394 Middle ear infections are a continuing cause of hear- ing loss, related complications, and even mortality. The problem is particularly prevalent in developing world regions. 1 The World Health Organization has noted that “acute otitis media is one of the most common infec- tions of childhood in all countries” and “it is the most important cause of conductive hearing loss in young people in developing countries.” 2 As part of an ongoing project to improve the diagnosis and treatment of otitis media, the Latin American Otitis Media Research and Training Program (LAOMRTP), a nonprofit organiza- tion, has presented educational programs to providers in Latin America. 3-9 This prospective study presents results from courses in six Mexican cities and one Venezuelan city. The study’s specific objective is to assess the efficacy of information transfer with the current multimodality curriculum, which includes both a didactic and a prac- tical component. METHODS AND MATERIAL The experiment was designed with a precourse and post- course examination of each participant with subjects serving as their own controls. The course examination consisted of 33 multiple choice items, which included 35 mm slide projec- tions of a normal tympanic membrane, a perforation, acute otitis media, otitis media with effusion, a pressure equaliza- tion tube in place, and an attic cholesteatoma. Each course was conducted in 1 day. The course began with a precourse examination. The course participants’ iden- tities were kept anonymous with a code used to label the pre- course and postcourse examinations. After the pretest, didac- tic sessions including lectures, videotapes, and live demon- strations were conducted on the following: the anatomy and physiology of the middle ear; pathophysiology of otitis media; epidemiology; microbiology; clinical presentation; clinical diagnosis with an emphasis on pneumatic otoscopy; audiometry including pure-tone audiometry, speech testing, and evoked potentials; medical and surgical treatment; and complications. The participants then were divided into four groups and rotated through four stations of practical experi- ence. Station 1 involved practice pneumatic otoscopy and tympanocentesis with double-headed otoscopes and man- nequins with replaceable tympanic membranes. Station 2 pre- sented an otoscopy video demonstration of various patholog- Educational outcomes of an otitis media workshop for primary care providers in Latin America ALBERTO VILLASEÑOR, MD, MOISÉS A. ARRIAGA, MD, ROLAND D. EAVEY, MD, JOSÉ IGNACIO SANTOS, MD, and EDGAR CHISSONE, MD, Guadalajara, Jalisco, Mexico, Pittsburgh, Pennsylvania, Boston, Massachusetts, and Caracas, Venezuela Otitis media is a prevalent condition that can be diagnosed and treated by primary care providers skilled in otoscopy. Previous analysis demonstrated that brief, intensive instruction at one site in rural Mexico improved the test scores of health care providers and changed long-term practices (Eavey R, et al. Otolaryngol Head Neck Surg 1993;109:895-8). We want- ed to confirm these test score findings at other sites. A didactic course on otitis media with a practical otoscopy workshop was conducted at six Mexican locations and in one Venezuelan city by an interdisciplinary group of physicians. The same coded test was given immediately before and after the course. The Wilcoxon test for significance of intra- subject performance before and after intervention was used as a nonparametric assess- ment. At all seven sites (n = 190 subjects), test scores demonstrated statistically significant improvement (range = p < 0.001 to p < 0.0001). We conclude that this educational method consistently improved short-term knowledge of otitis media and that further teaching efforts and a longer term practice-impact study are warranted. (Otolaryngol Head Neck Surg 1998;118:394-6.) From the Unidad de Investigacion Epidemiologica Y Microbiologica en Servicos de Salud IMSS (Dr. Villaseñor); the Hearing and Balance Center and Pittsburgh Ear Associates (Dr. Arriaga), Allegheny General Hospital; the Department of Otolaryngology (Dr. Eavey), Massachusetts Eye and Ear Infirmary; the Department of Otology and Laryngology (Dr. Eavey), Harvard Medical School; Epidemiology Surveillance Coordinator (Dr. Santos), Ministry of Health, Mexico; and the Venezuela Foundation of Otology (Dr. Chissone). Supported in part by a donation from the American Academy of Otolaryngology–Head and Neck Surgery Foundation, Inc. Presented at the Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery, New Orleans, La., Sept. 17-20, 1995. Reprint requests: Moisés A. Arriaga, MD, FACS, Hearing and Balance Center, Allegheny General Hospital, 420 E. North Ave., Suite 402, Pittsburgh, PA l5212. Copyright © 1998 by the American Academy of Otolaryngology– Head and Neck Surgery Foundation, Inc. 0194-5998/98/$5.00 + 0 23/77/87074