Orthopaedic Training Research Articles

Optimizing orthopedic education in resource-limited settings: A strategic review of current practices and reforms

This narrative comparative review analyzes the current structure, challenges, and potential reforms in orthopedic education in Vietnam. Using a structured literature review and expert-informed synthesis, we examine Vietnam’s dual-track training pathways, including undergraduate medical education, residency programs, specialty certifications (Specialty Certification Level 1 and Specialty Certification Level 2), and academic degrees (Master’s and PhD). The ky challenges include variability in training quality, limited access to surgical technology, geographic disparities in workforce distribution, and insufficient research integration. To contextualize Vietnam’s experience, we compare it with orthopedic education models in China, India, Saudi Arabia, and Côte d’Ivoire (Africa). These countries share common issues such as regional inequities, inconsistent clinical exposure, and gaps in standardized curricula, while also offering unique strategies for improvement, such as competency-based training, national fellowship programs, and international partnerships. The review recommends establishing a national certification board, investing in technological infrastructure, expanding fellowship opportunities, and implementing financial support schemes to ensure equitable access. These findings provide relevant insights for policymakers and educators aiming to enhance orthopedic training in low- and middle-income countries.

Comparison of orthopaedic specialty registrar training opportunities in trusts with and without an elective surgical hub: a review of administrative data.

During the COVID-19 pandemic in England, orthopaedic surgery trainees experienced a reduction in training opportunities due to periods of elective surgery suspension. We aimed to explore training opportunities for orthopaedic trainees in trusts with and without access to an elective surgical hub. This retrospective analysis of administrative data used eLogbook data for registrars who performed six high-volume, low-complexity orthopaedic procedures in NHS hospitals in England between April 2017 and March 2023. Data included training grade, role in the procedure, trust where the procedure was performed and procedure date. These were linked to Hospital Episodes Statistics (HES) data on the total number of these procedures conducted during the study period and whether the trust hosted or fed into an elective surgical hub at the time of the procedure. Data were analysed for 1,755 trainees acting as first surgeon in 125,759 procedures. Trusts with access to an elective surgical hub significantly increased the proportion of procedures conducted by a trainee compared with non-hub trusts over the study period. Most of the increase in trainee involvement was associated with more senior trainees (ST6-8). The proportional increase was not enough to offset the decline in the absolute number of procedures conducted by trainees (25,598 (2017-2018), 21,057 (2022-2023)). Elective surgical hubs have made a positive contribution to training opportunities for orthopaedic trainees but not enough to offset the post-pandemic fall in activity. The number of procedures conducted in NHS hospitals and the rate of training opportunities must be increased.

The risk of early revision after trainee led primary unicompartmental and total knee replacement.

The risk of early revision after trainee led primary unicompartmental and total knee replacement.

Recommended Treatment for Pediatric Upper Extremity Fractures Varies Among Orthopaedic Surgeons and Trainees

Recommended Treatment for Pediatric Upper Extremity Fractures Varies Among Orthopaedic Surgeons and Trainees

Practical Review of Clinical Research Methodology and Statistics for the Orthopaedic Surgeon.

All orthopaedic surgeons and trainees interact with peer-reviewed literature at some level, from consumer to author. Although orthopaedic practitioners have strong clinical backgrounds and frequently read orthopaedic literature to stay up to date on clinical advances, they often lack formal training or sufficient literacy in clinical research methodology to thoroughly dissect study design and statistics. With an increasing number of orthopaedic surgeons and trainees involved in clinical research, the goal of this review is to provide a concise and pragmatic overview of basic study design and comparative statistical methodology in the context of orthopaedic surgery research. This review discusses first the levels of evidence that can be assigned to a research study and then outlines common comparative study designs seen in orthopaedic literature, their advantages, and statistical considerations for each. Next, statistical versus clinical significance and ways of assessing these findings are reviewed, including the concepts of type I and II error, power, and fragility index. Finally, some common pitfalls in the statistical methodology of orthopaedic research are discussed, including tips and tricks for designing successful clinical research studies.

Virtual reality arthroscopic simulator in shoulder arthroscopy training improves trainee efficiency with limited improvement in quantitative skills: a systematic review.

