Teaching Professionalism in Orthopaedic Surgery Residency Programs

Zuckerman, Joseph D.; Holder, Justin P; Mercuri, John J; Phillips, Donna; Egol, Kenneth A.

doi:10.2106/jbjs.k.00504

Cited by 12 publications

(12 citation statements)

References 35 publications

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“…As noted by Zuckerman and colleagues, 4 assessment motivates residents to learn important skills and is therefore a form of learning in itself. We believe that by exposing very junior residents (PGY0) to scenarios they will likely soon encounter (complaints of delayed surgery, difficult interaction with operating room staff), learning opportunities can be created in an environment suitable for feedback and coaching.…”

Section: Discussionmentioning

confidence: 99%

“…However, despite the widespread popu larity of Can-MEDS and other competency frameworks and the mandate to both teach and assess these competencies, the best methods of teaching them remain unknown. 3,4 Assessment options for the intrinsic roles (those other than the medical expert role) include in-training evaluation reports (ITERs), structured oral examinations, 360° assessments and objective structured clinical examinations (OSCE). 4 A survey of a wide variety of medical and surgical program directors in Canada identified that the ITER is the most commonly used method to evaluate the CanMEDS roles, despite its acknowledged subjective nature.…”

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confidence: 99%

“…3,4 Assessment options for the intrinsic roles (those other than the medical expert role) include in-training evaluation reports (ITERs), structured oral examinations, 360° assessments and objective structured clinical examinations (OSCE). 4 A survey of a wide variety of medical and surgical program directors in Canada identified that the ITER is the most commonly used method to evaluate the CanMEDS roles, despite its acknowledged subjective nature. [5][6][7] Respondents reported dissatisfaction with current methods of evaluating the intrinsic roles, especially the manager and health advocate roles.…”

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How to assess communication, professionalism, collaboration and the other intrinsic CanMEDS roles in orthopedic residents: use of an objective structured clinical examination (OSCE)

Dwyer

Takahashi

Hynes

et al. 2014

cjs

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Background: Assessing residents' understanding and application of the 6 intrinsic CanMEDS roles (communicator, professional, manager, collaborator, health advocate, scholar) is challenging for postgraduate medical educators. We hypothesized that an objective structured clinical examination (OSCE) designed to assess multiple intrinsic CanMEDS roles would be sufficiently reliable and valid. Methods:The OSCE comprised 6 10-minute stations, each testing 2 intrinsic roles using case-based scenarios (with or without the use of standardized patients). Residents were evaluated using 5-point scales and an overall performance rating at each station. Concurrent validity was sought by correlation with in-training evaluation reports (ITERs) from the last 12 months and an ordinal ranking created by program directors (PDs).Results: Twenty-five residents from postgraduate years (PGY) 0, 3 and 5 participated. The interstation reliability for total test scores (percent) was 0.87, while reliability for each of the communicator, collaborator, manager and professional roles was greater than 0.8. Total test scores, individual station scores and individual CanMEDS role scores all showed a significant effect by PGY level. Analysis of the PD rankings of intrinsic roles demonstrated a high correlation with the OSCE role scores. A correlation was seen between ITER and OSCE for the communicator role, while the ITER medical expert and total scores highly correlated with the communicator, manager and professional OSCE scores. Conclusion:An OSCE designed to assess the intrinsic CanMEDS roles was sufficiently valid and reliable for regular use in an orthopedic residency program.Contexte : Évaluer la compréhension et l'application des 6 rôles intrinsèques Can-MEDS (communicateur, professionnel, gestionnaire, collaborateur, promoteur de la santé, érudit) chez les résidents pose un défi pour les responsables de la formation médi-cale postdoctorale. Nous avons émis l'hypothèse selon laquelle un examen clinique objectif structuré (ECOS) conçu pour évaluer plusieurs rôles CanMEDS intrinsèques serait suffisamment fiable et valide.Méthodes : L'ECOS comportait 6 stations de 10 minutes, permettant chacune d'évaluer 2 rôles intrinsèques à l'aide de scénarios basés sur des cas (avec ou sans recours à des patients standardisés). Les résidents ont été notés au moyen d'échelles en 5 points et d'une évaluation globale de leur rendement à chacune des stations. La validité convergente a été vérifiée par corrélation avec les rapports d'évaluation en cours de formation (RÉF) des 12 mois précédents et un classement chiffré créé par les directeurs du programme (DP).Résultats: Vingt-cinq résidents des années 0, 3 et 5 y ont participé. La fiabilité interstation pour les scores totaux aux tests (en pourcentage) a été de 0,87, tandis que la fiabilité pour chacun des rôles de communicateur, collaborateur, gestionnaire et professionnel, a été supérieure à 0,8. Les scores totaux aux tests, les scores aux stations individuelles et les scores pour les rôles CanMEDS indivi...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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How to assess communication, professionalism, collaboration and the other intrinsic CanMEDS roles in orthopedic residents: use of an objective structured clinical examination (OSCE)

