Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Symposium: New Directions in Orthopaedic Education 6 articles


Objective Structured Assessments of Technical Skills (OSATS) Does Not Assess the Quality of the Surgical Result Effectively

Donald D. Anderson PhD, Steven Long BSE, Geb W. Thomas PhD, Matthew D. Putnam MD, Joan E. Bechtold PhD, Matthew D. Karam MD

Performance assessment in skills training is ideally based on objective, reliable, and clinically relevant indicators of success. The Objective Structured Assessment of Technical Skill (OSATS) is a reliable and valid tool that has been increasingly used in orthopaedic skills training. It uses a global rating approach to structure expert evaluation of technical skills with the experts working from a list of operative competencies that are each rated on a 5-point Likert scale anchored by behavioral descriptors. Given the observational nature of its scoring, the OSATS might not effectively assess the quality of surgical results.

Cognitive and Psychomotor Entrustable Professional Activities: Can Simulators Help Assess Competency in Trainees?

Tim Dwyer MBBS, Veronica Wadey MD, MEd, Douglas Archibald PhD, William Kraemer MD, Jesse Slade Shantz MD, John Townley MD, Darrell Ogilvie-Harris MD, MSc, Massimo Petrera MD, Peter Ferguson MD, MSc, Markku Nousiainen MD, MEd

An entrustable professional activity describes a professional task that postgraduate residents must master during their training. The use of simulation to assess performance of entrustable professional activities requires further investigation.

Musculoskeletal Medicine Is Underrepresented in the American Medical School Clinical Curriculum

Benedict F. DiGiovanni MD, Leigh T. Sundem BS, Richard D. Southgate MD, David R. Lambert MD

Musculoskeletal (MSK) conditions are common, and their burden on the healthcare system is increasing as the general population ages. It is essential that medical students be well prepared to evaluate and treat MSK disorders in a confident manner as they enter the workforce. Recent studies and the American Association of Medical Colleges have raised concern that medical schools may not give sufficient instruction on this topic. Other authors have shown that preclinical instruction has increased over the past decade; however, it is unclear if required clinical instruction also has followed that trend.

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Justues Chang MD, Daniel C. Banaszek MD, Jason Gambrel MD, Davide Bardana MD

Work-hour restrictions and fatigue management strategies in surgical training programs continue to evolve in an effort to improve the learning environment and promote safer patient care. In response, training programs must reevaluate how various teaching modalities such as simulation can augment the development of surgical competence in trainees. For surgical simulators to be most useful, it is important to determine whether surgical proficiency can be reliably differentiated using them. To our knowledge, performance on both virtual and benchtop arthroscopy simulators has not been concurrently assessed in the same subjects.

Orthopaedic Surgery Residents and Program Directors Agree on How Time Is Currently Spent in Training and Targets for Improvement

Christopher L. Camp MD, John R. Martin MD, Matthew D. Karam MD, Daniel B. Ryssman MD, Norman S. Turner MD

Although much attention has been paid to the role of deliberate practice as a means of achieving expert levels of performance in other medical specialties, little has been published regarding its role in maximizing orthopaedic surgery resident potential. As an initial step in this process, this study seeks to determine how residents and program directors (PDs) feel current time spent in training is allocated compared with a theoretical ideal distribution of time.