Orthopaedic Education During the COVID-19 Pandemic

Monica Kogan, Sandra E Klein, Charles P Hannon, Michael T Nolte, Monica Kogan, Sandra E Klein, Charles P Hannon, Michael T Nolte

Abstract

The COVID-19 global pandemic presents a challenge to orthopaedic education. Around the world, including in the United States, elective surgeries are being deferred and orthopaedic residents and fellows are being asked to make drastic changes to their daily routines. In the midst of these changes are unique opportunities for resident/fellow growth and development. Educational tools in the form of web-based learning, surgical simulators, and basic competency tests may serve an important role. Challenges are inevitable, but appropriate preparation may help programs ensure continued resident growth, development, and well-being while maintaining high-quality patient care.

Conflict of interest statement

None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Kogan, Dr. Klein, Dr. Hannon, and Dr. Nolte.

Figures

Figure 1
Figure 1
Illustration showing theresidency surge plan. Schematic diagram of a residency surge plan for an orthopaedic program with 30 residents. After a 2-week period, the Hospital team switches with the Home team, helping to ensure that at least half of the residents are healthy at any one time.
Figure 2
Figure 2
Illustration showing the sample resident weekly schedule. This sample schedule consists of a few key mandatory weekly meetings for all residents and the program director. A number of service-specific events are mandatory for residents assigned to that service but are made available to all residents wishing to attend. The remainder of time is filled with independent study, research, or webinars made available through the American Academy of Orthopaedic Surgeons or the subspecialty societies. An assigned time with a surgical simulator in the resident workspace is an option for programs that can safely provide this method of learning. All meetings take place via a virtual platform.

