Orthopedic boot camp: Examining the effectiveness of an intensive surgical skills course

doi:10.1016/j.surg.2010.11.011

Surgery

Volume 149, Issue 6, June 2011, Pages 745-749

Presented at the third annual meeting of the Consortium of ACS-Accredited Education Institutes, March 12–13, 2010, Chicago, IL.

https://doi.org/10.1016/j.surg.2010.11.011 Get rights and content

Background

Changes in health care across the globe have had a profound impact on the number of hands-on surgical training opportunities that are available to residents. In the current study, we examine whether an intensive laboratory-based skills course at the start of orthopedic surgical training is an effective mechanism for teaching core technical skills.

Methods

First-year residents were divided into 3 groups (on-service, n = 8; off-service, n = 8; and a new, competency-based program that has as a major element of the curriculum a focused, intensive skills laboratory-based experience, n = 6). Baseline surgical skills were assessed prior to commencing training. The intensive skills laboratory group was then given an intensive surgical skills course, whereas the other 2 groups embarked on traditional residency. After the surgical skills course, all the residents were assessed for core surgical skills using an objective structured assessment of technical skills (OSATS) procedure.

Results

Pretraining scores revealed no differences between the groups of residents using both checklist (F[2,19] = 0.852, P = .442) and global rating scores (F[2,19] = 0.704, P = .507). Post-training scores revealed a significant difference, with residents from the intensive skills laboratory group performing better on both the checklists (on-service = 78.9, off-service = 78.6, intensive skills laboratory = 92.3; F[2,19] = 6.914, P < .01) and global rating scores (on-service = 3.4, off-service = 3.4, intensive skills laboratory = 4.3; F[2,19] = 5.722, P < .01), than the other groups who showed no differences between them.

Conclusion

The intensive skills course used in this study was highly effective at teaching and developing targeted surgical skills in first-year orthopedic residents. We predict that allowing residents to acquire key technical skills at the start of their training will enhance learning opportunities at later stages of training.

Section snippets

Methods

First-year residents admitted to the orthopedic surgery program at the University of Toronto were divided into 2 groups: standard training paradigm [STD] (n = 16) and a novel competency-based curriculum which has as major component an intensive skills laboratory training program [ISL] (n = 6). The residents in the standard training group were subdivided into those who began training with a 3-month orthopedic rotation (on-service, n = 8) and those who began with a 3-month off-service rotation

Results

An analysis of data from the checklists revealed no significant performance differences between the groups prior to the commencement of their respective training programs (on-service = 70.1, off-service = 67.4, ISL = 72.1; main effect of group F(2,19) = 0.852, P = .442). The mean pretest GRS scores also revealed no significant differences between the groups prior to the commencement of training (on-service = 2.8, off-service = 2.7, ISL = 2.9; F(2,19) = 0.704, P = .507).

At the end of their first

Discussion

No measurable differences were found in the performance of the 3 different groups prior to the start of their training program, as expected. After the surgical skills course, however, the ISL group showed significant improvement over both the on-service and off-service resident groups. Both checklist and GRS measures revealed that the largest improvements were observed on tasks specific to orthopedic surgery (wedge cutting using reciprocating and oscillating saws, bone drilling and screw

Acknowledgments

Lisa Satterthwaite, Renee Ong, Greg Drozdzal, Andrew Yuen, Jim Burkitt, John Ihnat and the technicians from the University of Toronto Surgical Skills Centre assisted with data collection and manuscript preparation.

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Thirty health sciences students with no previous arthroscopy experience were recruited and randomized into 1 of 3 groups: MBT, TL, or C (1:1:1 ratio). Participants in MBT were required to independently practice on a VirtaMed ArthroS simulator (VirtaMed AG, Zurich, Switzerland) for a minimum of 2 hours per week, whereas TL received one-on-one coaching by a senior orthopaedic resident for 15 minutes per week. The control group received no training. All groups were assessed at baseline and at 4 weeks based on objective measures generated by the surgical simulator (procedure time, camera path length, meniscus cutting score, detailed visualization, safety score and total score), and subjective ratings scales (Objective Assessment of Arthroscopic Skill [OAAS] global assessment form, and Competency-Based Assessment form).
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: Supported in part by the Network of Excellence in Simulation for Clinical Teaching and Learning.

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Simulation-Based Surgical EducationOrthopedic boot camp: Examining the effectiveness of an intensive surgical skills course

Background

Methods

Results

Conclusion

Section snippets

Methods

Results

Discussion

Acknowledgments

Ophthalmology

Am J Surg

J Surg Res

Reforming higher specialist training in the United Kingdom–a step along the continuum of medical education

Med Educ

Education of senior house officers: current challenges

Postgrad Med J

A structured competency based training programme for junior trainees in emergency medicine: the “Dundee Model.”

Emerg Med J

A model for GME: shifting from process to outcomes. A progress report from the Accreditation Council for Graduate Medical Education

Med Educ

Cognitive skills and their acquisition

Long term athlete development in Canadian fencing

Developing a standardized test for the assessment of suturing skill in novice microsurgeons

Microsurgery

Competency-based residency training: the next advance in graduate medical education

Acad Med

Design, implementation, and outcome of a hands-on arthrocentesis workshop

J Clin Rheumatol

Simulation-Based Surgical Education
Orthopedic boot camp: Examining the effectiveness of an intensive surgical skills course