Updated Analysis of the Oncology Section of the OITE from 2007 to 2019

Analysis of Hip Preservation Questions on the Orthopaedic In-Training Examination Over the Past 20 Years

Background

The orthopaedic in-training examination (OITE) is a 275-question test for orthopaedic residents administered annually. As the field of orthopaedics changes, the OITE evolves its content. The incidence of hip preservation-related procedures has increased substantially over the past decade; nonetheless, an analysis of the trends of hip preservation questions on the OITE has not yet been performed.

Purpose/Hypothesis

The purpose of the study was to evaluate the number and type of questions on the OITE related to hip preservation to determine whether trends over time paralleled the increases in hip-related care in clinical practice. It was hypothesized that the frequency of hip preservation questions on the OITE would increase with time.

Study Design

Cross-sectional study.

Methods

Each OITE between 2002 and 2021 was reviewed for questions related to hip preservation. The types of questions included under "hip preservation" were those related to femoroacetabular impingement (FAI), athletic soft tissue injuries of the hip, acetabular labral tears, hip arthroscopy, and surgical management of adult hip dysplasia-excluding arthroplasty. Questions were quantified and categorized by topic, taxonomy level, associated imaging, and cited sources.

Results

There were 30 hip preservation-related questions between 2002 and 2021. Of these, 77% occurred within the past 10 years. Also, 14 questions (47%) had associated images in the question stem-the most common being radiographs (n = 8 questions). The most commonly tested subcategories were FAI (n = 11 questions [37%]), athletic injuries (n = 7 questions [23%]), and anatomy (n = 7 questions [23%]). Over the last 10 years, 97.9% of citations were from journal articles-the most common being the Journal of the American Academy of Orthopaedic Surgeons, Clinical Orthopedics and Related Research, and the American Journal of Sports Medicine.

Conclusion

The frequency of hip preservation-related questions on the OITE has increased with time, reflecting trends in clinical practice.

Update on Educational Resources and Evaluation Tools for Orthopaedic Surgery Residents

Innovations in orthopaedic resident educational resources and evaluation tools are essential to ensuring appropriate training and ultimately the graduation of competent orthopaedic surgeons. In recent years, there have been several advancements in comprehensive educational platforms within orthopaedic surgery. Orthobullets PASS, Journal of Bone and Joint Surgery Clinical Classroom, and American Academy of Orthopaedic Surgery Resident Orthopaedic Core Knowledge each have their own unique advantages in preparation for the Orthopaedic In-Training Examination and American Board of Orthopaedic Surgery board certification examinations. In addition, the Accreditation Council for Graduate Medical Education Milestones 2.0 and the American Board of Orthopaedic Surgery Knowledge Skills Behavior program each provide objective assessment of resident core competencies. Understanding and using these new platforms will help orthopaedic residents, faculty, residency programs, and program leadership to best train and evaluate their residents.

Analysis of Questions in Sections of the Orthopaedic In-Training Examination: A Scoping Review

PURPOSE

The purpose of this review was to assess all available studies that analyzed the types of questions in individual sections of the Orthopaedic In-Training Examination, which may be used as a reference for residents studying for their examination.

METHODS

Following the Providing Innovative Service Models and Assessment extension for Scoping Reviews guidelines, a systematic review was conducted on studies that report on sections or question categories of the Orthopaedic In-Training Examination using PubMed, MEDLINE, and Web of Science databases. Two reviewers and an arbitrator reviewed and extracted relevant data from 20 included studies which made up the systematic review.

RESULTS

All 20 studies in the review reported the mean number of questions per section, with the highest coming from musculoskeletal trauma (18.9% to 19.0%). 18 studies reported the Buckwalter taxonomic classification; 42.0% of questions were T1, 18.2% were T2, and 39.5% were T3 with a wide range from section to section. Primary sources were nearly three times more likely to be cited when compared with textbook sources. There were 12 journals that were commonly cited with the most being the Journal of Bone and Joint Surgery: American Volume (17/18).

DISCUSSION

This study accurately portrays the characteristics of each section of the Orthopaedic In-Training Examination over the past 10 years. These data suggest that orthopaedic residents may be inclined to focus on musculoskeletal trauma, topics related to clinical management, and primary journal sources for studying. In addition, residency programs may choose to focus on higher yield sources or material to prepare their residents for the examination.