Shoulder arthroscopy is associated with a steep learning curve. Virtual reality (VR) arthroscopic simulator training has recently gained prominence as a promising training modality for shoulder arthroscopy. However, there is a lack of high-quality evidence regarding its efficacy. Thus, in this study we perform a systematic review to investigate the effects of VR simulator in shoulder arthroscopy training. We performed a systematic search of four databases (PubMed, Embase, Scopus, and Cochrane Library). Studies that compared outcomes pre- and post-VR training as well as outcomes between VR groups and control (non-VR/low fidelity) groups were included. Primary outcomes between VR and control consisted of time to completion and arthroscopic evaluation score. Additionally, pre- versus post-training improvement in arthroscopic evaluation score was evaluated. Seven studies were included in this systematic review. Total cohort size was 143, with 93 in the VR group and 50 in the control group. Studies that compared time to completion in VR and control groups all showed significantly shorter time to completion in the VR group, with individual study standardized mean difference (SMD) ranging from -0.24 to -1.37. In terms of arthroscopic evaluation score, several studies showed pre- to post-training improvement in (individual SMD range, 0.32 to 2.32) but no difference between VR and control groups (individual SMD range, -0.02 to 0.82). In this study we found that VR training results in shorter task completion time for trainees, whereas there are no differences in arthroscopic evaluation scores between VR versus control groups. Hence, VR simulator training improves arthroscopic efficiency for orthopedic trainees, with limited improvement in quantitative skills. Level of evidence: II.

Course Review: 50th Week of Exercise in Microsurgery.

Microsurgery plays a vital role in plastic surgery and orthopedic training curricula. Despite the availability of various practical microsurgery courses, it is challenging to find one that strikes the right balance between hands-on practice and educational content to help participants gain confidence in microsurgical techniques.Introducing the Microsurgery Week Course, a 5-day program designed for plastic surgery and orthopedic trainees. This course aims to impart the principles of microsurgery through a combination of self-directed learning, informative lectures, and practical workshops with hands-on training. The course boasts an international faculty and attracts delegates from all around the world, making it a truly diverse experience. The location for this course is Ioannina, Greece, and the registration fee is set at 500 euros.In my review, I will thoroughly evaluate the Microsurgery Week Course, shedding light on its effectiveness, strengths, and any areas that might need improvement.

Exploratory research on the reform of diversified teaching methods in residency training education: a case study of orthopedics

Abstract Objectives In orthopedic residency training (ORT), an urgent issue is how to effectively train orthopedic doctors with solid professional skills, good professional ethics, and a sense of patriotism. Traditional teaching methods, while imparting knowledge, often neglect the comprehensive cultivation of students, failing to meet the modern demands for medical talent. This paper aims to explore the application of a diversified teaching model that integrates professional knowledge with elements of ideological and political education in ORT. Methods By comparing traditional teaching methods with the diversified teaching model, we aim to assess the effectiveness of this approach in enhancing clinical skills, learning motivation, and course satisfaction, providing insights and guidance for future medical education reform. This study hypothesizes that the diversified teaching model can significantly improve the clinical skills, learning motivation, and course satisfaction of orthopedic residents, compared to the traditional teaching model. Additionally, it is expected to more effectively cultivate medical professionals with high professional ethics and patriotic sentiment. This study employed a quasi-experimental design to evaluate the effectiveness of the diversified teaching model in ORT as the methods and data were gathered from experimental groups and control groups. Results Experimental group showed statistically significant differences (p<0.05) compared to the control group in terms of teaching model satisfaction, learning motivation, course design adaptability, and clinical knowledge enhancement. Though there was no significant difference between the groups in clinical skill improvement, the overall trend indicated that the diversified teaching model produced better teaching outcomes. Conclusions This research on the reform and exploration of the diversified teaching model centered on professional knowledge in orthopedic residency training plays a positive role in meeting the needs of the times and cultivating orthopedic doctors with solid professional skills, patriotism, and professional ethics.

