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 (postgraduate 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

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.

Table 1.docx (13 kB)
Modified Cormack-Lehane grading score by level of training

Table 2.docx (13 kB)
P-values of pairwise comparisons for level of training

Table 3.docx (13 kB)
Comparison of FNL timings based on level of experience

Table 4.docx (13 kB)
Average Patient Age Undergoing FNL Based on Level of Training



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