A Learner-Centered Education Strategy: Optimizing an Interactive and Multimodal Learning Format in Orthopaedic Hip & Knee Arthroplasty

Abstract

The Accreditation Council for Graduate Medical Education (ACGME) and The American Board of Orthopaedic Surgery proposed The Orthopaedic Surgery Milestone Project. Training residency and fellowship programs have evolved accordingly adjusting academic curriculums. A new comprehensive Learner-Centered Education Curriculum (LCEC) was designed based on critical reviews and interactive collaboration between faculty, residents, and fellows using structured interviews and iterative feedback. We aim to evaluate the results at 4 years after implementation of a new curriculum. The new adult arthroplasty LCEC was implemented in 2015; data collected between 2015 and 2019 was retrospectively reviewed and analyzed. Our primary goal was to evaluate educational, research, and quality successes using objective and quantitative academic quality metrics including annual Orthopedic In-Training Examination scores for the Hip & Knee domain to evaluate the medical knowledge competency. This study was conducted at the Department of Orthopedic Surgery residency and fellowship program of Adult Arthroplasty and Joint Reconstruction Surgery, University of Florida (tertiary care center). Participants include 25 learners (PGY-1 to 5, Clinical fellows) and faculty of an ACGME-accredited orthopedic surgery residency and adult arthroplasty fellowship program. Significant improvements in academic, research and quality metrics were obtained since implementation of the LCEC: Orthopedic In-Training Examination scores for Hip & Knee domain increased from 50th to 87th percentile (P=0.042), annual learner peer-reviewed publications and research awards from none before intervention to 20 and 8 respectively (p < 0.05). Resident and fellows conference attendance improved from 81% to 99% (p = 0.0001). The ACGME resident Likert-evaluations also improved from 4.6 to 4.8. This LCEC, by enhancing an interactive and active academic learning experience, positively influenced fund of knowledge, conceptual thinking, and interest in the specialty and learner attitudes. Significant and consistent improvements in academic, research, and quality metrics were obtained, while maintaining the highest resident evaluation scores in the program.