Core Concepts: Orthopedic Intern Curriculum Boot Camp

Abstract

Orthopedic surgical interns must gain a broad array of clinical skills in a short time. However, recent changes in health care have limited resident-patient exposures. With the reported success of simulation training in the surgical literature, the American Board of Orthopaedic Surgery (ABOS) and Residency Review Committee for Orthopaedic Surgery have required that surgical simulation training be a component of the intern curricula in orthopedic surgical residencies. This study examined the short-term effectiveness of an orthopedic "intern boot camp" covering 7 of 17 simulation training concept modules published by the ABOS. Eight orthopedic post-graduate year 1 (PGY-1) residents (study group) completed a structured 3-month curriculum and were compared with 7 post-graduate year 2 (PGY-2) residents (comparison group) who had just completed their orthopedic surgical internship. Seven core skills were assessed using both task-specific and global rating scales. The PGY-1 residents demonstrated a statistically significant improvement in all 7 modules with respect to their task-specific pre-test scores: sterile technique (P=.001), wound closure (P<.001), knot tying (P=.017), casting and splinting (P<.001), arthrocentesis (P=.01), basics of internal fixation (P<.001), and compartment syndrome evaluation (P=.004). After the camp, PGY-1 and -2 scores in task-specific measures were not significantly different. A 3-month simulation-based boot camp instituted early in orthopedic internship elevated a variety of clinical skills to levels exhibited by PGY-2 residents.

Variability in training Experience during orthopaedic surgery post-graduate year-1

“…In 2015, a study by Jones et al compared scores in task-specific measures between PGY-1 residents following a three-month orthopaedic "intern boot camp" and PGY-2 residents immediately following their orthopaedic internship that did not include the surgical skills curriculum. 7 The authors found that there was no difference in performance during the surgical skill examinations between the two groups.…”

Changes to Training Practices during a Pandemic - The Experience of the Irish National Trauma & Orthopaedic Training Scheme

“…With respect to the acquisition of orthopaedic skills, many studies have demonstrated that simulation results in improved clinical outcomes with proportional reduction in operating times, however not without substantial cost [39] . Previous literature has demonstrated that non-suite simulation offers an ideal platform in order to teach new orthopaedic interns the basic skills of splinting, casting, suturing and knot tying [40] . Furthermore, Seeley et al proposed that mobile life-sized prosthetic limbs are be suitable teaching adjuncts for practicing and mastering the skills of fracture reduction and immobilization [41] , whilst further studies have demonstrated standard-driven cast removal simulation training to aid trainee learning and ensure patient safety [ 42 , 43 ].…”

Getting up to Speed: A Resident-Led Inpatient Curriculum for New Internal Medicine Interns

“…Reports of graduate medical education curricula are limited to a few intern boot camps in surgical residencies, obstetrics and gynecology, pediatrics, and pediatric cardiology fellowships, [7][8][9][10][11][12][13] as well as reports of a simulation-based boot camp, ambulatory boot camp, and orientation workshops focused on safe handoffs and Accreditation Council for Graduate Medical Education General Competencies for internal medicine interns. [14][15][16][17] This curriculum is unique in that, to our knowledge, there are no published reports of a clinical reasoning-oriented, inpatientfocused transition curricula designed for newly deployed internal medicine interns, including in MedEdPORTAL.…”