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Three-Year Experience with an Innovative, Modular Competency-Based Curriculum for Orthopaedic Training
Peter C. Ferguson, MD, FRCSC1; William Kraemer, MD, FRCSC1; Markku Nousiainen, MD, FRCSC1; Oleg Safir, MD, FRCSC1; Ranil Sonnadara, PhD2; Benjamin Alman, MD, FRCSC1; Richard Reznick, MD, FRCSC3
1 Department of Surgery, University of Toronto, 600 University Avenue, Suite 476G, Toronto, ON M5G 1X5, Canada. E-mail address for P.C. Ferguson: pferguson@mtsinai.on.ca
2 Department of Surgery, McMaster University, A.N. Bourns Science Building, Room 131, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada
3 Department of Surgery, Queen’s University, Macklem House, 18 Barrie Street, Kingston, ON K7L 3N6, Canada
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Investigation performed at the University of Toronto, Toronto, Ontario, Canada

Disclosure: One or more 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 an aspect of this work. In addition, 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 Nov 06;95(21):e166 1-6. doi: 10.2106/JBJS.M.00314
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In response to multiple stresses in current surgical education, we developed a new model of orthopaedic training that combines curricular reform with a competency-based framework. For the past three years, this pilot program has been run in parallel to our conventional curriculum for a select number of residents. In this article, we share our initial experience with this approach to training and describe its successes and challenges. We review the existing concerns with surgical training in a new era of work-hour restrictions and describe the pedagogical rationale for the model that we have developed. We then discuss the design of this curriculum, including the basic tenets and principles that guided our approach. Finally, we detail our preliminary results, which add evidence that a focused, modular-based program, with concentrated teaching of technical skills and frequent formative and summative evaluations, can result in rapid acceleration in surgical competency, knowledge acquisition, and comprehensive professional skills. This new model deserves further study and consideration for implementation on a broader scale in today’s challenging medical education environment.
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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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