Orthopaedic in-training examination performance: a nine-year review of a residency program database.

BACKGROUND: The Orthopaedic In-Training Examination (OITE) provides an objective way for both the residency program and the resident to monitor progress.
METHODS: This longitudinal descriptive study tracks the OITE performance of 16 residents from one orthopaedic surgery residency program over nine years (1997-2005). Domain comparisons are made to national averages (N > 3000) by mean difference and split middle celeration line assessment trend analysis to evaluate program strengths and weaknesses. Further evaluation by postgraduate year (PGY) is made of domains that were deemed to be in need of moderate attention.
RESULTS: Resident performance for the medically related issues, rehabilitation, and sports medicine domains were deemed acceptable. Resident performance on the orthopaedic science, orthopaedic diseases, hip and knee reconstruction, spine, and shoulder and elbow domains were deemed to be in need of minor attention. Musculoskeletal trauma, pediatric orthopaedics, foot and ankle, and hand domains were deemed to be in need of moderate attention. Further analysis of these domains by PGY revealed less positive slopes for the pediatric orthopaedics and musculoskeletal trauma domains, and a negative slope for the hand domain between PGY-3 and PGY-4, each indicative of lower domain-specific OITE scores than the national mean. A similar, less positive slope was identified between PGY-2 and PGY-3 for the foot and ankle domain.
CONCLUSIONS: A longitudinal descriptive review of orthopaedic surgery resident OITE performance enables the departmental education committee to identify curricular content areas that require attention, select the most efficient modes of educational information delivery, facilitate learning through the application of innovative educational technologies, establish measurable educational program goals, and more prescriptively allocate personnel and equipment resources.