Our 2012 experience A Basic Surgical Skills Curriculum for PGY1 Training M. Daniel Wongworawat, MD Professor and Program Director Loma Linda University.

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Presentation transcript:

Our 2012 experience A Basic Surgical Skills Curriculum for PGY1 Training M. Daniel Wongworawat, MD Professor and Program Director Loma Linda University

Disclosures Committee/Board Appointments AAOS Chair, Central Evaluations Committee (OITE/OSAE/OSIE) ASSH Self-Assessment Examination Committee San Bernardino County Medical Society Vice President ABOS/AAOS/AOA/CORD PGY-1 Surgical Skills Taskforce Editorial Board Senior Editor, Clinical Orthopaedics and Related Research Stock ownership Stryker, Medtronic, Amgen

Overview Needs assessment based on semi-annual program evaluation meeting in 2011/2012 Focus on low-tech options Course objectives Perform sharp and dull dissection Place deep, dermal, subcuticular sutures and secure knots Operate power drill, saw, wire driver Place K-wires, lag screws, compression plates, locking plates, tension bands Operate basic arthroscopy equipment

Methods Content divided into four modules Supervised by faculty members Tasks deconstructed into components One day per week, over four weeks Modules Soft tissue handling Power tool operation Bone handling Arthroscopy

Soft tissue handling Fresh pork belly

Soft tissue handling Fresh pork belly Muscle fascial planes Dermal layer Incision Scissor dissection along planes Suture placements Simple Mattresses Inverted dermals Subcuticular Knot tying

Power tool operation Introduction to: Stryker cordless K-wire driver/collets Drill chuck Quick release chuck Oscillating saw

Basic bone handling K-wire and oscillating saw skills 10-cc syringe Numbers as targets Transverse wire placement Oblique wire placement Sawbones humerus Saw cuts Neck fractures Supracondylar fractures Wire fixation Visualized Under towel-wrapped envelope

Basic bone handling Concepts discussion Screw placement Lag technique Plate fixation Neutralization Compression Locked Tension band placement

Basic arthroscopy Scope operation 30° angle Triangulation Instrument handling Knot tying board Visualized knot tying Visualized through clear cannula Visualized on monitor

Post course evaluations, 2012 Good feedback from learners Goals met Suggestions for improvement Include closed reduction techniques Include splinting and casting Expand modules Increase time dedication

Future direction Expansion of modules Dedicated month Improvement of assessments checklist Checklist validation … introduction to PGY-1 Surgical Skills Taskforce Joint project of AAOS/ABOS/AOA/CORD Led by J. Lawrence Marsh

Thank You