Orthopaedic Education Research Articles

Unveiling the ultimate advantage: a meta-analysis of 3D visualization and problem-based learning in orthopedic education

BackgroundThree-dimensional (3D) visualization has become increasingly prevalent in orthopedic education to tackle the distinct anatomical challenges of the field. However, there is a conspicuous lack of systematic reviews that thoroughly evaluate both the advantages and drawbacks of integrating 3D with problem-based learning (3D + PBL).MethodsA rigorous search of English databases (Cochrane Library, Embase, PubMed, Scopus, and Web of Science) and Chinese databases (National Knowledge Infrastructure: CNKI, Chongqing VIP: VIP, and Wan Fang) were performed up to July 2024 to identify relevant studies. Relevant studies were selected based on established eligibility criteria, with clinical data carefully extracted for analysis. Eighteen randomized controlled trials involving a total of 1,077 participants were included in the analysis.ResultsThe findings indicated that 3D + PBL instruction significantly outperformed traditional lecture-based learning (LBL) in terms of theoretical knowledge (SMD = 1.62, 95% CI: 1.14–2.10, P < 0.00001) and practical operational scores (SMD = 2.29, 95% CI: 1.41–3.16, P < 0.00001). Furthermore, students exposed to 3D + PBL teaching exhibited a significantly better understanding of orthopedic anatomical structures compared to those receiving LBL (SMD = 1.18, 95% CI: 0.71–1.65, P < 0.00001). Additionally, students in the 3D + PBL group achieved higher theoretical grades (OR = 2.95, 95% CI: 1.57–5.55, P = 0.0008) and reported greater overall satisfaction (OR = 3.26, 95% CI: 1.91–5.54, P < 0.0001) compared to their LBL counterparts.ConclusionGiven the unique demands of orthopedic education, 3D + PBL emerges as a highly effective teaching method. It not only improves students' theoretical scores but also enhances their communication skills and comprehension of complex concepts. Furthermore, students exhibit greater satisfaction with this approach.

Foot and ankle fellowship-trained osteopathic orthopaedic surgeons: a review, analysis, and understanding of current trends.

Over the past several decades, orthopedic surgery has seen a substantial increase in the number of surgeons completing fellowship training. Doctors of Osteopathic Medicine (DOs) continue to advance their orthopedic education through subspecialty fellowship training. DOs have represented between approximately 6 % and 15 % of American Orthopaedic Foot and Ankle Society (AOFAS) fellows. Although historical representation has been considered strong, the fellowship match years 2020 and 2021 have seen a decline in osteopathic orthopedic surgeons participating in foot and ankle fellowships. This deviates from the recent trends of increasing participation across orthopedic subspecialities. To investigate and review the trends of orthopedic foot and ankle fellowship training. Data was reviewed from the AOFAS regarding number of fellows matched and degree obtained. Data from the Federation of State Medical Boards (FSMB), American Orthopaedic Foot and Ankle Society (AOFAS) and Association of American Medical Colleges (AAMC) were reviewed for physician trends and match statistics. Fellowship match years 2020 and 2021 have seen a decline in osteopathic orthopedic surgeons participating in foot and ankle fellowships, with only roughly 3% of AOFAS fellows being osteopathic trained. Orthopedic surgery has the highest rate of subspecialty training of all surgical specialties. Although there is hope for an increasing osteopathic presence in orthopedic surgery, recent literature has pointed to potential for continued bias in opportunities for osteopathic students. We hope that increased participation of osteopathic graduates in orthopedic surgery training programs will result in the continued expansion of osteopathic orthopedic surgeons completing fellowship training, including in foot and ankle surgery.

Breaking the Mould: Comparing 3D-Printed and Composite Bone Models in Orthopaedic Training.

