Nguyen Lanchi B, Long Steven A, Lawler Ericka A, Karam Matthew D
Institute for Clinical and Translational Science, University of Iowa, Iowa City, Iowa.
Department of Orthopedics and Rehabilitation, University of Iowa Carver College of Medicine, Iowa City, Iowa.
JB JS Open Access. 2024 Jul 17;9(3). doi: 10.2106/JBJS.OA.24.00036. eCollection 2024 Jul-Sep.
The University of Iowa orthopaedic residency previously designed a month-long surgical skill rotation for postgraduate year (PGY)-1 residents. This successful initiative has become a model of interest for other teaching institutions. In addition to the intern year, an important phase in residency occurs during the transition from PGY2 to PGY3, when residents assume greater responsibility and autonomy in leading surgical procedures.
To directly address this transition and assess residents' readiness, our residency program established a week-long PGY2 surgical skills rotation. This rotation serves as a training checkpoint and focuses on both training and evaluation of level-appropriate skills in joint arthroplasty, trauma, arthroscopy, and wire navigation. The primary objective of the PGY2 surgical skills rotation is to enhance orthopaedic residents' operative skills and experience by providing increased exposure and practice of requisite technical skills. Similar to the Orthopedic In-Training Examinations that assess residents' knowledge, this week-long program, aimed at assessing residents' proficiency in fundamental orthopaedic technical skills, occurs before their PGY3 year.
Faculty-led training and assessment sessions in each area offer residents many opportunities for dedicated practice and improvement. Transferring these acquired skills from the laboratory to the operating room is essential for a training program. To confirm improvement, the final day of the surgical skills rotation was exclusively dedicated to structured performance evaluations, with a specific emphasis on establishing proficiency benchmarks.
We herein describe the University of Iowa's PGY2 surgical skills rotation, providing insights into its development, implementation, and outcomes. By sharing our experience, we offer a framework for other academic departments seeking to optimize surgical skills education and ensure the successful transition of mid-level residents.
爱荷华大学骨科住院医师培训项目之前为第一年住院医师(PGY-1)设计了为期一个月的外科技能轮转。这一成功举措已成为其他教学机构感兴趣的典范。除了实习年,住院医师培训中的一个重要阶段发生在从PGY2到PGY3的过渡期间,此时住院医师在主导手术过程中承担更大的责任和自主权。
为了直接应对这一过渡并评估住院医师的准备情况,我们的住院医师培训项目设立了为期一周的PGY2外科技能轮转。该轮转作为一个培训检查点,专注于关节置换术、创伤、关节镜检查和钢丝导航等适合该水平技能的培训和评估。PGY2外科技能轮转的主要目标是通过增加必要技术技能的接触和实践,提高骨科住院医师的手术技能和经验。与评估住院医师知识的骨科住院医师培训考试类似,这个为期一周的项目旨在评估住院医师在骨科基本技术技能方面的熟练程度,在他们PGY3年之前进行。
每个领域由教员主导的培训和评估课程为住院医师提供了许多专门练习和提高的机会。将这些所学技能从实验室转移到手术室对培训项目至关重要。为了确认改进情况,外科技能轮转的最后一天专门用于结构化绩效评估,特别强调建立熟练程度基准。
我们在此描述爱荷华大学的PGY2外科技能轮转,深入介绍其发展、实施和成果。通过分享我们的经验,我们为其他寻求优化外科技能教育并确保中级住院医师顺利过渡的学术部门提供了一个框架。