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Table 3 Selected student comments on barriers to performing pneumatic otoscopy

From: A survey comparison of educational interventions for teaching pneumatic otoscopy to medical students

Group Comment
Task Trainer I did not see ANY other providers doing pneumatic otoscopy. Not a single attending or resident. This sort of made it feel like an added part of the exam that was not quite necessary.
  [Pneumatic otoscopy] was not used at all by supervising physicians and was regarded as unnecessary.
Video Presentation No attendings used insufflators in practice, and I think this was the biggest barrier to using the insufflator, myself. I found that when I was in a room alone, I was more likely to use the insufflator.
  Outpatient office asked me not to do [pneumatic otoscopy].
Peer-to-peer Preceptor advised [me] not to use pneumatic exams because they hurt patients.
  I didn’t see one attending use an insufflator, and I followed suit at first just to save time, but then got out of the habit and stopped.