Background and aim Synthetic composite bone models (reinforced solid foam) have become the standardised material used in practical orthopaedic education. However, with discussions regarding whether composite foam truly replicates human bone, there has been a drive to explore other available models. Three-dimensional (3D) printing has risen in both popularity and availability, providing a new option in the creation of anatomically accurate bone models. We designed a pilot study to assess whether a new formulation of synthetic bone provides the same tactile feedback that is essential for training purposes. Method Orthopaedic trainees of various grades across two London hospital trusts were invited to participate in a distal radius fixation workshop. As part of the workshop, trainees were asked to complete the following three tasks on the two different models: Kirschner-wire driving, pilot hole drillingand screw insertion. Participants were blinded in this trialand not informed which model was made via 3D printing or the conventional composite bone. Following completion, participants provided feedback on tactile feedback for each task on each model. Results Twenty-three orthopaedic trainees participated in the workshop, with overall majority agreement in all clinical skills that the 3D-printed model provided better tactile feedback. Three-dimensional models were rated superior in K-wire driving (mean score 7.39 vs 4.82; p<0.001) and pilot hole drilling (7.87 vs 4.96; p<0.001), with no significant difference in screw insertion. Qualitative feedback from testers noted a more anatomical representation of the 3D-printed bone, in addition to an overall better representation of the corticomedullary junction. Conclusion Overall, 3D printed models provide a new high-fidelity and sustainable option when seeking bone models for modern-day orthopaedic training. At present composite bone remains the standard for workshops. However, with the growing availability of 3D-printing models, and as supported by this study, they crucially provide the medium for future orthopaedic surgeons to learn and gain confidence.

CORR® Curriculum—Orthopaedic Education: Thinking the Unthinkable: How Should We Train for Future Combat Casualty Care?

CORR® Curriculum—Orthopaedic Education: Thinking the Unthinkable: How Should We Train for Future Combat Casualty Care?

Musculoskeletal Clinical Online Cases With a Focus on Anatomy for Preclinical Learners.

While musculoskeletal disorders are leading causes of medical visits, musculoskeletal education is underrepresented in US medical curricula. Previous studies have demonstrated that undergraduate medical students often fail to demonstrate competency surrounding musculoskeletal disorders. More educational content is needed to support musculoskeletal knowledge in learners. We developed an online, case-based musculoskeletal module for second-year medical students alongside their standard course material and presented clinical cases with multiple-choice question quizzes regarding the presentation, diagnosis, and anatomic correlation of musculoskeletal conditions. Cases, under 10 minutes each, targeted common, medically important areas of musculoskeletal health. Grades in the required musculoskeletal course were significantly and positively correlated with online module quiz performance. 258 (73%) of 354 students completed at least one quiz, and students completed an average of 14 out of 15 quizzes. Learners who completed more than 50% of the quizzes performed significantly better in the course than those who completed fewer quizzes; this was true for a formative internal course exam (p = .035), an NBME customized assessment (p = .008), and the course overall (p = .021). Additional analyses of students' perceptions revealed that students valued the self-directed online learning environment. The high completion rate (73%) for the online module also signaled student value in the content and format. This module represents educational material that has been demonstrated to improve medical student musculoskeletal learning. Additionally, the module could be expanded to address inadequacies in orthopedic education among other students, such as allied health learners.

Enhancing Access to Orthopedic Education: Exploring the Potential of Generative Artificial Intelligence (AI) in Improving Health Literacy on Rotator Cuff Injuries.

Health literacy plays a vital role in determining one's health status, as studies have shown that poor health literacy is associated with negative health results. The Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) advise that patient educational materials (PEMs) should be written at an eighth-grade reading level or lower, matching the average reading level of adult Americans. This study evaluated the ability of generative artificial intelligence (AI) to rewrite PEMs about rotator cuff injuries (RCIs) to align with the eighth-grade reading level recommendation of the CDC and NIH. Online PEMs about RCI from the 25 highest ranked orthopedic hospitals from the 2022 U.S. News and World Report Best Hospitals Specialty Ranking were collected. Chat Generative Pretrained Transformer Plus, version 4.0 (OpenAI, San Francisco, CA) was then instructed to rewrite the PEMs to adhere to CDC and NIH-recommended guidelines. Readability scores were calculated for the original and rewritten PEMs, and paired t-tests were used to determine statistical significance. Analysis of the original and rewritten PEMs about RCI demonstrated significant reductions in reading-grade level and word count of 4.33 ± 1.50 (p < 0.001) and 442.68 ± 351.45 (p < 0.001), respectively. Our study determined that generative AI is capable of rewriting PEMs about RCI at a reading comprehension level that conforms to the CDC and NIH guidelines. Hospital administrators and orthopedic surgeons should consider the findings of this study, and the potential utility of AI when crafting PEMs of their own.

