Educational Resource Utilization by Current Orthopaedic Surgical Residents: A Nation-wide Survey

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

Personalized care models are dominating modern medicine. These models are rooted in teaching future physicians the skill set to keep up with innovation. In orthopedic surgery and neurosurgery, education is increasingly influenced by augmented reality, simulation, navigation, robotics, and in some cases, artificial intelligence. The postpandemic learning environment has also changed, emphasizing online learning and skill- and competency-based teaching models incorporating clinical and bench-top research. Attempts to improve work-life balance and minimize physician burnout have led to work-hour restrictions in postgraduate training programs. These restrictions have made it particularly challenging for orthopedic and neurosurgery residents to acquire the knowledge and skill set to meet the requirements for certification. The fast-paced flow of information and the rapid implementation of innovation require higher efficiencies in the modern postgraduate training environment. However, what is taught typically lags several years behind. Examples include minimally invasive tissue-sparing techniques through tubular small-bladed retractor systems, robotic and navigation, endoscopic, patient-specific implants made possible by advances in imaging technology and 3D printing, and regenerative strategies. Currently, the traditional roles of mentee and mentor are being redefined. The future orthopedic surgeons and neurosurgeons involved in personalized surgical pain management will need to be versed in several disciplines ranging from bioengineering, basic research, computer, social and health sciences, clinical study, trial design, public health policy development, and economic accountability. Solutions to the fast-paced innovation cycle in orthopedic surgery and neurosurgery include adaptive learning skills to seize opportunities for innovation with execution and implementation by facilitating translational research and clinical program development across traditional boundaries between clinical and nonclinical specialties. Preparing the future generation of surgeons to have the aptitude to keep up with the rapid technological advances is challenging for postgraduate residency programs and accreditation agencies. However, implementing clinical protocol change when the entrepreneur-investigator surgeon substantiates it with high-grade clinical evidence is at the heart of personalized surgical pain management.

Orthopaedic Sports Medicine Podcasts Should Tailor Characteristics Such as Episode Length and Social Media Utilization for Best Audience Engagement

Purpose

To describe the growth and characteristics of active orthopaedic sports medicine podcasts.

Methods

Three common podcasting platforms (Apple, Google, and Spotify) were queried July 24, 2021 using the search term “sports medicine.” For each unique active podcast hosted by an orthopaedic surgeon, data were collected on year of the first episode, number of episodes, frequency of episodes, types of guests, topics discussed, episode length, and social media presence. Descriptive characteristics were then calculated.

Results

15 podcasts met inclusion criteria. Seven (46.7%) of these podcasts were started within 12 months of July 24, 2021. The most common episode release schedule was weekly, and podcast lengths averaged 21 minutes, 47 seconds (SD 17:17, range: 11:02–1:49:13). All podcasts featured guests, most often from a variety of sports medicine backgrounds. Social media platforms were commonly used by podcast hosts, with social media account follower numbers as high as over 100,000, and consistent engagement across three major social media platforms for most podcasts.

Conclusions

This study found that episodes are typically released weekly and average 21 minutes, 47 seconds long, with most covering a wide array of topics in sports medicine. The Facebook accounts of these podcasts displayed higher numbers of followers compared to other social media platforms; however, Instagram was superior for engagement.

Clinical Relevance

Orthopaedic sports medicine podcasts have an increasing presence and can be used to increase trainee engagement and public exposure via tailoring of podcast episode lengths and selection of social media platforms with high audience interaction.

Online educational resources for orthopaedic residency-a narrative review

PURPOSE

Residency programs in the medical education field are considered the keystone in the development of aptitude and skills required for practice. With the worldwide current scenario of the COVID-19 pandemic, there has been a shift in the paradigm especially in the teaching of the residents from face-to-face classes to more and more online sessions. The purpose of this study is to present a compendium of knowledge-providing sites, smartphone applications (apps), YouTube channels, and podcasts that can provide better online resource management for students in the field of orthopaedics.

METHODS

Search terms were used for making a list of various online resources which can be of help during orthopaedic residency. An initial list of the selected websites, smartphone apps, podcasts, and YouTube channels was made. The corresponding author with years of teaching experience and faculty for post-graduate and fellowship training programs then selected the final list.

RESULTS

A list of 16 websites with brief points on their content and online address along with the availability of free or paid content was identified as being appropriate. A total of 39 apps available for android/apple smartphones, nine podcasts, and 11 YouTube channels were also identified as being extremely useful and have been discussed elaborately in this article.

CONCLUSION

Online educational tools are of immense importance in imparting adequate knowledge to an orthopaedic resident and act as an adjunct to conventional teaching methods. This article focuses on presenting various online educational resources in a simple yet concise way, which may be beneficial for the current generation of residents especially in this current time of unprecedented COVID-19 pandemic.

Impact of COVID-19 pandemic on urology residency training

CONTEXT

The COVID-19 pandemic has led a lot of countries worldwide to go on lockdown. Potential collateral damage is the impact of residency.

