Analysis of Hand Surgery Questions on Orthopedic In-training Examination From 2014 to 2019

Abstract

Background: The orthopedic in-training examination (OITE) continues to evolve over time. It is important for orthopedic residents and residency programs to have an up-to-date understanding of the content and resources being used on the OITE to study and tailor curricula accordingly. This study presents an updated analysis of the OITE hand domain from 2014 to 2019. Methods: All OITE questions related to hand surgery from 2014 to 2019 were analyzed for topic, subtopic, taxonomy, imaging modalities, and bibliometric factors related to cited references. Results: Of the 1600 OITE questions, there were 113 hand surgery questions (7.1%) over a 6-year period. The most commonly tested topics were nerve (n = 22; 19%), fracture/dislocation (n = 21; 19%), and tendon/ligament (n = 19; 17%). Complex clinical management questions were the most common taxonomic category (n = 66; 58%). Two hundred fifty-two references were cited, the most common of which were from the Journal of Hand Surgery (American Volume) (n = 76; 30%), Journal of the American Academy of Orthopaedic Surgeons (n = 27; 11%), and Hand Clinics (n = 21; 8%). Publication lag decreased over the study period ( P = .009). Twenty-five questions (22%) used imaging modalities, and 21 (19%) used clinical photos. Compared with a prior analysis from 2002 to 2006, there were more questions related to nerves (19.5% vs 9.8%, P = .041). Conclusions: Residents and residency programs can benefit from an updated understanding of OITE hand surgery content and resources. The current analysis identifies high-yield topics and resources that can guide resident preparation for the OITE.

Update on Educational Resources and Evaluation Tools for Orthopaedic Surgery Residents

“…Because of this emphasis, trends in recent examination questions have been investigated to aid in preparation for the annual examination. 17,[19][20][21][22][23][24][25][26] Although several studies have shown a correlation between OITE performance and passing the Part I Certifying Exam, the validity of the OITE as a predictive measure for success on the Certifying Exam has been questioned because the two examinations have been written by separate organizations without a common blueprint. [27][28][29][30][31] A linking study found that on the 2021 AAOS OITE, the minimum OITE score that corresponded to passing the Part I Certifying Exam was 69.2%, but this was noted to be applicable to the 2021 OITE examination only.…”

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

“…7 Similarly, Lebrun et al found a statistically significant increase in T3 questions in the hand section from 2014 to 2019. 10 An increase in T3-level questions over time was also observed in the sports medicine 11,22 and oncology 17 sections of the OITE. As the rate of T3 questions is generally high and increasing in certain sections, the OITE is requiring an increasing level of clinical knowledge and critical thinking.…”

“…Most of these publications focus on identifying numbers of questions, types of questions, topics, references used, and publication lag. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] This systematic review aims to assess all available studies that analyzed the types of questions in individual sections of the OITE. Currently, most relevant literature describes characteristics, references, and levels of evidence for individual sections of the examination.…”

The number of shoulder and elbow questions on the orthopedic in-training examination is increasing with greater emphasis on critical thinking over recall

“…This methodology has been used in similar studies evaluating OITE questions after 2016. 1,6,10,20 The following data were abstracted for each question: topic, taxonomy, type of imaging used, and reference source with publication year. Shoulder and elbow question topics were adopted from a previous study 26 and included trauma, anatomy/biomechanics, degenerative joint disease/stiffness/arthroplasty, instability/athletic injury, rotator cuff, and miscellaneous.…”