The Changing Nature of the Oncology Section of the Orthopaedic In-Training Examination

Abstract

Introduction: The Orthopaedic In-Training Examination (OITE) assesses orthopaedic resident knowledge over 275 multiple-choice questions.Since the first publication examining the contents of the pathology section was published over ten years ago, the pathology content has been renamed (oncology) and revamped. As the overall extent of these alterations is currently unknown, the efficacy of current orthopaedic oncology educational practices for optimal OITE performance should be questioned. To determine how the oncology (pathology) material has changed, we compared the following characteristics from previous examinations (2002 to 2006) to current examinations (2012 to 2016): (1) What are the average number of oncology questions being asked? (2) What are the specific imaging modalities presented for examinee interpretation? (3) Which pathologic diagnoses are commonly examined? (4) What is the pattern of taxonomic question classifications? Methods: The 2012 to 2016 OITE study guides were reviewed, and each oncology question was categorized into one of the following: benign or malignant, imaging modality grouping, common pathologic diagnosis, question type, and taxonomic classification. The aforementioned information was extrapolated from the previous pathology publication published in 2010 to create the previous examination cohort (2002 to 2006). The current examination characteristics were then compared with those of the previous examinations. Results: The current number of oncology OITE questions significantly decreased from previous years (27.2 versus 21.2; P = 0.015). Current examinations displayed a significant increase in testing the interpretation of diagnostic imaging modalities compared with previous examinations (78.3% versus 55.8%; P < 0.001). The current examinations examined a wide spectrum of pathologic diagnoses, including previously untested pathologies. The number of taxonomy 1 questions on current examinations significantly decreased (36.8% versus 24.5%; P = 0.032), whereas the number of taxonomy 3 questions significantly increased from previous examinations (48.1% versus 32.4%; P = 0.032). Discussion: This study demonstrated that the nature of the orthopaedic oncology (pathology) section has changed over the past 10 years. Although the overall number of pathology-related questions decreased, the difficulty level of these questions increased, demanding a higher level of knowledge and critical thinking. A formal orthopaedic oncology rotation may be the best method to educate and improve OITE oncology performance. Level of Evidence: Prognostic study, level III

Analysis of Hand Surgery Questions on Orthopedic In-training Examination From 2014 to 2019

“…12 This is consistent with a recent study of the Oncology domain of the OITE which demonstrated that the proportion of T1 questions decreased and the proportion of T3 questions increased from 2002 to 2006 and 2012 to 2016. 7 Another finding from this study is that approximately 34% of questions in the hand domain rely on at least 1 imaging modality or clinical photo, with clinical photos being the most common.…”

“…10,13 Each question was classified according to a well-described taxonomy classification. [3][4][5][6][7]14 Imaging modalities included radiography, computerized tomography, magnetic resonance imaging, ultrasound, pathology slide, other imaging modalities (eg, angiography), and clinical photographs. References were grouped into journal articles and books or textbooks.…”

“…2 Several studies have evalu-ated domains of the OITE for content, question taxonomy, and reference usage. [3][4][5][6][7][8][9] The hand domain has been reviewed in multiple studies, the most recent of which reviewed data from 2009 to 2015. 10 A separate study by Silvestre et al 11 compared hand questions on the OITE with those on the plastic surgery in-service training examination (PSITE) from 2009 to 2013.…”

Analysis of Questions in Sections of the Orthopaedic In-Training Examination: A Scoping Review

“…Most of these publications focus on identifying numbers of questions, types of questions, topics, references used, and publication lag. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] This systematic review aims to assess all available studies that analyzed the types of questions in individual sections of the OITE. Currently, most relevant literature describes characteristics, references, and levels of evidence for individual sections of the examination.…”

The Evolution of the Musculoskeletal Trauma Section of the Orthopaedic In-Training Examination

“… 1 , 2 , 7 8 9 10 11 12 13 14 OITE content undergoes frequent modifications to adhere to the advancing field of orthopaedics, and recent studies have been conducted to determine whether subspecialty content in the OITE changes over time; however, this has not been done for the musculoskeletal trauma section. 15 , 16 Our goal for this study was to analyze OITE musculoskeletal trauma questions from 2012 to 2019 and compare them with the results reported by Cross et al and Lackey et al from 2011.…”