Artificial intelligence in orthopaedic education: A comparative analysis of ChatGPT and Bing AI's Orthopaedic In‐Training Examination performance

AbstractBackgroundThis study evaluated the performance of generative artificial intelligence (AI) models on the Orthopaedic In‐Training Examination (OITE), an annual exam administered to U.S. orthopaedic residency programs.MethodsChatGPT 3.5 and Bing AI GPT 4.0 were evaluated on standardised sets of multiple‐choice questions drawn from the American Academy of Orthopaedic Surgeons OITE online question bank spanning 5 years (2018–2022). A total of 1165 questions were posed to each AI system. The performance of both systems was standardised using the latest versions of ChatGPT 3.5 and Bing AI GPT 4.0. Historical data of resident scores taken from the annual OITE technical reports was used as a comparison.ResultsAcross the five datasets, ChatGPT 3.5 scored an average of 55.0% on the OITE questions. Bing AI GPT 4.0 scored higher with an average of 80.0%. In comparison, the average performance of orthopaedic residents in national accredited programs was 62.1%. Bing AI GPT 4.0 outperformed ChatGPT 3.5 and Accreditation Council for Graduate Medical Education examinees, and analysis of variance analysis demonstrated p &lt; 0.001 among groups. The best performance was by Bing AI GPT 4.0 on OITE 2020.ConclusionGenerative AI can provide a logical context across answer responses through its in‐depth information searches and citation of resources. This combination presents a convincing argument for the possible uses of AI in medical education as an interactive learning aid.

Integrating ChatGPT in Orthopedic Education for Medical Undergraduates: Randomized Controlled Trial.

ChatGPT is a natural language processing model developed by OpenAI, which can be iteratively updated and optimized to accommodate the changing and complex requirements of human verbal communication. The study aimed to evaluate ChatGPT's accuracy in answering orthopedics-related multiple-choice questions (MCQs) and assess its short-term effects as a learning aid through a randomized controlled trial. In addition, long-term effects on student performance in other subjects were measured using final examination results. We first evaluated ChatGPT's accuracy in answering MCQs pertaining to orthopedics across various question formats. Then, 129 undergraduate medical students participated in a randomized controlled study in which the ChatGPT group used ChatGPT as a learning tool, while the control group was prohibited from using artificial intelligence software to support learning. Following a 2-week intervention, the 2 groups' understanding of orthopedics was assessed by an orthopedics test, and variations in the 2 groups' performance in other disciplines were noted through a follow-up at the end of the semester. ChatGPT-4.0 answered 1051 orthopedics-related MCQs with a 70.60% (742/1051) accuracy rate, including 71.8% (237/330) accuracy for A1 MCQs, 73.7% (330/448) accuracy for A2 MCQs, 70.2% (92/131) accuracy for A3/4 MCQs, and 58.5% (83/142) accuracy for case analysis MCQs. As of April 7, 2023, a total of 129 individuals participated in the experiment. However, 19 individuals withdrew from the experiment at various phases; thus, as of July 1, 2023, a total of 110 individuals accomplished the trial and completed all follow-up work. After we intervened in the learning style of the students in the short term, the ChatGPT group answered more questions correctly than the control group (ChatGPT group: mean 141.20, SD 26.68; control group: mean 130.80, SD 25.56; P=.04) in the orthopedics test, particularly on A1 (ChatGPT group: mean 46.57, SD 8.52; control group: mean 42.18, SD 9.43; P=.01), A2 (ChatGPT group: mean 60.59, SD 10.58; control group: mean 56.66, SD 9.91; P=.047), and A3/4 MCQs (ChatGPT group: mean 19.57, SD 5.48; control group: mean 16.46, SD 4.58; P=.002). At the end of the semester, we found that the ChatGPT group performed better on final examinations in surgery (ChatGPT group: mean 76.54, SD 9.79; control group: mean 72.54, SD 8.11; P=.02) and obstetrics and gynecology (ChatGPT group: mean 75.98, SD 8.94; control group: mean 72.54, SD 8.66; P=.04) than the control group. ChatGPT answers orthopedics-related MCQs accurately, and students using it excel in both short-term and long-term assessments. Our findings strongly support ChatGPT's integration into medical education, enhancing contemporary instructional methods. Chinese Clinical Trial Registry Chictr2300071774; https://www.chictr.org.cn/hvshowproject.html ?id=225740&v=1.0.