Dwyer

Takahashi

Hynes

et al. 2014

cjs

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“…While broad concepts of professionalism can be difficult to apply to clinical practice, we identified practical methods of application to resident training. [10][11][12][13] Subordinance of their own interests to the interest of others Adherence to high ethical and moral standards Responsive to societal needs and works towards the benefit of the communities in which they live and serve Adherence to the core humanistic values of honesty and integrity, compassion, altruism, empathy, respect for others, and trustworthiness Accountability for themselves and for their colleagues…”

Section: Defining Professionalismmentioning

confidence: 99%

Operationalizing professionalism: A meaningful and practical integration for resident education

Nichols

Poetker

et al. 2013

The Laryngoscope

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“…Medical education experts have proven the role of the “hidden curriculum” in adult learning. The concept of the hidden curriculum refers to the summation of the incompetent teacher’s behaviors, attitudes, habits, and manners that could be indirectly and unconsciously acquired by the learner during contact with the teacher 5,17,18. A reward and punishment system can be implemented to improve orthopedic education.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the orthopedic residency training program in Saudi Arabia and comparison with a selected Canadian residency program

Al-Ahaideb

Alrabai

Alrehaili

et al. 2014

AMEP

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ObjectiveThe primary aim of the present study was to assess the quality of the Saudi Orthopedic Residency Program.MethodologyAs a comparator, a cross-sectional survey involving 76 Saudi residents from different training centers in Saudi Arabia namely; Riyadh, Jeddah, Medina, Abha, and Dammam and 15 Canadian.ResultsThe results showed that Canadian residents read more peer-reviewed, scholarly articles compared with Saudi residents (P=0.002). The primary surgical role for residents was to hold retractors during surgery. The survey respondents strongly supported the ability to recommend removal of incompetent trainers. Saudi trainees were more apprehensive of examinations than Canadian trainees (P<0.0001). Most residents preferred studying multiple-choice questions before examinations. Saudi and Canadian participants considered their programs to be overcrowded. Unlike Canadian participants, Saudi trainees reported an inadequate level of training (P<0.0001).ConclusionEducational resources should be readily accessible and a mentorship system monitoring residents’ progress should be developed. The role of the resident must be clearly defined and resident feedback should not be ignored. Given the importance of mastering basic orthopedic operative skills for residents, meaningful remedial action should be taken with incompetent trainers.

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Teaching Professionalism in Orthopaedic Surgery Residency Programs

Cited by 12 publications

References 35 publications

How to assess communication, professionalism, collaboration and the other intrinsic CanMEDS roles in orthopedic residents: use of an objective structured clinical examination (OSCE)

How to assess communication, professionalism, collaboration and the other intrinsic CanMEDS roles in orthopedic residents: use of an objective structured clinical examination (OSCE)

Operationalizing professionalism: A meaningful and practical integration for resident education

Evaluation of the orthopedic residency training program in Saudi Arabia and comparison with a selected Canadian residency program

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