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At baseline, a larger percentage of third-year students correctly matched both tympanic membranes compared to first-year students (27% vs 8%, P less then .01). After otoscopy training, correct matching of both tympanic membranes significantly improved among both first-year students (8-31%, P less then .01) and third-year students (27-54%, P less then .01). CONCLUSION The use of tympanic membrane photographs from standardized patients provides a novel technique for objectively assessing proficiency in otoscopic visualization of th