AIMS

The aim of this study is to assess the impact of COVID-19 pandemic on urology training aspects, study habits of residents, and their awareness and training regarding COVID-19.

SETTINGS AND DESIGN

A questionnaire aiming to assess the impact of COVID-19 pandemic on different urology training aspects. The questionnaire was sent to all urology residents under the Saudi Commission for Health Specialties (SCFHS) programs.

SUBJECTS AND METHODS

Urology residents under SCFHS programs, excluding 1st-year residents. The questionnaire included the following sections: demographic data, studying habits during the pandemic, involvement in training before the pandemic, involvement in training during the pandemic, and training related to COVID-19.

STATISTICAL ANALYSIS USED

Using the SPSS software, frequencies of all data were calculated, and a Wilcoxon-signed rank test was done to assess the change in ordinal data.

RESULTS

A total of 77 residents completed the survey (38% response rate). Most residents (40.5%) reported that they "strongly agree" with the statement that they have more time for reading. There has been a decrease in on-call duties, outpatient visits, diagnostic procedures, endoscopic surgeries urology, minimally-invasive surgeries, and major open surgeries in comparison to before the pandemic, with a decrease in mean scores in all domains, especially in diagnostic procedures.

CONCLUSIONS

There has been a decrease in residents' involvement in all training domains, and this has been similar to the results of other studies. E-learning sources, during these times, present themselves as a valuable source to compensate for what has been missed in training.

COVID-19 as a disruptor: innovation and value in a national virtual fracture conference

Objectives:

The aim of this study was to determine the educational value of a national virtual fracture conference implemented during the COVID-19 disruption of resident education.

Design:

Survey study.

Setting:

National virtual conference administered by the Orthopaedic Trauma Association.

Participants:

Attendees of virtual fracture conference.

Intervention:

Participation at a national virtual fracture conference.

Main outcome measure:

Surveys of perception of quality and value of virtual conferences relative to in-person conferences.

Results:

Ninety-six percent of participants rated the virtual fracture conference as similar or improved educational quality relative to conventional in-person fracture conference. Participants also felt they learned as much (35%) or more (57%) at each virtual fracture conference compared to the amount learned in-person. The quality of interpersonal interactions at both the resident–faculty level and faculty–faculty level was also perceived to be overall superior to those at participants’ own institutions. Learners felt they were more likely to engage the primary literature as well. Overall, 100% of participants were likely to recommend virtual conference to their colleagues and 100% recommended continuing this conference even after COVID-19 issues resolve.

Conclusions:

We found that learners find significant educational value in a national virtual fracture conference compared to in-person fracture conferences at their own institution. COVID-19 has proven to be a disruptor not only in health care but in medical education as well, accelerating our adoption of innovative and novel resident didactics.

Level of Evidence:

Therapeutic Level III.

Understanding the study habits of Saudi residents in a psychiatry programme

OBJECTIVES

Understanding the way psychiatry residents select, consume, and prioritise their educational resources during their psychiatry residency programme is essential. The purpose of this study was to evaluate Saudi psychiatry residents' study habits during their residency training.

METHODS

In this cross-sectional study, 150 Saudi psychiatry residents were invited to complete an anonymous survey with 18 close-ended statements. The responses were recorded on a 5-point Likert scale. The survey included items about study volume, motivational factors, study resources, study methods, and overall satisfaction with training.

RESULTS

We received responses from 121 residents. There were more men (57.9%) than women (42.1%). A larger percentage of residents studied between two and five hours per day (30.6%). A larger proportion of residents did not agree that the psychiatry residency programme had some degree of protected time prior to their board exams (42.2%). The most crucial motivating factor for their study was the final board exam; 28.1% and 35.5% of residents ranked this factor as highly and very highly motivating, respectively. The most useful study resources were books such as Kaplan, Oxford, and Oral Board materials.

CONCLUSION

Our study is the first of its kind that provides insight into the study habits of Saudi psychiatry residents. The information can be used to improve the quality of training and medical education of psychiatry residents.

COVID-19: how has a global pandemic changed manual therapy technique education in chiropractic programs around the world?

Background

Manual therapy is a cornerstone of chiropractic education, whereby students work towards a level of skill and expertise that is regarded as competent to work within the field of chiropractic. Due to the COVID-19 pandemic, chiropractic programs in every region around the world had to make rapid changes to the delivery of manual therapy technique education, however what those changes looked like was unknown.

Aims

The aims of this study were to describe the immediate actions made by chiropractic programs to deliver education for manual therapy techniques and to summarise the experience of academics who teach manual therapy techniques during the initial outbreak of COVID-19 pandemic.

Methods

A qualitative descriptive approach was used to describe the immediate actions made by chiropractic programs to deliver manual therapy technique education during the COVID-19 pandemic. Chiropractic programs were identified from the webpages of the Councils on Chiropractic Education International and the Council on Chiropractic Education – USA. Between May and June 2020, a convenience sample of academics who lead or teach in manual therapy technique in those programs were invited via email to participate in an online survey with open-ended questions. Responses were entered into the NVivo software program and analysed using a reflexive thematic analysis by a qualitative researcher independent to the data collection.

