Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: New Directions in Orthopaedic Education 4 articles


Is Teaching Simple Surgical Skills Using an Operant Learning Program More Effective Than Teaching by Demonstration?

I. Martin Levy MD, Karen W. Pryor BA, Theresa R. McKeon BA

A surgical procedure is a complex behavior that can be constructed from foundation or component behaviors. Both the component and the composite behaviors built from them are much more likely to recur if it they are reinforced (operant learning). Behaviors in humans have been successfully reinforced using the acoustic stimulus from a mechanical clicker, where the clicker serves as a conditioned reinforcer that communicates in a way that is language- and judgment-free; however, to our knowledge, the use of operant-learning principles has not been formally evaluated for acquisition of surgical skills.

Simulation for Teaching Orthopaedic Residents in a Competency-based Curriculum: Do the Benefits Justify the Increased Costs?

Markku T. Nousiainen MD, MSc, MEd, Sydney A. McQueen BSc, MSc, Peter Ferguson MD, MSc, Benjamin Alman MD, William Kraemer MD, Oleg Safir MD, MEd, Richard Reznick MD, MEd, Ranil Sonnadara PhD

Although simulation-based training is becoming widespread in surgical education and research supports its use, one major limitation is cost. Until now, little has been published on the costs of simulation in residency training. At the University of Toronto, a novel competency-based curriculum in orthopaedic surgery has been implemented for training selected residents, which makes extensive use of simulation. Despite the benefits of this intensive approach to simulation, there is a need to consider its financial implications and demands on faculty time.

A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study

R. Kyle Martin MD, Danny Gillis MD, Jeff Leiter MSc, PhD, Jesse Slade Shantz MD, MBA, Peter MacDonald MD

Previously validated knee arthroscopy evaluation tools have used human cadaveric knees. This is unsustainable because of the cost and scarcity of these specimens. Porcine (pig) knees are anatomically similar, affordable, and easily obtainable; however, whether porcine knees represent a suitable alternative to human specimens has not been evaluated.

Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

Tina Raman MD, Rami George Alrabaa BS, Amit Sood MD, Paul Maloof MD, Joseph Benevenia MD, Wayne Berberian MD

More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty.