Literature DB >> 31274728

Perceptions of the Recommended Resident Experience with Common Orthopaedic Procedures: A Survey of Program Directors and Early Practice Surgeons.

Alan K Stotts1, Jessica M Kohring1, Angela P Presson1, Morgan M Millar1, John J Harrast, Ann E Van Heest2, Chong Zhang1, Charles L Saltzman1.   

Abstract

BACKGROUND: U.S. orthopaedic residency training is anchored by the Accreditation Council for Graduate Medical Education (ACGME) requirements, which include minimum numbers for 15 categories of procedures. The face validity of these recommendations and expectations for exposure to other common procedures has not been rigorously investigated. The main goals of this investigation were to understand the perceptions of program directors and early practice surgeons regarding the number of cases needed in residency training and to report which of the most commonly performed procedures residents should be able to perform independently upon graduation.
METHODS: We sent surveys to 157 current program directors of ACMGE-approved orthopaedic surgery residency programs and to all examinees sitting for the American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination in 2017, requesting that they estimate the minimum number of exposures for the 22 adult and 24 pediatric procedures that are most commonly performed during residency and the first 2 years in practice. Where applicable, we compared these with the ACGME "Minimum Numbers" and the average ACGME resident experience data from 2010 to 2012 for resident graduates. For each of the 46 procedures, participants were asked if every orthopaedic resident should be able to independently perform the procedure upon graduation. We compared the percent for independence between the early practice surgeons and the program directors.
RESULTS: For the majority of adult and pediatric procedures, the early practitioners reported significantly higher numbers of cases needing to be performed during residency than the program directors. ACGME Minimum Numbers were always lower than the case numbers that were recommended by the early practice surgeons and the program directors. Overall we found good-to-excellent agreement for independence at graduation between program directors and early practitioners for adult cases (intraclass correlation coefficient [ICC], 0.98; 95% confidence interval [CI], 0.82 to 0.99) and moderate-to-good agreement for pediatric cases (ICC, 0.96; 95% CI, 0.74, 0.99).
CONCLUSIONS: The program directors frequently perceived the need for resident operative case exposure to common orthopaedic procedures to be lower than that estimated by the early practice surgeons. Both program directors and early practice surgeons generally agreed on which common cases residents should be able to perform independently by graduation.

Entities:  

Year:  2019        PMID: 31274728      PMCID: PMC6641477          DOI: 10.2106/JBJS.18.00149

Source DB:  PubMed          Journal:  J Bone Joint Surg Am        ISSN: 0021-9355            Impact factor:   5.284


  8 in total

1.  Shifting paradigms: from Flexner to competencies.

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2.  The next GME accreditation system--rationale and benefits.

Authors:  Thomas J Nasca; Ingrid Philibert; Timothy Brigham; Timothy C Flynn
Journal:  N Engl J Med       Date:  2012-02-22       Impact factor: 91.245

3.  The role of assessment in competency-based medical education.

Authors:  Eric S Holmboe; Jonathan Sherbino; Donlin M Long; Susan R Swing; Jason R Frank
Journal:  Med Teach       Date:  2010       Impact factor: 3.650

Review 4.  Intraclass correlations: uses in assessing rater reliability.

Authors:  P E Shrout; J L Fleiss
Journal:  Psychol Bull       Date:  1979-03       Impact factor: 17.737

5.  The clinical learning environment: the foundation of graduate medical education.

Authors:  Kevin B Weiss; James P Bagian; Thomas J Nasca
Journal:  JAMA       Date:  2013-04-24       Impact factor: 56.272

6.  A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research.

Authors:  Terry K Koo; Mae Y Li
Journal:  J Chiropr Med       Date:  2016-03-31

7.  Operative Experience During Orthopaedic Residency Compared with Early Practice in the U.S.

Authors:  Jessica M Kohring; Michael O Bishop; Angela P Presson; John J Harrast; J Lawrence Marsh; Theodore W Parsons; Charles L Saltzman
Journal:  J Bone Joint Surg Am       Date:  2018-04-04       Impact factor: 5.284

Review 8.  Realizing the promise and importance of performance-based assessment.

Authors:  Jennifer R Kogan; Eric Holmboe
Journal:  Teach Learn Med       Date:  2013       Impact factor: 2.414

  8 in total
  3 in total

Review 1.  Barriers to Increasing Diversity in Orthopaedics: The Residency Program Perspective.

Authors:  Tyler C McDonald; Luke C Drake; William H Replogle; Matthew L Graves; Jaysson T Brooks
Journal:  JB JS Open Access       Date:  2020-05-11

Review 2.  American Board of Orthopaedic Surgery's Initiatives Toward Competency-Based Education.

Authors:  Ann E Van Heest; April D Armstrong; Michael S Bednar; James E Carpenter; Kevin L Garvin; John J Harrast; David F Martin; Peter M Murray; Terrance D Peabody; Charles L Saltzman; Mona Saniei; Lisa A Taitsman; J Lawrence Marsh
Journal:  JB JS Open Access       Date:  2022-05-19

Review 3.  A Review of Orthopaedic Resident Case Logs to Identify Fluctuations in Exposure to Adult Orthopaedic Procedures.

Authors:  Michael F Levidy; Andrew Dobitsch; Justin Luis; Adam N Fano; Ashok Para; Michael Vosbikian; Kathleen Beebe; Neil Kaushal
Journal:  JB JS Open Access       Date:  2021-09-07
  3 in total

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