Document Type

Original Report


Higher Education | Medicine and Health Sciences | Otolaryngology


Background: To assess when residents become proficient in performing flexible nasolaryngoscopy (FNL) in the pediatric population.

Objective: To objectively evaluate the quality of FNL by year of residency training.

Methods: Ninety-five pediatric FNL’s were performed by otolaryngology residents and pediatric otolaryngology fellows (post-graduate year [PGY] 1 – 6). Three pediatric otolaryngologists rated the FNL videos (anonymized and without sound) using the Modified Cormack‐Lehane scoring system (MCLS). Data analysis was performed using two-way ANOVA and Tukey-Kramer adjustment.

Results: Overall, there was a significant difference in the quality of the FNL based on the year of training (p<0.0001). Comparing specific years, there was a statistically significant difference between PGY-1 and PGY-2 (p=0.004); however, there was no difference between years of training beyond the PGY-2 year.

Conclusion: The quality of pediatric FNL improves after the PGY -1 year. Current training consists of the traditional “see one, do one, teach one” rubric. Future educational goals should focus on developing a curriculum to shorten the time to achieve proficiency in pediatric FNL.




Pediatrics, Otolaryngology, Laryngoscopy

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.