Toronto Orthopaedic Boot Camp III: Examining the efficacy of student-regulated learning during an intensive, laboratory-based surgical skills course

Sonnadara, Ranil; Garbedian, Shawn; Safir, Oleg; Mui, Carween; Mironova, Polina; Nousiainen, Markku; Ferguson, Peter C.; Alman, Benjamin A.; Kraemer, William J.; Reznick, Richard

doi:10.1016/j.surg.2013.05.003

Cited by 36 publications

(23 citation statements)

References 28 publications

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“…11 Our initial exploration of the SLL paradigm examined its ability to enhance the acquisition of technical surgical skills. 16 Learning technical skills is an iterative process, during which trainees must analyze the skill, break it down into its components, define goals, and then create strategies to reach these goals. 15 Creating an internal representation of what optimal performance should be for each component allows trainees to compare their actual performance against this representation and continue to solicit additional feedback with each attempt at the skill to improve their performance.…”

mentioning

confidence: 99%

Student-led learning: a new teaching paradigm for surgical skills

Hoogenes

Mironova

Safir

et al. 2015

The American Journal of Surgery

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mentioning

confidence: 99%

Student-led learning: a new teaching paradigm for surgical skills

Hoogenes

Mironova

Safir

et al. 2015

The American Journal of Surgery

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“…Despite these costs, we believe that they are worth the augmented learner and trainer satisfaction and enhanced learning outcomes [14,15]. In fact, implementing a month-long, laboratory-based surgical skills training program (''Boot Camp'') at the onset of the competency-based curriculum program has been shown to greatly advance the knowledge and skills of new trainees [12,15]. These improvements have also been shown to be maintained well into the training program and long after completion of the course [14].…”

Section: Discussionmentioning

confidence: 99%

“…Although the financial costs and time demands on faculty in running the simulation program in the competencybased curriculum at the University of Toronto have been substantial, augmented learner and trainer satisfaction has been accompanied by direct evidence of improved and more efficient learning outcomes [12,14,15]. Although our division believes that the training is cost-effective, other training centers will have to decide individually as to whether the cost is worth the benefit.…”

Section: Discussionmentioning

confidence: 99%

“…After 2010 to 2011 and starting with the academic year of 2011 to 2012, all simulation teaching and assessments that were used in the competency-based curriculum program were universally applied to all residents in the regular stream of the residency training program. This measure was implemented because our research demonstrated that, in our context, the augmented simulation experiences our competency-based curriculum residents were receiving were translating to better learning outcomes compared with their regular stream peers [12,15]. The academic year of 2012 to 2013 was chosen to represent an academic year when simulation was used equally among the competency-based curriculum and regular stream residents.…”

Section: Methodsmentioning

confidence: 99%

“…Augmented learner and trainer satisfaction has been accompanied by direct evidence of improved and more effective learning outcomes in the competency-based curriculum residents [14,15]. In previous work we have shown that enrolling trainees in the month-long, laboratory-based training course (Boot Camp) at the onset of the competencybased curriculum greatly enhances the knowledge and skills of new trainees up to the level of senior residents [12,15]. These improvements have been shown to be maintained long after completion of the course [14].…”

Section: Introductionmentioning

confidence: 98%

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Simulation for Teaching Orthopaedic Residents in a Competency-based Curriculum: Do the Benefits Justify the Increased Costs?

Nousiainen

McQueen

Ferguson

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Although simulation-based training is becoming widespread in surgical education and research supports its use, one major limitation is cost. Until now, little has been published on the costs of simulation in residency training. At the University of Toronto, a novel competency-based curriculum in orthopaedic surgery has been implemented for training selected residents, which makes extensive use of simulation. Despite the benefits of this intensive approach to simulation, there is a need to consider its financial implications and demands on faculty time. Questions/purposes This study presents a cost and faculty work-hours analysis of implementing simulation as a teaching and evaluation tool in the University of Toronto's novel competency-based curriculum program compared with the historic costs of using simulation in the residency training program. Methods All invoices for simulation training were reviewed to determine the financial costs before and after implementation of the competency-based curriculum. Invoice items included costs for cadavers, artificial models, skills laboratory labor, associated materials, and standardized patients. Costs related to the surgical skills laboratory rental fees and orthopaedic implants were waived as a result of special arrangements with the skills laboratory and implant vendors. Although faculty time was not reimbursed, faculty hours dedicated to simulation were also evaluated. The academic year of 2008 to 2009 was chosen to represent an academic year that preceded the introduction of the competency-based curriculum. During this year, 12 residents used simulation for teaching. The academic year of 2010 to 2011 was chosen to represent an academic year when the competency-based curriculum training program was functioning parallel but separate from the regular stream of training. In this year, six residents used simulation for teaching and assessment. The academic year of 2012 to 2013 was chosen to represent an academic year when simulation was used equally among the competencybased curriculum and regular stream residents for teaching 123 Clin Orthop Relat Res (2016) 474:935-944 DOI 10.1007/s11999-015-4512-6 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® (60 residents)and among 14 competency-based curriculum residents and 21 regular stream residents for assessment. Results The total costs of using simulation to teach and assess all residents in the competency-based curriculum and regular stream programs (academic year 2012-2013) (CDN 155,750, USD 158,050) were approximately 15 times higher than the cost of using simulation to teach residents before the implementation of the competencybased curriculum (academic year 2008-2009) (CDN 10,090, USD 11,140). The number of hours spent teaching and assessing trainees increased from 96 to 317 hours during this period, representing a threefold increase. Conclusions Although the financial costs and time demands on faculty in running the simulation program in...

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