Gamification and Serious Games in Orthopedic Education: A Systematic Review.

Gamification and serious games have successfully been used in surgical specialties to improve technical skills related to systematic procedures. However, the use of gamified education material has remained limited in orthopedic residency training. The objective of this systematic review is to summarize the current use, development, and future directions of gamification for developing orthopedic skills. A comprehensive literature search was performed on Ovid MEDLINE, Web of Science, and Scopus between January 1, 2012, and the search date of July 1, 2023. After screening 1,915 papers, a total of four publications that utilized elements of gamification in acquiring and/or improving orthopedic skills were included. Three studies showed a positive correlation between video gaming experience and orthopedic skill performance, acquisition, or both. One study showed a positive response from residents when training sessions were hosted in a competitive, but friendly environment with direct observation from their attendings. Gamified learning has the potential to improve orthopedic education, but its current use is largely unexplored. A competitive or rewarding environment promotes engagement and active learning. To enable the highest and most efficient level of training, future development should be geared toward virtual reality simulators that incorporate haptic feedback to better simulate other orthopedic-based tasks.

Identifying Lower Extremity Deformities in the Coronal Plane: Lessons From Remote Learning During the COVID-19 Pandemic.

Introduction During the COVID-19 pandemic, the AO Foundation, an orthopedic education organization, had to transition its live education programs to an online format. Skills that were previously evaluated and corrected in person by educators were now assessed through online lectures and discussion groups. Our goal was to evaluate an online course designed to teach the skill of "leg length and coronal deformity measurement" and to assess participants' ability to demonstrate this skill using online software. Methods An IRB-approved study was conducted during an online osteotomy course. A total of 176 participants were instructed on how to measure length and angulation through the course lectures and planning tutorials. The Bonesetter App (Detroit Bonesetter, Detroit, Michigan, USA) was used as the digital planning tool. Participants analyzed four cases of coronal deformity using long-leg standing radiographs. They were required to identify any deformities present, specify the type of deformity, and determine whether it affected the femur, tibia, or joint. Additionally, participants needed to calculate the deformity as part of the osteotomy planning process. Their measurements and drawings were saved and subsequently evaluated by two independent observers. Results Out of 176 online participants, 76% (315 out of 417) correctly completed the four exercises. The most frequent errors occurred in measuring total deformity and joint deformity. The average standard deviation of length measurements was ±0.29 cm (based on 244 measurements), while for angular measurements, it was ±0.71 degrees (based on 688 measurements). The intraclass correlation coefficient was greater than 0.96. Conclusions The online course effectively taught coronal deformity measurement, although participants struggled most with measuring joint angles and total deformity. Future courses should provide more detailed explanations for these measurements.

The Impact of the Dobbs v. Jackson Supreme Court Decision on Orthopaedic Residency Programs: A Collaborative Orthopaedic Education Research Group (COERG) Survey.

Recent changes inreproductive health care policy have now led to state-specific differences in abortion care access across the United States. Members of the medical community in particular have issued concerns regarding these new policies and their potential impact on graduate medical training. Objectives: The purpose of this study was to sample orthopaedic surgery residency programs to gauge their perceptions of the Dobbs decision and its impact on residency training. Materials and methods:A 25-item questionnaire was developed toassess the attitudes of orthopaedic surgery residency programs on the Dobbs v. Jackson Women's Health Organization decision. Our survey-based study was first endorsed by and then distributed amongst members of the Collaborative Orthopaedic Education Research Group (COERG). A total of 24 representatives from 24 Accreditation Council for Graduate Medical Education (ACGME) accredited orthopaedic surgery residency programs agreed to participate in the study. Results: Twenty-four of 24 program correspondents completed the survey (100%). Of the 15 programs (68.2%) who reported that their institution does not have a contingency plan in place, only five (33.3%) see a need for one. Eighteen programs (75.0%) agreed that the ACGME should have a policy protecting residents or significant others needing reproductive care. Ten (41.7%) respondents indicated that the Dobbs decision will impact how students rank residency programs; however, none (0%) believe it will impact their ability to attract a diverse applicant pool. Conclusion: Although some programs surveyed have a contingency plan in place, the majority believe the ACGME should develop a policy that addresses the reproductive needs of residents. Given the higher rate of pregnancy complications experienced by women training in orthopaedic surgery it is paramount to have policies that protect residents seeking reproductive care.

