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Survey: Residents want better ways to track activities, mandatory board exam
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Editor’s note: In this article from the FORTE organization, FORTE vice president Nikolaos K. Paschos, MD, PhD, discusses results of a recent survey on the education and training goals of 684 orthopaedic and trauma residents in Europe. Look for more articles from FORTE members in future issues of Orthopaedics Today Europe.
Because the medical field is continuously evolving, orthopaedic surgeons face numerous challenges when it comes to staying in touch with the most updated and evidence-based knowledge in orthopaedics. In this demanding environment, providing effective education for trainees in trauma and orthopaedic surgery becomes even more complex.
To determine how residents in orthopaedics feel about their training and what their views for the future are, FORTE conducted a survey of its members in an attempt to take the “pulse” of orthopaedic residents concerning education and training in Europe.
The survey was done from March 2013 to March 2014 and 732 residents from 17 European countries participated. Among these, 684 surveys were complete and the responses were analyzed.
Survey asks about work hours, EBOT exam
Here are some of the responses from this survey:
Question: What kind of activities do you think is most efficient for your education?
The responses revealed that active participation in surgeries is the activity that is considered to be the most educative, followed by studying a textbook and attending a case-based discussion. Cadaver labs and journal clubs were also graded by those who took the survey as highly effective activities for education.
Question: What kind of resources do you mostly use in your orthopaedic education?
Textbooks continued to be the leading resource used by residents, followed closely by Internet-based learning activities. One noteworthy finding was the proportion of residents who use electronic resources for their education has doubled in the last 4 years.
Question: Do you have a regular curriculum for education in your department? Does it work effectively?
Most residents replied that despite the fact there is a regular curriculum for education in their department, it is not working properly. This was considered a major drawback. Even the residents who responded their curriculum works admitted there is room for improvement.
Question: Do you have a resident working activity report (e.g., log book)? Do you enter your activity dates regularly? Is it online (Internet-based)?
According to the replies, in most departments a log book is used to monitor the performance of the resident, but it is not very effective as it is hard to use and to update.
Question: Do you think the [European Board of Orthopaedics and Traumatology] EBOT exam is useful? Should EBOT be mandatory? Should EBOT be in different languages? Do you want to participate to international rotations during your residency (http://www.ebotexam.org)?
For this question, there was consensus. More than 75% of residents agreed the EBOT exam is useful and should be mandatory. Disagreement appeared in the responses to choice of language, which were divided between the use of English and native language on the exam.
Question: How many surgeries are performed as first surgeon by a resident in your department during residency?
Most residents responded they performed 200 to 300 surgeries as a first surgeon during their residency. However, the majority of residents surveyed believed this number is inadequate for their training. They said they believed more than 500 surgeries was a sufficient number of cases to complete as a resident first surgeon.
Question: When do you think it would be a good time to perform a fellowship (subspecialty)?
Agreement existed on this question and about the time period most suitable for performing a fellowship. More than 80% of the residents surveyed suggested a fellowship should be performed right after the completion of the residency.
Question: What do you think about European Working Time Directive (WTD) and the reduction in the maximum hours worked per week? How has this affected training?
Most residents suggest that the WTD improved their quality of life and provided time for studying. Unfortunately, most residents reported the WTD also had a negative effect on the number of surgeries in which they are able to participate.
Question: Do you think that European residents need to be represented by a Federation of Residents Associations to be able to express their opinions about educational matters?
More than 95% of those surveyed supported the need for an organization to represent them on a European scale, such as FORTE (www.forte-orthopaedics.com), which would help promote educational activities and act as a representative for their training and education requirements and concerns.
Changes underway
The findings this survey provided to the Executive Board of FORTE led to additional motivation and a greater responsibility to further grow and increase the organization’s educational activities. As a result, FORTE has made advancements in several educational activities in collaboration with the European Federation of National Associations of Orthopaedics and Traumatology (EFORT). This year, FORTE will create an Orthopaedic Study Guide Series in collaboration with Springer Publishing which aims to address the need for an effective and focused review of orthopaedic knowledge.
Also, FORTE actively collaborates with EFORT to organize additional educational activities, including courses and fellowships.
FORTE has organized a Summit to be held 19-20 February in Rolle, Switzerland, where EFORT is based. This is an attempt to increase the visibility of FORTE and establish a more effective relationship with EFORT and the European national orthopaedic and traumatology societies. Lastly, FORTE is establishing a new website with rich content and features that will be online soon. Until then, however, please follow us on Twitter and Facebook.
- For more information:
- Nikolaos K. Paschos, MD, PhD, can be reached at University of California – Davis, 1 Shields Ave., Davis, CA 95156 USA; email: npaschos@ucdavis.edu.
Disclosure: Paschos has no relevant financial disclosures.