Results

Data from 16 academics in 13 separate chiropractic programs revealed five, interconnected themes: Immediate response; Move to online delivery; Impact on learning and teaching; Additional challenges faced by educators; and Ongoing challenges post lockdown.

Conclusion

This study used a qualitative descriptive approach to describe how some chiropractic programs immediately responded to the initial outbreak of the COVID-19 pandemic in their teaching of manual therapy techniques. Chiropractic programs around the world provided their students with rapid, innovative learning strategies, in an attempt to maintain high standards of chiropractic education; however, challenges included maintaining student engagement in an online teaching environment, psychomotor skills acquisition and staff workload.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12998-021-00364-7.

The impact of COVID-19 on the future of orthopaedic training in the UK

The COVID-19 pandemic has had a major impact on global healthcare systems, has drastically affected patient care, and has had widespread effects upon medical education. As plans are being devised to reinstate elective surgical services, it is important to consider the impact that the pandemic has had and will continue to have on surgical training. We describe the effect COVID-19 has had at all levels of training in the UK within trauma and orthopaedics and evaluate how training might change in the future. We found that the COVID-19 pandemic has significantly impacted trainees within trauma and orthopaedics at all levels of training. It had led to reduced operative exposure, cancellations of examinations and courses, and modifications to speciality recruitment and annual appraisals. This cohort of trainees is witnessing novel methods of delivering orthopaedic services, which will continue to develop and become part of routine practice even once the pandemic has resolved. It will be important to observe the extent to which the rapid changes currently being introduced will impact the personal health, safety, and career progression of current trainees.

The Past, Present, and Future of Orthopedic Education: Lessons Learned From the COVID-19 Pandemic

The COVID-19 global pandemic has upended nearly every medical discipline, dramatically impacted patient care and has had far-reaching effects on surgeon education. In many areas of the country, elective orthopedic surgery has completely stopped to ensure that resources are available for the critically ill and to minimize the spread of disease. COVID-19 is forcing many around the world to re-evaluate existing processes and organizations and adapt to carry out business, of which medicine and education are not immune. Most national and international orthopedic conferences, training programs, and workshops have been postponed or canceled, and we are now critically evaluating the delivery of education to our colleagues as well as residents and fellows. This article describes the evolution of orthopedic education and significant paradigm shifts necessary to continue to teach ourselves and the future leaders of our noble profession.

COVID 19 and manual therapy: international lessons and perspectives on current and future clinical practice and education

BACKGROUND

The COVID-19 pandemic has altered clinical practice and education in manual therapy globally. Social distancing has limited in-person care and changed health-care provision. Education in manual therapy has moved to online platforms with in-person instruction restricted. The global impact on the clinical practice of manual therapy and education has to date not been explored.

METHODS

a questionnaire survey methodology was used. A sample of convenience of global leaders in manual therapy practice and education received an electronic link to two surveys: one on clinical practice and one on education. Contributors could complete one or both surveys.

RESULTS

Twenty-five surveys were received on clinical practice and 23 on education in manual therapy, representing the six major continents. Global themes in clinical practice demonstrated a sudden and dramatic shift away from patient contact, with limited modifications to manual therapy in patient care currently adopted. Themes in education were of a major shift to online learning, development of new modes of student instruction including video-based assessment and virtual case-based instruction.

CONCLUSION

The international perspectives provided demonstrate a major change in manual therapy practice and education globally. Various approaches have been taken in practice and education without a uniform approach being demonstrated.

How to Interpret Metal Ions in THA

BACKGROUND

Modern total hip arthroplasty has seen an unfortunate increase in proportional implant failures secondary to adverse local tissue reactions (ALTRs) secondary to wear of metal-on-metal (MoM) bearings and mechanically assisted crevice corrosion (MACC) related to corrosion at implant junctions and tapers. The purpose of this study is to describe the appropriate choice of metal ion testing and evaluation of those levels to identify failed total hip arthroplasty implants containing cobalt and chromium.

METHODS

When presented with an arthroplasty of concern, the surgeon must determine what metal ion levels to obtain and then incorporate those levels into a treatment algorithm. Patients with painful hip arthroplasties are evaluated for chromium and cobalt by obtaining whole blood and synovial metal levels.

RESULTS

Synovial fluid cobalt had the highest correlation with ALTR compared with the other tests, with a threshold of 19.75 ng/ml, with a specificity of 89%, if the cobalt-to-chromium ratio is greater than 1.4 ng/ml in a metal on polyethylene hip, with a sensitivity of 95%.

CONCLUSION

The interpretation of whole blood metal ions is a key component of the algorithm in treating the symptomatic hip arthroplasty but is not to be used in a vacuum.