Orthopaedic training during COVID-19 pandemic: should action be taken?

Objective: The purpose of this study was to develop, implement, and evaluate the effectiveness of an assessment framework aimed at improving formative feedback practices in a Canadian orthopaedic postgraduate training program. Methods: Tool development began in 2014 and took place in 4 phases, each building upon the previous and informing the next. The reliability, validity, and educational impact of the tools were assessed on an ongoing basis, and changes were made accordingly. Results: One hundred eighty-two tools were completed and analyzed during the study period. Quantitative results suggested moderate to excellent agreement between raters (intraclass correlation coefficient = 0.54-0.93), and an ability of the tools to discriminate between learners at different stages of training (p’s < 0.05). Qualitative data suggested that the tools improved both the quality and quantity of formative feedback given by assessors and had begun to foster a culture change around assessment in the program. Conclusions: The tool development, implementation, and evaluation processes detailed in this article can serve as a model for other training programs to consider as they move towards adopting competency-based approaches and refining current assessment practices.

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988 The Prevalence and Incidence of Gender Bias and Sexual Discrimination in Orthopaedics, and Mitigating Strategies: A Systematic Review

British Journal of Surgery ◽

10.1093/bjs/znab135.016 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A Elbayouk ◽

U Halim ◽

A Ali ◽

S Javed ◽

C Cullen

Keyword(s):

Systematic Review ◽

Gender Bias ◽

Role Models ◽

Educational Interventions ◽

Original Research ◽

Sexual Discrimination ◽

Orthopaedic Training ◽

Orthopaedic Community ◽

Training Programmes ◽

The Impact

Abstract Background The aim of this systematic review was to outline the prevalence and impact of Gender bias and sexual discrimination (GBSD) in orthopaedics, and to investigate interventions countering such behaviours. Method Original research papers pertaining to the prevalence and impact of gender bias or sexual discrimination, or mitigating strategies in orthopaedics, were suitable for inclusion. PRISMA guidelines were adhered to in this review. Results Of 570 papers, 27 were eligible for inclusion. A total of 13 papers discussed the prevalence of GBSD, whilst 13 related to the impact of these behaviours, and 6 discussed mitigating strategies. GBSD were found to be prevalent in the orthopaedic workplace, with all sources showing females to be the victims. The impact of GBSD includes poor workforce representation, lower salaries, barriers to career progression, and reduced academic output for females in orthopaedics. Mitigating strategies in the literature are focussed on encouraging females to apply for orthopaedic training programmes, by providing female role models, mentors, and educational interventions. Conclusions GBSD are highly prevalent in orthopaedic surgery, impacting females at all stages of their careers. Mitigating strategies have been tested but are limited in their scope. As such, the orthopaedic community as a whole is obliged to do more to tackle GBSD.

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Augmented Reality, Virtual Reality and Artificial Intelligence in Orthopedic Surgery: A Systematic Review

Applied Sciences ◽

10.3390/app11073253 ◽

2021 ◽

Vol 11 (7) ◽

pp. 3253

Author(s):

Umile Giuseppe Longo ◽

Sergio De Salvatore ◽

Vincenzo Candela ◽

Giuliano Zollo ◽

Giovanni Calabrese ◽

...

Keyword(s):

Artificial Intelligence ◽

Systematic Review ◽

Virtual Reality ◽

Augmented Reality ◽

Orthopaedic Surgery ◽

Resident Training ◽

Comprehensive Search ◽

Virtual And Augmented Reality ◽

Orthopaedic Training ◽

Meta Analyses

Background: The application of virtual and augmented reality technologies to orthopaedic surgery training and practice aims to increase the safety and accuracy of procedures and reducing complications and costs. The purpose of this systematic review is to summarise the present literature on this topic while providing a detailed analysis of current flaws and benefits. Methods: A comprehensive search on the PubMed, Cochrane, CINAHL, and Embase database was conducted from inception to February 2021. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The Cochrane Risk of Bias Tool and the Methodological Index for Non-Randomized Studies (MINORS) was used to assess the quality and potential bias of the included randomized and non-randomized control trials, respectively. Results: Virtual reality has been proven revolutionary for both resident training and preoperative planning. Thanks to augmented reality, orthopaedic surgeons could carry out procedures faster and more accurately, improving overall safety. Artificial intelligence (AI) is a promising technology with limitless potential, but, nowadays, its use in orthopaedic surgery is limited to preoperative diagnosis. Conclusions: Extended reality technologies have the potential to reform orthopaedic training and practice, providing an opportunity for unidirectional growth towards a patient-centred approach.

