USF Health’s Division of Allergy and Immunology will create a pilot educational program to train fellows how to use fiberoptic rhinopharyngolaryngoscopy (rhinoscopy for short) to evaluate upper airway diseases. The program, which will combine streaming-video lectures with hands-on procedure training, was the first of its kind approved by the national Residency Review Committee.

“We are in a position to set up a program to train all other Allergy and Immunology training programs in North America as experts in the area of rhinoscopy, an essential part of our specialty’s practice,” said Division Director Richard Lockey, MD, professor of medicine who oversees the USF Allergy and Immunology Fellowship Training Program.

Upon successful implementation of the novel online educational module, the Accreditation Council for Graduate Medical Education’s RRC will extend the A & I training program’s recent reaccreditation from five to 10 years. “If we did not have such an excellent record with the ACGME, this distinction would not be possible,” Dr. Lockey said.

Rhinoscopy, performed by inserting a thin flexible tube into the nasal passage, uses a fiberoptic light to examine inside the nose and throat. It can help the physician identify problems that may not be detected by X-ray or CT scan, including sinus infections, nasal polyps, laryngeal evidence of acid reflux and vocal cord dysfunction. It can evaluate if medications are working or if surgery is needed.

While proficiency in rhinoscopy is not yet a requirement for graduate medical education in allergy and immunology, recent advances in technology have increased its usefulness as a diagnostic technique for chronic upper respiratory diseases. Yet, less than 30 percent of the 71 A&I programs in North America have the resources to teach the endoscopic procedure to their physicians in training, said Mark Glaum, MD, PhD, assistant professor of medicine in the Division of Allergy and Immunology.

Dr. Glaum, who developed USF’s proposal with colleagues Roger Fox, MD, and Dennis Ledford, MD, presented the proposed pilot project to A&I program directors at their winter meeting in San Antonio, TX, earlier this year. “It was very well received,” he said. “Meaningful training in rhinoscopy represents an important skill and current curriculum gap in many programs… Our program may be a new modality to help physicians-in-training based in more rural areas without access to certain technology, equipment and expertise.”

The USF Division of Allergy and Immunology will prepare a web-based educational module including online lectures and instructional video demonstrating rhinoscopy for evaluation of upper airway diseases. The program will be offered through streaming video on the A&I Division website and available to download onto mobile computer devices, like PDAs and smartphones, through Apple’s iTunes U website. This online content will reinforce and be coordinated with hands-on rhinoscopy training sessions at the American Academy of Allergy, Asthma & Immunology (AAAI) and American College of Allergy, Asthma and Immunology (ACAAI) meetings.

USF will evaluate the pilot program’s effectiveness by surveying A &I program directors and fellowship graduates who did and did not participate in the project.

The Division plans to roll out the online course by January 2010 and couple it with the hands-on rhinoscopy workshop at the 2010 AAAI annual meeting in New Orleans, LA.

– Story by Anne DeLotto Baier, USF Health Communications