VIRTUAL REALITY FOR SURGICAL TRAINING AND SIMULATION IN ORTHOPAEDIC FRACTURE SURGERY

The use of VR in orthopaedic surgical training is currently limited, primarily utilised within the realm of arthroscopy and arthroplasty procedures. Orthopaedic trauma surgery represents a significant portion of orthopaedic workload and a core component of orthopaedic training. Currently, VR as an education tool within orthopaedic trauma surgery has very little evidence.The aim of this study was to assess the utility of a new and novel VR simulation as a tool for training orthopaedic surgeons in the assessment and surgical management of ankle fractures.Orthopaedic trainees completed a VR task, assessing ankle fracture patterns and planning surgical fixation. Mixed methods were used to evaluate the utility of VR to assess and plan surgical fixation, assessing confidence, competence and acceptability of the tool, in addition to thematic analysis of participants feedback of the VR software.Following the VR exercise, participant confidence classifying ankle fracture patterns increased from 3.2 to 7.2 out of 10 (p=<0.01). Confidence in ankle fracture fixation and surgical planning increased from 3.5 to 6.6 out of 10 (p=<0.01). Themes from semi-structured group review of the VR platform included; improved visualisation of fracture patterns, better informed planning of surgical approach and improved fixation planning.VR represents an effective educational tool for orthopaedic ankle fracture surgery. Benefits include increased trainee confidence identifying fractures requiring surgical fixation, with VR informing surgical approach and fixation principles. Orthopaedic trainees look forward to seeing an increase in the utilisation of VR within their training.

Simulation-based learning in orthopaedics: A qualitative systematic review.

Simulation-based learning in orthopaedics: A qualitative systematic review.

Gender Equity Issues in Orthopaedics: A Scoping Review

Abstract Background Patients have improved outcomes when their diversity is reflected in the healthcare team providing treatment. Despite recent increases in female representation, orthopaedics continues to lag behind other medical specialties. The purpose of this study was to identify major themes relating to gender equity in orthopaedics, examine trends in gender representation, and summarize the existing evidence within these themes. Methods We conducted a scoping review in accordance with PRISMA guidelines using Medline, EMBASE and Global Index Medicus to identify original research articles on gender equity issues in orthopaedics. Data-driven studies examining issues across the orthopaedic training spectrum were included. A thematic analysis was conducted and descriptive statistics were used to describe trends within each theme. Results In total, 179 studies were included representing seven themes: gender diversity and representation (n = 45), research and authorship (n = 41), leadership and mentorship (n = 30), microaggressions and lived experiences (n = 24), gender-based health impacts (n = 13), monetary aspects (n = 10), and geographic representation (n = 5), with 11 miscellaneous studies. Nearly 80% (n = 133) of studies originated from the USA, and 74.4% of studies were published from 2021 to 2025. Nearly all included studies reported that while there have been modest improvements in female representation, there remains significant gender disparity, and the field lags behind other specialties. Conclusion This scoping review identified a compelling volume of literature demonstrating that women are underrepresented across all career stages in orthopaedics. Women surgeons disproportionately experience microaggressions, discrimination and health impacts. While representation is improving, concerted, collaborative efforts are needed to achieve gender parity in the field globally.

A Review of Medical Ethics in Orthopaedic Surgery: Current Foci and Future Considerations.

➢ Medical ethics education is a required component of orthopaedic surgery resident training per the Accreditation Council for Graduate Medical Education (ACGME) guidelines, although no standardized curriculum currently exists.➢ Beyond the 4 principles of bioethics (autonomy, beneficence, nonmaleficence, justice), additional ethical concepts relevant to orthopaedic care include utilitarianism, deontology, virtue ethics, moral intuitionism, microethics, and narrative ethics.➢ Ethical themes identified in the literature relevant to orthopaedic surgery include the ethics involved in medical decision-making, use of new technologies, caring for vulnerable patients, performing high-stakes procedures, the impacts of trainee status on patient care, and patient attitude regarding conflict of interest.➢ Ethical themes that we sought to identify in the literature but found lacking include the ethics of providing orthopaedic care in low-resource settings, orthopaedics entrepreneurship, disability ethics, trainee mistreatment by their supervisors, and the ethics involved in the recognition and reporting of child and elder abuse.

Shaping Tomorrow's Surgeons: The Need for Orthopaedic Reform at United Kingdom Medical Schools.

Musculoskeletal disorders account for a significant portion of healthcare consultations in the UK, yet orthopaedics remains markedly underrepresented in medical school curricula. This disparity limits students' clinical exposure, practical experience, and research opportunities, contributing to reduced interest in orthopaedic careers and exacerbating workforce shortages. This article explores the current limitations of orthopaedic education, highlighting the consequences for patient care and future workforce planning. It proposes a multifaceted reform strategy that includes simulation-based learning, structured mentorship, curriculum redesign, and national standardisation. Enhancing orthopaedic training is essential to ensure equitable, high-quality musculoskeletal care and to prepare a capable, innovative surgical workforce for the future.

