Teaching Ear Examination Skill to Undergraduate Students Using Check List


For examination of ear, proper illumination is a pre requisite. Diseases related to ear may lead to altered sense of hearing and may affect normal balance system. If students are taught to examine ear using a check list, they may perform better. To teach ear examination to undergraduate students using a check list. Total 50 undergraduate students of M.B.B.S. attending E.N.T. clinic in Chirayu Medical College and Hospital were included in the study. They were given enrolment no. 1 to 50 and were divided into two groups. Group 1, enroll. no. 1 to 25 and group 2, enroll. no. 26 to 50. Group 1 was taught using check list and the Group 2 was taught without use of checklist. Both the groups were evaluated using check list. The group B students were again taught, using check list and were again evaluated using check list. Use of check list showed that there was statistically significant improvement in learning by students using check list in group 1 students compared to group 2 students who were taught without use of check list. The group 2 students also had improvement on evaluation, after they were taught using check list. Study suggests that use of check list for ear examination skill to undergraduate students has significant role and students learn better than when taught without use of checklist. Inclusion of checklist for teaching ear examination to undergraduate students may be considered.

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  1. 1.

    Clack GB (1994) Medical graduates evaluate the effectiveness of their education. Med Educ 28:418–431

    CAS  Article  Google Scholar 

  2. 2.

    Remmen R, Denekens J, Scherpbier A, Hermann I, van der Vleuten C, van Royen P, Bossaert L (2000) An evaluation study of the didactic quality of clerkships. Med Educ 34:460–464

    CAS  Article  Google Scholar 

  3. 3.

    Sanson-Fisher RW, Rolfe IE, Williams N (2005) Competency based teaching: the need for a new approach to teaching clinical skills in the undergraduate medical education course. Med Teach 27(1):29–36

    CAS  Article  Google Scholar 

  4. 4.

    Williams S, Dale J, Glucksman E, Wellesley A (1997) Senior house officers’ work related stressors, psychological distress, and confidence in performing clinical tasks in accident and emergency: a questionnaire study. BMJ 314:713–718

    CAS  Article  Google Scholar 

  5. 5.

    Bradley P, Bligh J (2004) Setting up and running clinical skills learning programmes. Med Educ Clin Teach 1(2):53–58

    Article  Google Scholar 

  6. 6.

    Bradley P, Bligh J (1999) One year’s experience with a clinical skills resource centre. Med Educ 33:114–120

    CAS  Article  Google Scholar 

  7. 7.

    Bradley P, Bligh J (2005) Clinical skills centres: where are we going? Med Educ 39:649–650

    Article  Google Scholar 

  8. 8.

    Bradley P, Postlethwaite K (2003) Setting up a clinical skills learning facility. Med Educ 307(Suppl. 1):6–13

    Article  Google Scholar 

  9. 9.

    Nomura Y (1982) A needle oto scope. An instrument of endotoscopy of the middle ear. Acta Otolaryngol 93(1–2):73–79

    CAS  Article  Google Scholar 

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Correspondence to Anil Kumar Jain.

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Appendix 1: Ear Examination Check List

  1. 1.

    Explains the procedure to the patient

    Explains that an instrument will be used, but it will not be painful.

  2. 2.

    Prepares to examine:

  3. (a)

    Sits down close alongside or in front of the patient;

  4. (b)

    Positions the patient so that her/ his ear faces the student squarely.

  5. (c)

    Selects the speculum which fits snugly into the patient’s external ear opening and fits it to the otoscope.

  6. (d)

    Takes up the otoscope and switches it on—should use the right hand for the right ear examination and left hand for the left ear.

  7. (e)

    Retracts the pinna upwards and backwards, to bring the cartilaginous canal into line with the bony canal.

  8. (f)

    Places the speculum and otoscope into the external meatus (no deeper than 1 cm) and looks through it.

  9. 3.

    Examines the external ear canal and comments on:

  10. (a)

    Its contents (wax, secretions, foreign bodies).

  11. (b)

    Its walls (smooth, pinkish, dry).

  12. 4.

    Examines the eardrum and comments on:

  13. (a)

    Whether it is intact (normal: no perforations).

  14. (b)

    Its colour (normal: pearly grey).

  15. (c)

    Cone of light (normal: shiny—a cone, from the centre forwards and downwards).

  16. (d)

    The handle of the malleus.

  17. 5.

    Checks hearing using whispered voice.

  18. 6.

    Occludes opposite ear and lips not visible.

  19. 7.

    Performs Weber test.

  20. 8.

    Rinne test.

  21. 9.

    Absolute Bone Conduction test.

  22. 10.

    Communicates the findings of the examination briefly to the patient.

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Jain, S., Jain, A.K. Teaching Ear Examination Skill to Undergraduate Students Using Check List. Indian J Otolaryngol Head Neck Surg 71, 1529–1534 (2019). https://doi.org/10.1007/s12070-019-01596-z

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  • Check list
  • Ear examination
  • Under graduate students
  • M.B.B.S