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Current and Future Use of Surgical Skills Training Laboratories in Orthopaedic Resident Education: A National Survey
Matthew D. Karam, MD1; Robert A. Pedowitz, MD, PhD2; Hazel Natividad, MA3; Jayson Murray, MA3; J. Lawrence Marsh, MD1
1 University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01019 JPP, Iowa City, IA 52242. E-mail address for M.D. Karam: matthew-karam@uiowa.edu
2 David Geffen School of Medicine at UCLA, Santa Monica UCLA Medical Center and Orthopaedic Hospital, 1250 16th Street, Suite 3145A, Santa Monica, CA 90404
3 American Academy of Orthopaedic Surgeons, 6300 North River Road, Rosemont, IL 60018-4262
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Jan 02;95(1):e4 1-8. doi: 10.2106/JBJS.L.00177
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Acquisition of surgical skills through laboratory-based training and simulation is appealing to surgical training programs. The purpose of this study was to provide baseline information on the current use of surgical skills training laboratories in orthopaedic resident education and to determine the interest in expansion of these facilities and training techniques.


The creation of the survey was a collaborative effort between the authors and the American Academy of Orthopaedic Surgeons (AAOS). Two online versions of the Surgical Skills Simulation survey were created, one (with twenty-three items) specifically for program directors and one (with fourteen items) for orthopaedic residents. The survey was sent via e-mail to 185 program directors and 4549 residents. Data were retrieved and analyzed by the AAOS Department of Research and Scientific Affairs.


Eighty-six (46%) of the 185 surveys distributed to orthopaedic surgery residency directors and 687 (15%) of the 4549 distributed to orthopaedic surgery residents were completed. Seventy-six percent of the program directors reported having a surgical skills laboratory, and 46% of these reported having a structured surgical skills laboratory curriculum. Fifty-eight percent of program directors and 83% of residents believed that surgical skill improvement by orthopaedic residents was not being objectively measured. Both 80% of program directors and 86% of residents agreed that surgical skills simulations should become a required part of training, and 82% and 76% were interested in a standardized surgical skills curriculum. Eighty-seven percent of program directors identified a lack of available funding as the most substantial barrier to development of a formal surgical skills program at their institution.


There was strong agreement among both program directors and residents that surgical skills laboratories and simulation technology should be a required component of orthopaedic resident training. At the present time, the most substantial barrier to adoption of surgical skills laboratories and a formalized surgical skills curriculum is the lack of funding.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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