A surgical skills training curriculum for PGY-1 residents: AAOS exhibit selection.

Abstract

A paradigm shift is currently taking place in orthopaedic surgical skills education1. Traditionally, surgical skills have been acquired through an apprenticeship method, which has produced skilled surgeons. However, recent reports have attributed over 60% of errors in the operating room (OR) to technical problems2,3. Incoming orthopaedic residents have little to no surgical training, and it is virtually impossible to assess the surgical skills aptitude of individual residency candidates4. An increased focus on patient safety, the mandate for trainee work-hour restrictions, and the advent of more skills-intensive technology have driven the need to develop standardized skills training curricula. Other surgical specialties such as general surgery have required simulation training and have developed skills curricula that are used in residency training5. The Residency Review Committee (RRC) for Orthopaedic Surgery and the American Board of Orthopaedic Surgery (ABOS) have recently mandated that residency training programs implement a structured surgical skills curriculum for resident education in postgraduate year (PGY)-16. The curriculum must include skills required for emergency orthopaedic care and provide initial training in basic skills of orthopaedic surgery. In advance of these new requirements, our Department of Orthopaedics and Rehabilitation developed and piloted a one-month surgical skills course with a structured curriculum for PGY-1 orthopaedic residents. The curriculum incorporated multiple instructional elements, including background reading and didactic teaching (cognitive knowledge), live and video-recorded expert demonstrations, expert-guided and independent dedicated practice (skills training), and multiple opportunities for assessment and critical feedback. We herein describe the course from its initial planning through curriculum development and finally to its implementation. Lessons learned from the experience and potential areas for improvement are highlighted. ### Source of Funding The course was funded in part by an OTA (Orthopaedic Trauma Association) grant, an OREF (Orthopaedic Education and Research Foundation) grant, a …