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Global variability in orthopedic surgery training

Orthopedic Reviews ◽

10.4081/or.2019.8152 ◽

2019 ◽

Author(s):

Andrew D. Sobel ◽

Davis Hartnett ◽

David Hernandez ◽

Adam E. M. Eltorai ◽

Alan H. Daniels

Keyword(s):

United States ◽

Orthopedic Surgery ◽

Orthopaedic Surgery ◽

Educational Development ◽

The United States ◽

Surgery Training ◽

Orthopaedic Care ◽

The World ◽

Orthopaedic Training ◽

And Training

Medical and orthopaedic training varies throughout the world. The pathways to achieve competency in orthopaedic surgery in other countries differ greatly from those in the United States. This review summarizes international educational requirements and training pathways involved in the educational development of orthopaedic surgeons. Understanding the differences in training around the world offers comparative opportunities which may lead to the improvement in education, training, and competency of individuals providing orthopaedic care.

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The orthopaedic experience of COVID-19: A literature review

Journal of Perioperative Practice ◽

10.1177/1750458920971506 ◽

2021 ◽

Vol 31 (3) ◽

pp. 102-107

Author(s):

Ali Al-kulabi ◽

Mohamed A Mansour ◽

Azeem Thahir

Keyword(s):

Literature Review ◽

Acute Care ◽

Outpatient Clinics ◽

Screening Methods ◽

Front Line ◽

Orthopaedic Practice ◽

Social Distancing ◽

Education And Care ◽

Orthopaedic Training ◽

Orthopaedic Education

This literature review aims to provide an account of the changes to orthopaedics in the era of COVID-19. Herein, the authors explored the use of telemedicine in orthopaedics as well as changes in surgical protocols, screening methods, work priorities and orthopaedic education. There was increased utilisation of telemedicine in orthopaedic training and outpatient cases as a means to provide continuity in education and care. The need to implement social distancing measures, coupled with the reduced availability of staff, has dictated that the practice of orthopaedics shifts to focus on acute care whilst redistributing resources to front-line specialities. This was facilitated by the cancellation of electives and the reduction of outpatient clinics. Thus, it is demonstrated that major changes have been implemented in many aspects of orthopaedic practice in order to address the challenges of the COVID-19 pandemic.

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A Brief Comparison of Orthopaedic Training in English-Speaking Countries

Annals of The Royal College of Surgeons of England ◽

10.1308/003588409x359303 ◽

2009 ◽

Vol 91 (3) ◽

pp. 226-231 ◽

Cited By ~ 6

Author(s):

Shakir Syed ◽

Aun H Mirza ◽

Ashgar Ali

Keyword(s):

English Speaking ◽

Orthopaedic Training ◽

The Uk

The purpose of this article is to examine current orthopaedic training in the UK and objectively compare this with other English-speaking countries.

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Association between surgeon grade and implant survival following hip and knee replacement: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-047882 ◽

2021 ◽

Vol 11 (11) ◽

pp. e047882

Author(s):

Timothy J Fowler ◽

Alex L Aquilina ◽

Ashley W Blom ◽

Adrian Sayers ◽

Michael R Whitehouse

Keyword(s):

Systematic Review ◽

Knee Replacement ◽

Revision Rate ◽

Meta Analysis ◽

Secondary Outcome ◽

Published Data ◽

Implant Survival ◽

Knee Replacements ◽

Orthopaedic Training ◽

Training Programmes

ObjectiveTo investigate the association between surgeon grade (trainee vs consultant) and implant survival following primary hip and knee replacement.DesignA systematic review and meta-analysis of observational studies.Data sourcesMEDLINE and Embase from inception to 6 October 2021.SettingUnits performing primary hip and/or knee replacements since 1990.ParticipantsAdult patients undergoing either a primary hip or knee replacement, predominantly for osteoarthritis.InterventionWhether the surgeon recorded as performing the procedure was a trainee or not.Primary and secondary outcome measuresThe primary outcome was net implant survival reported as a Kaplan-Meier survival estimate. The secondary outcome was crude revision rate. Both outcomes were reported according to surgeon grade.ResultsNine cohort studies capturing 4066 total hip replacements (THRs), 936 total knee replacements (TKRs) and 1357 unicompartmental knee replacements (UKRs) were included (5 THR studies, 2 TKR studies and 2 UKR studies). The pooled net implant survival estimates for THRs at 5 years were 97.9% (95% CI 96.6% to 99.2%) for trainees and 98.1% (95% CI 97.1% to 99.2%) for consultants. The relative risk of revision of THRs at 5 and 10 years was 0.88 (95% CI 0.46 to 1.70) and 0.68 (95% CI 0.37 to 1.26), respectively. For TKRs, the net implant survival estimates at 10 years were 96.2% (95% CI 94.0% to 98.4%) for trainees and 95.1% (95% CI 93.0% to 97.2%) for consultants. We report a narrative summary of UKR outcomes.ConclusionsThere is no strong evidence in the existing literature that trainee surgeons have worse outcomes compared with consultants, in terms of the net survival or crude revision rate of hip and knee replacements at 5–10 years follow-up. These findings are limited by the quality of the existing published data and are applicable to countries with established orthopaedic training programmes.PROSPERO registration numberCRD42019150494.

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