CORR ® Curriculum — Orthopaedic Education: Developing Safe, Independent Practitioners

Resident Involvement in Shoulder Arthroscopy Is Not Associated With Short-term Risk to Patients

“…2,7,16 This fine balance of care versus education is complicated by additional external pressures from the health care system as well as from the patient and patient’s family. 7 There is increasing pressure from hospital administration and the health care system to increase productivity while limiting cost; at the same time, patients and their families are increasingly aware of trainee involvement. One solution to assuage some of these pressures has been an increasing emphasis on resident education through arthroscopic simulation and laboratory practice prior to hands-on intraoperative education.…”

“…Attending-level surgeons are often tasked with balancing the delivery of safe and effective patient care with the expectation of hands-on resident education. 2,7,16 This fine balance of care versus education is complicated by additional external pressures from the health care system as well as from the patient and patient’s family. 7 There is increasing pressure from hospital administration and the health care system to increase productivity while limiting cost; at the same time, patients and their families are increasingly aware of trainee involvement.…”

“…26 With these factors in mind, the Accreditation Council for Graduate Medical Education has included shoulder arthroscopy as one of the core competency procedures for orthopaedic residents in training. 7…”

Impact of resident involvement on complication rates in revision total knee arthroplasty

“…This may also stem from residents lacking confidence in their surgical skills due to decreased autonomy and stricter requirements regarding faculty supervision. 40 , 41 , 42 It is crucial that orthopaedic residents gain these skills and are able to perform at an attending level to help combat the growing demand for revision knee arthroplasty. 43 …”

CORR Insights®: Do Postoperative Results Differ in a Randomized Trial Between a Direct Anterior and a Direct Lateral Approach in THA?

“…When the impetus for developing a new technique is additionally influenced by nonclinical factors such as marketability, the impact of the learning curve on patient safety and risk of complications must be considered carefully. In recent years, orthopaedic education has appropriately trended towards a competency-based model with advancement dependent upon achievement of defined performance standards [2,5,9]. Such competencybased evaluation may be more practically applicable to the traditional graduated apprenticeship model of residency and fellowship as opposed to the alternate models of observation, course enrollment, and cadaveric laboratory participation more commonly used by experienced surgeons seeking to gain specialized skills after completion of formal training.…”