Best Practices for Developing International Academic Partnerships in Orthopaedics.

Traumatic and nontraumatic orthopaedic conditions are major contributors to global morbidity and account for the majority of life-years lived with disability worldwide. Additionally, the burden of musculoskeletal injuries has increased substantially over the past 3 decades. Unfortunately, in low and middle-income countries (LMICs), access to orthopaedic care is limited, leading to a disproportionate burden of disease. The Lancet Commission on Global Surgery has emphasized the urgent need for unified international commitment and research collaboration to achieve universal access to safe and affordable surgical care. However, conducting high-quality orthopaedic research in LMICs remains challenging as a result of disparities in training, access to resources, infrastructure, and equipment availability. Partnerships between high-income countries (HICs) and LMICs have emerged in recent decades as an effective approach to combatting some of these challenges. These partnerships aim to bridge the gaps by facilitating collaborative research and knowledge exchange. The establishment of successful partnerships requires a collaborative and reciprocal approach that starts with a clear understanding of mutual research aims and the availability of resources. Despite the potential benefits, various factors can make establishing such partnerships difficult. However, these partnerships can have a substantial impact in delivering quality orthopaedic education and research training, thus improving access to care in resource-limited environments. This paper represents the collaborative effort of multiple international academic orthopaedic surgeons with extensive experience in HIC-LMIC partnerships. Our aims were to outline the best practices for conducting orthopaedic research within these relationships and to provide guidance for future successful collaborations.

Enhanced Total Hip Arthroplasty Education Using Augmented Reality: A Survey From a Tertiary Center.

For total hip arthroplasty (THA), a new technology in the evolution of computer-assisted surgery has emerged in the form of augmented reality (AR). We sought to determine the impact of AR on resident and fellow education after implementation at an academic teaching center. The senior author's intraoperative technique allows for the orthopedic trainee to use AR to correct the acetabular component's position after an attempt is made with standard instrumentation. One year after the implementation of this AR method, both resident and fellow trainees were issued an anonymous survey regarding their experience and descriptive statistics were calculated for the results. Sixteen trainees responded to the survey. One hundred percent felt the use of AR improved their understanding of acetabular component placement and improved their intraoperative experience. Sixty-nine percent reported feeling there was a small increase in operative time but 25% reported no increase in operative time when using AR. Seventy-five percent of trainees felt that patients benefited from the technology and would be in favor of AR if they were having a THA. The majority of those surveyed reported a desire to use AR in their practice if it is available. Computer-assisted surgery has demonstrated variable impacts on orthopedic education. After the implementation of AR at an academic teaching center, all trainees reported it improved their intraoperative experience and their understanding of acetabular component placement. Further studies are needed to determine if AR is able to improve a trainee's component placement. [Orthopedics. 2024;47(4):e157-e160.].

A Curricular Model for Simulation Within Orthopaedic Residency Training.

American Board of Orthopaedic Surgery/American Council on GraduateMedical Education Residency Review Committee training requirements have necessitated the need for the adoption of simulation education into existing programmatic requirements. Current guidelines focus only on interns at a potentially significant cost to programs; both in total dollar amount and time. The authors aim to provide a model that can maximize utility for all resident levels, manage cost by maximizing the use of cadaveric material, and allow integration of varied industry support. The Oregon Health & Science University Orthopaedic education program has developed a high-fidelity training curriculum that (1) is applicable to both junior and senior residents (2) has minimized the cost per resident with the reuse of cadaveric specimens and (3) has nurtured partnerships with industry stakeholders to reduce bias in training by collaborating with most major industry representatives. The simulation curriculum outlined in this manuscript may serve as a reference for other programs and institutions to develop their own residency educational curriculum models.

