Australian orthopaedic surgery training: Australian Orthopaedic Association's strategic education review

Abstract

BackgroundThe Australian Orthopaedic Association (AOA) is the peak professional body for orthopaedic surgeons in Australia and is responsible for their training and continuing medical education. The 2012 AOA strategic education review employed a gap analysis to identify issues and generate a roadmap for the enhancement of AOA's education and training activities. This paper describes the process and outcomes of this review, which led to the ‘AOA 21’ Education Re‐design Project, and the review's relevance to surgical education in Australia.MethodsThe AOA strategic education review was undertaken by international clinician education and orthopaedic experts, and involved AOA staff, fellows and trainee members throughout Australia. This review progressed through four phases: a review of current training; a global ‘best‐practice’ perspective; a set of aspirational goals; and a roadmap for implementation.ResultsSeven key strengths (e.g. camaraderie in training and surgical skills teaching) and 15 challenges (e.g. ‘non‐technical’ skills teaching, subjective methods of decision making and inadequate assessment practices) were identified in the review stage. Sixteen major recommendations for improvements incorporating current or emerging world's best education practices were targeted in an 8‐year implementation framework.ConclusionThe AOA's strategic education review serves as a roadmap for other specialty training organizations to review their programmes and implement contemporary best practices in surgical training. The AOA 21 project has positioned orthopaedic surgery as a leader in competency‐based surgical education and training in Australia.

Competence By Design: a transformational national model of time-variable competency-based postgraduate medical education

“…In a 2021 study by the International CBME Collaborators, the majority of CBME programs surveyed had worked on implementing two of the van Melle Core Components: a competence framework and programmatic assessment [158]. However, four major PGME programs were comparable in scope and scale to Competence by Design: the Triple-C project of the College of Family Physicians of Canada [27,159,160], the ACGME Outcomes project in the US [22], the Australian Orthopaedic Association's AOA-21 curriculum [161], and the Dutch Association of Medical Specialties' Individualizing Postgraduate Medical Training project [162].…”

“…(Time-variability was not a design element of Triple-C and ACGME.) Overall, all of these major competency-based PGME curricula for the 21st century were successfully deployed, sustained, and evolved over time [93,[159][160][161][162][167][168][169].…”

From Competence by Time to Competence by Design: Lessons From A National Transformation Initiative

“…The CBME movement began with early innovations such as the CanMEDS framework [ 3 4 5 6 7 ], the ACGME Outcomes Project [ 8 9 10 ], entrustable professional activities [ 11 12 ], the Dutch CBME curriculum [ 13 14 ], the Cincinnati observable practice activities [ 15 ], the College of Family Physicians of Canada Triple C Curriculum [ 15 16 17 ], and the University of Toronto Orthopedic program [ 18 ]. CBME has now spread worldwide with implementations in, for example, Switzerland, Taiwan, Australian Orthopedic training [ 19 ], Finland, South Africa, Brazil, and many more countries. Competency based education is now a part of many health professions beyond medicine, including nursing [ 20 ] and veterinary medicine [ 21 ].…”