Virtual Reality Simulation in Orthopedic Surgery Education Improves Immediate Procedural Skill and Knowledge Acquisition, But Evidence on Cost-Effectiveness and Skill Retention Remains Lacking.

Virtual reality (VR) simulation in orthopedic education has gained recent interest in the literature. VR simulation provides a virtual space to practice surgical steps accurately, creating a user-controlled environment for novice surgical trainee skill development. Despite the reported benefits, VR is not routinely incorporated into orthopedic residency core curriculum. This study reviews and synthesizes contemporary data assessing the efficacy of VR simulation in orthopedic surgical training. Twenty-three studies across six subspecialty areas were included. Seven hundred and forty-eight participants trained on over nine different VR simulators. Control groups included no additional training, surgical technique guides, surgical videos, and benchtop simulators. Outcome measurements included procedure-specific checklists, objective grading scales, time-to-task completion, and accuracy of implant placement, among others. No outcomes directly focused on patient safety or involved live patients. Across disciplines, VR simulation training improved outcomes when compared to controls, conferring quicker procedure times, higher correct step completion, and more accurate implant placement, although not always statistically significant. Virtual reality is a tool employed by various industries that offers immersive, interactive, and realistic learning experiences. In orthopedics, VR has the potential to enhance skills, improve safety, and increase trainee confidence. In most of the included studies, trainees performed better in the VR simulation groups when compared to control education modalities, and participants readily embraced VR. However, there is mixed evidence on its use, and future studies are needed involving longitudinal VR education to better assess the actual impact on trainee skills, as well as performance in the operating room and its impact on patient outcomes.

Immersive Virtual Reality Training for a Junior Orthopaedic Surgery Resident

Successful orthopedic training includes mastering the orthopedic principles while developing a high level of surgical skills. Gaining experience and repetitions with these techniques can be particularly challenging for junior orthopedic residents, who typically have limited time in the operating room. There is a need to improve the education approach for junior orthopedic residents, and some residency programs have begun exploring the possibility of using virtual reality to augment orthopedic surgical training. Immersive Virtual Reality (iVR) technology is revolutionizing medical education and can potentially mitigate some of the challenges associated with traditional surgical training. This paper aims to describe how iVR training enhanced the skills of a first-year orthopedic surgery resident through a narrative review of their experiences. The resident participated in a comprehensive iVR training program (PrecisionOS™ iVR system) where the resident completed a learning curriculum of all-encompassing modules focusing on basic anatomy, surgical approaches, individual procedure techniques, and more. Utilizing iVR training allowed the resident to get real-time feedback, learn the anatomy, and also master the steps of different procedures before stepping into the operating room. The repetitive nature of iVR with the constant feedback allowed the resident to refine their technical skills, and with time, the steps became muscle memory. The resident observed a noticeable improvement in the overall efficiency and mastery in performing orthopedic procedures. From the attending’s standpoint, the guided preoperative preparation increased the trust and confidence in the resident, as the attending was able to give real-time feedback during the iVR module, making active changes and modifications. If there was a mistake made in the iVR space, it was very easy to reset the step and repeat it, and there was never any risk to the patient. In the experience of this resident, Immersive Virtual Reality (iVR) can be a helpful tool for a junior orthopedic surgery resident. It provides the resident with an opportunity to learn the surgical workflow and increase surgical efficiency in a safe and cost-effective environment.

The Impact of Duty Hour Restrictions on Orthopedic Surgical Training.

The Impact of Duty Hour Restrictions on Orthopedic Surgical Training.

Simulation-Based Training Improves Developmental Hip Dysplasia Examination and Diagnosis Skills on Newborns.

Simulation-Based Training Improves Developmental Hip Dysplasia Examination and Diagnosis Skills on Newborns.

Academic and demographic characteristics of spine societies presidents.

Academic and demographic characteristics of spine societies presidents.

Augmented reality simulation framework for minimally invasive orthopedic surgery.

Augmented reality simulation framework for minimally invasive orthopedic surgery.

Institutional disparities in the treatment of bone metastases by orthopaedic surgeons at training facilities designated by the Japanese orthopaedic association-A nationwide survey.

Institutional disparities in the treatment of bone metastases by orthopaedic surgeons at training facilities designated by the Japanese orthopaedic association-A nationwide survey.