Performance of Two Artificial Intelligence Generative Language Models on the Orthopaedic In-Training Examination.

Artificial intelligence (AI) generative large language models are powerful and increasingly accessible tools with potential applications in health care education and training. The annual Orthopaedic In-Training Examination (OITE) is widely used to assess resident academic progress and preparation for the American Board of Orthopaedic Surgery Part 1 Examination. Open AI's ChatGPT and Google's Bard generative language models were administered the 2022 OITE. Question stems that contained images were input without and then with a text-based description of the imaging findings. ChatGPT answered 69.1% of questions correctly. When provided with text describing accompanying media, this increased to 77.8% correct. In contrast, Bard answered 49.8% of questions correctly. This increased to 58% correct when text describing imaging in question stems was provided (P<.0001). ChatGPT was most accurate in questions within the shoulder category, with 90.9% correct. Bard performed best in the sports category, with 65.4% correct. ChatGPT performed above the published mean of Accreditation Council for Graduate Medical Education orthopedic resident test-takers (66%). There is significant variability in the accuracy of publicly available AI models on the OITE. AI generative language software may play numerous potential roles in the future in orthopedic education, including simulating patient presentations and clinical scenarios, customizing individual learning plans, and driving evidence-based case discussion. Further research and collaboration within the orthopedic community is required to safely adopt these tools and minimize risks associated with their use. [Orthopedics. 2024;47(3):e146-e150.].

Discrepancies in Publication Volume Per Matched-Applicant Between Sex, Geographic Regions and Program Affiliation in the 2023 Orthopaedic Surgery Residency Match

Objective: This study aims to examine potential gender-based publication disparities among 2023 orthopaedic surgery matched-applicants, investigate variations in research emphasis based on program affiliation and assess publication differences across different geographic regions. Methods: Orthopaedic surgery residency programs participating in the 2023 NRMP with a publicly available incoming resident class were identified using the NRMP database. Each resident was searched using PubMed and ORCID identifiers for publications. Each program was designated as “university-based”, “community-based”, “community-based/university affiliated” or “other” using the American Medical Association’s FRIEDA database. Results: In total, 763 residents were identified with a mean and median number of publications of 6.1 (SD=10.0) and 3.0 (IQR=1.0-7.0) respectively. There was no significant difference in the median number of publications between males (2.0) and females (3.0, p=0.2315). Those who matched to “community-based/university affiliated” (median=2.0) programs had a lower median number of publications than those who matched to “university-based” (median=3.0, p&lt;0.0001) or “other” (median=6.0, p=0.0006). Geographically, applicants in the West-South Central region (median=1.0) had the lowest publication median compared to those in the New England (median=4.0, p=0.0010) or Pacific (median=4.0, p=0.0015) regions. Conclusion: There lies a perceived increase in significance of research publications for competitiveness in the orthopaedic surgery match. This largely follows the elimination of objective Step-1 scoring to help stratify potential applicants. Research remains an objective manner to stratify applicants; however, new data lacks on recent analysis of the 2023 match pool. There was not a significant difference in the number of publications between male vs female matched-applicants. The program category “other” and the New England and Pacific regions had the highest median number of publications. Keywords: Orthopaedics; Medical Residency; Graduate Medical Education; Medical School; Residency Match; Orthopaedic Education; Orthopaedic Residency

Do Women and Minority Orthopaedic Residents Report Experiencing Worse Well-being and More Mistreatment Than Their Peers?

Do Women and Minority Orthopaedic Residents Report Experiencing Worse Well-being and More Mistreatment Than Their Peers?

Current Procedural Terminology Code Selection, Attitudes, and Practices of the Orthopaedic Surgery Resident Case Log: A Survey of Residents and Program Directors.