References

    1. References printed in bold type are those published within the past 5 years.

    1. Ferguson NM, Laydon D, Nedjati-Gilani G, et al. : Impact of Non-pharmaceutical Interventions (NPIs) to Reduce COVID-19 Mortality and Healthcare Demand. London, Imperial College COVID-19 Response Team, 2020, pp 16.
    1. Kelly JD, IV: CMS urges delay of non-essential medical, surgical procedures during COVID-19 pandemic. 2020.
    1. Boden SD: How to deploy residents during COVID-19. Available at: . 2020, vol 2020.
    1. Liao J, Fan S, Chen J, et al. : Epidemiological and clinical characteristics of COVID-19 in adolescents and young adults. medRxiv 2020.
    1. Dougherty PJ, Marcus RE: ACGME and ABOS changes for the orthopaedic surgery PGY-1 (intern) year. Clin Orthop Relat Res 2013;471:3412-3416.
    1. Palan J, Roberts V, Bloch B, Kulkarni A, Bhowal B, Dias J: The use of a virtual learning environment in promoting virtual journal clubs and case-based discussions in trauma and orthopaedic postgraduate medical education: The leicester experience. J Bone Joint Surg Br 2012;94:1170-1175.
    1. Cisco webex. Available at: . 2020, vol 2020.
    1. Google classroom. Available at: . 2020, vol 2020.
    1. Microsoft teams. Available at: . 2020, vol 2020.
    1. Zoom. Available at: . 2020, vol 2020.
    1. Miyamoto RG, Jr, Klein GR, Walsh M, Zuckerman JD: Orthopedic surgery residents' study habits and performance on the Orthopedic In-Training Examination. Am J Orthop 2007;36:E185-E188.
    1. American Board of Orthopaedic Surgery: Rules and procedures for residency education. Available at: . 2020, vol 2020.
    1. American Association of Hip and Knee Surgeons: COVID-19 resources. Available at: . vol 2020.
    1. Pedowitz RA, Marsh LJ: Motor skills training in orthopaedic surgery: A paradigm shift toward a simulation-based educational curriculum. J Am Acad Orthop Surg 2012;20:407-409.
    1. Laurance J: Surgeons should train on simulators like pilots. The Independent. London, UK, Independent News and Media, Ltd, 2009.
    1. Sonnadara RR, Van Vliet A, Safir O, et al. : Orthopedic boot camp: Examining the effectiveness of an intensive surgical skills course. Surgery 2011;149:745-749.
    1. Holland JP, Waugh L, Horgan A, Paleri V, Deehan DJ: Cadaveric hands-on training for surgical specialties: Is this back to the future for surgical skills development? J Surg Educ 2011;68:110-116.
    1. Blyth P, Stott NS, Anderson IA: A simulation-based training system for hip fracture fixation for use within the hospital environment. Injury 2007;38:1197-1203.
    1. Gomoll AH, O'toole RV, Czarnecki J, Warner JJ: Surgical experience correlates with performance on a virtual reality simulator for shoulder arthroscopy. Am J Sports Med 2007;35:883-888.
    1. Atesok K, Satava RM, Van Heest A, et al. : Retention of skills after simulation-based training in orthopaedic surgery. J Am Acad Orthop Surg 2016;24:505-514.
    1. VanHeest A, Kuzel B, Agel J, Putnam M, Kalliainen L, Fletcher J: Objective Structured Assessment of Technical Skill in upper extremity surgery. J Hand Surg 2012;37:332-337.e4.
    1. Bernard JA, Dattilo JR, Srikumaran U, Zikria BA, Jain A, LaPorte DM: Reliability and validity of 3 methods of assessing orthopedic resident skill in shoulder surgery. J Surg Educ 2016;73:1020-1025.
    1. Alvand A, Logishetty K, Middleton R, et al. : Validating a Global Rating Scale to monitor individual resident learning curves during arthroscopic knee meniscal repair. Arthroscopy 2013;29:906-912.
    1. Shanedling J, Van Heest A, Rodriguez M, Putnam M, Agel J: Validation of an online assessment of orthopedic surgery residents' cognitive skills and preparedness for carpal tunnel release surgery. J Grad Med Educ 2010;2:435-441.
    1. Mulcahey MK, Waterman BR, Hart R, Daniels AH: The role of mentoring in the development of successful orthopaedic surgeons. J Am Acad Orthop Surg 2018;26:463-471.
    1. Sambunjak D, Straus SE, Marusic A: A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. J Gen Intern Med 2010;25:72-78.
    1. LaPorte DM, Tornetta P, Marsh JL: Challenges to orthopaedic resident education. J Am Acad Orthop Surg 2019;27:419-425.
    1. Accreditation Council for Graduate Medical Education: Three stages of GME during the COVID-19 pandemic. Available at: . 2020, vol 2020.
    1. Cuomo AM: No. 202.10: Continuing temporary suspension and modification of laws relating to the disaster emergency. 2020.
    1. Benson JA: Enhancing standards of excellence in internal-medicine training. Ann Intern Med 1987;107:775-778.
    1. Philibert I, Friedmann P, Williams WT: New requirements for resident duty hours. JAMA 2002;288:1112-1114.
    1. Nasca TJ, Philibert I, Brigham T, Flynn TC: The next GME accreditation system—Rationale and benefits. N Engl J Med 2012;366:1051-1056.
    1. Camp CL, Wang D, Turner NS, Grawe BM, Kogan M, Kelly AM: Objective predictors of grit, self-control, and conscientiousness in orthopaedic surgery residency applicants. J Am Acad Orthop Surg 2019;27:e227-e234.
    1. Salles A, Cohen GL, Mueller CM: The relationship between grit and resident well-being. Am J Surg 2014;207:251-254.
    1. Salles A, Lin D, Liebert C, et al. : Grit as a predictor of risk of attrition in surgical residency. Am J Surg 2017;213:288-291.
    1. Walker A, Hines J, Brecknell J: Survival of the grittiest? Consultant surgeons are significantly grittier than their junior trainees. J Surg Educ 2016;73:730-734.
    1. Tangney JP, Boone AL, Baumeister RF: High self-control predicts good adjustment, less pathology, better grades, and interpersonal success, in Self-Regulation and Self-Control. Routledge, 2018, pp 181-220.
    1. Rose C: Am I part of the cure or am I part of the disease? Keeping coronavirus out when a doctor comes home. N Engl J Med 2020.
    1. Maunder R, Hunter J, Vincent L, et al. : The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ 2003;168:1245-1251.

Source: PubMed

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