Effectiveness of a Modified Skull Model for Nasopharyngeal Swab Training among Undergraduate Medical Students: A Prospective Interventional Study

Introduction: Nasopharyngeal swab collection is considered one of the most sensitive methods for obtaining upper respiratory tract specimens; however, it requires adequate anatomical understanding and proper technique. Inadequate training may lead to patient discomfort, procedural complications, and falsenegative results. Aim: To assess the effectiveness of a modified skull model in improving knowledge, confidence, and technical skills related to nasopharyngeal swab collection among undergraduate medical students. Materials and Methods: The present prospective interventional study was conducted among 75 Phase III MBBS students by the Department of Otorhinolaryngology at Varun Arjun Medical College & Rohilkhand Hospital, Uttar Pradesh, India, a tertiary care teaching hospital in Northern India between November 2024 and mid-February 2025. A cadaveric skull model was modified using silicone, cotton pads, and coloured inks to simulate nasal and nasopharyngeal anatomy. Participants received a structured demonstration followed by supervised hands-on practice until three consecutive successful swabs were achieved. Knowledge, confidence, and procedural skills were assessed before and after training using a structured questionnaire and an observational checklist. Results: The mean knowledge score improved significantly from 1.85±1.06 before training to 8.10±1.20 after training (p<0.0001). Confidence levels increased markedly, with 64 participants (85.3%) reporting high confidence (Likert 4-5) after training. Significant improvement was also observed in procedural skills, including swab direction, insertion depth, and correct identification of the nasopharyngeal sampling site (p<0.0001). Conclusion: The modified skull model proved to be an effective, affordable, and reproducible tool for improving knowledge, confidence, and technical proficiency in nasopharyngeal swab collection among undergraduate medical students.