respond effectively to high-stress situations in actual clinical settings. Simulation also promotes active learning, where participants can interact with equipment, practice key procedures such as intubation or nasal packing, and refine their decision-making abilities under supervision. The structured feedback provided during these sessions further reinforces learning and skill development.  One of the most crucial aspects of ORL emergency care is airway management. Airway obstruction, whether caused by foreign body aspiration, laryngeal trauma, or swelling, is a potentially life-threatening emergency that requires prompt and decisive action. The ability to quickly assess and secure the airway is a core competency that all junior doctors should possess, particularly when they are often the first healthcare professionals to encounter these cases in emergency settings.  The workshop described in this study specifically focused on airway management techniques, including the use of advanced airway devices, and helped participants practice these skills in a controlled, supervised environment. The importance of airway management training has been highlighted by several studies, that delays in managing airway obstruction are a significant cause of morbidity and mortality in emergency settings, particularly when junior doctors lack the experience or confidence to intervene promptly.  This study supports the idea that well-structured workshops can address this gap by equipping junior doctors with the necessary skills to manage airway emergencies efficiently. Through repeated practice and simulation, junior doctors are better prepared to make critical decisions when managing patients with compromised airways, ultimately improving patient outcomes. While the immediate improvements in knowledge and confidence are encouraging, the long-term impact of specialized workshops remains an important area for further research. Sustained improvements in clinical practice and confidence depend on how well new knowledge is integrated into everyday clinical settings.  Although junior doctors may show marked improvements immediately following training, it is essential to evaluate how well they retain and apply these skills over time. Continued support and reinforcement, such as through follow-up sessions or online educational modules, could help solidify the knowledge gained during workshops and ensure its practical application in real-world emergency settings. Future studies should aim to track the long-term outcomes of such interventions, including clinical decision-making, patient safety, and reduction in errors related to ORL emergencies. Moreover, the increasing demand for specialized training in ORL suggests that similar workshops could be integrated into routine medical curricula. The growing complexity of patient care in emergency departments, coupled with the increasing number of cases involving ORL conditions, makes it imperative that junior doctors receive comprehensive training in this area. Furthermore, expanding training opportunities to include multidisciplinary teams could further improve collaboration and enhance patient care during ORL emergencies. As noted by Brooks et al, structured emergency training not only improves the response of junior doctors but also facilitates better teamwork and communication within healthcare teams, leading to more coordinated and effective management of critical cases.  

This study demonstrates that specialized workshops focused on ORL emergencies can significantly improve junior doctors’ knowledge, skills, and confidence in managing urgent ORL conditions. The results highlight the importance of targeted educational initiatives in bridging the training gaps that often exist in the early stages of medical careers. Given the life-threatening nature of many ORL emergencies, such as airway obstruction and severe epistaxis, providing junior doctors with the tools to manage these conditions is essential for improving patient outcomes. Future research should further explore the long-term effects of such training programs and evaluate their broader implementation in medical education. This study has several limitations. The relatively small sample size of 41 interns may limit generalizability, and the voluntary nature of participation could introduce selection bias, as attendees may have had a greater interest in ENT. Additionally, using the same questionnaire for both pre- and posttests raises concerns about familiarity bias, potentially inflating posttest scores. The lack of a control group restricts our ability to attribute knowledge gains solely to the workshop. Furthermore, while cognitive knowledge was assessed, the study did not evaluate practical skills in real or simulated scenarios. It also did not explore participants’ interests in procedural versus non-procedural specialties, which could impact engagement. Lastly, the focus on immediate outcomes without long-term follow-up and the absence of psychometric evaluation for the assessments raise questions about reliability and sustainability of the findings. Acknowledging these limitations is essential for interpreting the results and informing future research. 

Authors are grateful to all the study participants for their co-operation and support. 

Conceptualization: Sandarva Giri. Data curation: Sandarva Giri, Zenith Rauniyar, Anurag Rimal. Writing – original draft: Sandarva Giri, Sajjad Ahmed Khan. Writing – review & editing: Sandarva Giri, Sajjad Ahmed Khan, Surya Bahadur Parajuli. 