The Accreditation Council for Graduate Medical Education Resident Case Log is one of the primary tools used to track surgical experience. Owing to the self-reported nature of case logging, there is uncertainty in the consistency and accuracy of case logging. The aims of this study are two-fold: to assess current resident case log Current Procedural Terminology (CPT) code selection and practices across orthopaedic surgery residencies and to understand current attitudes of both program directors (PD) and residents surrounding case logging. Residents and PDs from 18 residency programs received standardized, consensus-built surveys distributed through the Collaborative Orthopaedic Educational Research Group. Resident surveys additionally contained clinical orthopaedic subspecialties vignettes on sports, trauma, and spine. Each subspecialty section contained 4 clinical vignettes with stepwise increases in complexity/CPT coding procedures. One hundred sixteen residents (response rate: 28.4%) and 16 PDs (response rate: 88.9%) participated. Formal case log training was reported by 53.0% of residents and 56.3% of PDs. A total of 7.8% of residents rated themselves "excellent" at applying CPT codes for the case log, while 0.0% PDs rated their residents' ability as "excellent." In total, 40.9% of residents and 81.3% of PDs responded that it was "extremely important" or "very important" to code accurately (p = 0.006). Agreement between resident CPT code selection and number of cases and procedures logged for each clinical vignette was conducted using Fleiss' kappa. As the clinical vignettes increased in complexity, there was a decreasing trend in kappa values from the first (least complex) to the last (most complex) clinical vignette. The inconsistent case logging practices, dubious outlook on case log accuracy and resident case logging ability and attitude, and lack of formal training signals a need for formal, standardized case log training. Enhanced case logging instruction and formalized educational training for PDs and residents would be a meaningful step toward capturing true operative experience, which would have a substantial impact on orthopaedic surgery resident education and assessment.

OrthoTV: Broadcasting Orthopedics around the World.

OrthoTV has emerged as a pioneering platform in the field of orthopedic education, leveraging technology to create a comprehensive and accessible knowledge repository. Originating from the vision of the Indian Orthopedic Research Group in 2013, OrthoTV has evolved into a global educational hub, streaming thousands of hours of surgical videos, webinars, and podcasts. It provides a dynamic learning environment through live interactive sessions, fostering real-time engagement with experts and facilitating a global exchange of knowledge. OrthoTV's expansion during the COVID-19 pandemic underscored its vital role in continuing medical education amidst travel restrictions. The platform extends beyond educational resources to include career support, collaborative research initiatives, and even virtual fellowships, embodying a multifaceted approach to professional development. With the introduction of OrthoAI, OrthoTV integrates advanced artificial intelligence to offer personalized, evidence-based responses to queries, setting a new standard in digital medical education. This narrative review highlights OrthoTV's foundational principles, its significant impact on orthopedic education and practice, and its commitment to democratizing knowledge across the globe. OrthoTV's innovative use of technology bridges geographical barriers enriches learning experiences, and fosters a vibrant community of orthopedic professionals, marking a significant advance in the field of medical education.

Application of ChatGPT for Orthopedic Surgeries and Patient Care.

Artificial intelligence (AI) has rapidly transformed various aspects of life, and the launch of the chatbot "ChatGPT" by OpenAI in November 2022 has garnered significant attention and user appreciation. ChatGPT utilizes natural language processing based on a "generative pre-trained transfer" (GPT) model, specifically the transformer architecture, to generate human-like responses to a wide range of questions and topics. Equipped with approximately 57 billion words and 175 billion parameters from online data, ChatGPT has potential applications in medicine and orthopedics. One of its key strengths is its personalized, easy-to-understand, and adaptive response, which allows it to learn continuously through user interaction. This article discusses how AI, especially ChatGPT, presents numerous opportunities in orthopedics, ranging from preoperative planning and surgical techniques to patient education and medical support. Although ChatGPT's user-friendly responses and adaptive capabilities are laudable, its limitations, including biased responses and ethical concerns, necessitate its cautious and responsible use. Surgeons and healthcare providers should leverage the strengths of the ChatGPT while recognizing its current limitations and verifying critical information through independent research and expert opinions. As AI technology continues to evolve, ChatGPT may become a valuable tool in orthopedic education and patient care, leading to improved outcomes and efficiency in healthcare delivery. The integration of AI into orthopedics offers substantial benefits but requires careful consideration and continuous improvement.