每周的教学会议能否提高住院医师在骨科住院医师培训考试儿科领域的表现？

Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

作者信息

Franklin Corinna C, Bosch Patrick P, Grudziak Jan S, Dede Ozgur, Ramirez Rey N, Mendelson Steven A, Ward W Timothy, Brooks Maria, Kenkre Tanya, Lubahn John D, Deeney Vincent F, Roach James W

机构信息

*Shriners Hospitals for Children, Philadelphia †Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh §Department of Orthopaedic Surgery, UPMC Hamot, Erie, PA ‡Department of Orthopaedic Surgery, Cooper Medical School of Rowan University, Camden, NJ.

出版信息

J Pediatr Orthop. 2017 Mar;37(2):149-153. doi: 10.1097/BPO.0000000000000726.

DOI:10.1097/BPO.0000000000000726

PMID:26866645

Abstract

BACKGROUND

Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain.

METHODS

In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores.

RESULTS

Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (P<0.0001). Compared with the preconference years, Hamot residents answered 3.99 more questions correctly (P<0.0001) and Pitt residents answered 2.93 more questions correctly (P<0.0001). Before the conference, site was not a predictor of OITE score (P=0.06) or percentile (P=0.08); there was no significant difference found between the mean scores per program. However, in the postconference years, site did predict OITE scores. Controlling for year in training, Hamot residents scored higher on the OITE (2.3 points higher, P=0.003) and had higher percentiles (0.07 higher, P=0.004) than Pitt residents during the postconference years.

CONCLUSIONS

This study suggests that adding a didactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores.

LEVEL OF EVIDENCE

Level III-retrospective case-control study.

摘要

背景

骨科住院医师培训考试（OITE）的成绩与美国骨科医师协会考试笔试部分的成绩相关。在此，我们试图探究增加定期的儿科理论讲座是否能提高住院医师在OITE儿科领域的成绩。

方法

2012年，匹兹堡大学医学中心（UPMC）哈莫特骨科住院医师培训项目（哈莫特）启动了一个理论讲座系列。该系列涵盖小儿骨科手术的所有主题，有授课教师出席，每周举行，所有住院医师都参加。邻近的项目[UPMC匹兹堡（匹兹堡）]也参与这些会议，但仅在其儿科轮转期间。我们试图通过比较每个项目在OITE考试儿科领域的历史成绩与讲座设立后的成绩，并比较这两个项目的成绩，来确定该会议的有效性。

结果

两个项目的OITE成绩均有提高。2008年，平均考试成绩为19.6±4.3（11.0至30.0），平均百分位数为57.7±12.6（32.0至88.0）；2014年，平均考试成绩为23.5±4.2（14.0至33.0），平均百分位数为67.1±12.1（40.0至94.0）。OITE成绩和百分位数随研究生年级的增加而提高（P<0.0001）。与讲座前的年份相比，哈莫特的住院医师正确回答的问题多3.99个（P<0.0001），匹兹堡的住院医师正确回答的问题多2.93个（P<0.0001）。在讲座前，培训地点不是OITE成绩（P=0.06）或百分位数（P=0.08）的预测因素；每个项目的平均成绩之间没有显著差异。然而，在讲座后的年份里，培训地点确实可以预测OITE成绩。在控制培训年份的情况下，在讲座后的年份里，哈莫特的住院医师在OITE上的得分更高（高2.3分，P=0.003），百分位数也更高（高0.07，P=0.004）。