Competency-Based Training for Orthopedic Surgery: An Evaluation of the Australian Orthopedic Association Training Program 2017-2021

IF 2.6 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2025-05-24 DOI:10.1016/j.jsurg.2025.103550

Bryan Ashman FRACS , Adrian Cosenza MBA , Jason Frank MD , Ian Incoll FRACS , Chris Kondogiannis FRACS , Markku Nousiainen MD , Linda Snell MD , James Tomlinson FRCS , Sindy Vrancic FRACS

{"title":"Competency-Based Training for Orthopedic Surgery: An Evaluation of the Australian Orthopedic Association Training Program 2017-2021","authors":"Bryan Ashman FRACS , Adrian Cosenza MBA , Jason Frank MD , Ian Incoll FRACS , Chris Kondogiannis FRACS , Markku Nousiainen MD , Linda Snell MD , James Tomlinson FRCS , Sindy Vrancic FRACS","doi":"10.1016/j.jsurg.2025.103550","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Surgical training systems worldwide are undertaking reforms to incorporate competency-based education. There is little published evidence on how competency-based surgical training curricula can be effectively implemented and evaluated.</div></div><div><h3>Summary of Work</h3><div>We describe an evaluation of the impact of the re-design of the Australian Orthopedic Association national surgical training program, which transitioned from a time-based apprenticeship model to a competency-based model in 2017. We used a mixed-methods research approach with a combination of quantitative analysis of in-training portfolio data and qualitative thematic analysis of survey responses and focus group transcripts.</div></div><div><h3>Results</h3><div>Survey responses from trainees, recent graduates and training faculty revealed alignment in most areas but divergent opinions in some. Detailed discussion of these discrepancies with the focus groups enabled better understanding of the impact of the re-designed program on them and other interested parties. A national core curriculum, programmatic assessment with workplace-based tools, a formal teaching syllabus and appropriate supervision were identified as strengths of the new program. Variability in the delivery of several aspects of the curriculum and use of assessment tools were noted as ongoing challenges.</div></div><div><h3>Discussion</h3><div>Trainee exposure to teaching and learning of professional skills was variable, as was clinical experience in all orthopaedic pathology domains. Assessment of competence in clinical and professional skills was perceived to be onerous for both trainees and trainers. A better supported faculty development process and enhanced engagement with all participants was recommended to improve buy-in to the educational aims of the program and improve assessment.</div></div><div><h3>Conclusion</h3><div>The program evaluation panel concluded that many of the original aims of the re-design process were implemented successfully but several challenges emerged, echoing common issues encountered globally in organizational change projects in healthcare and the implementation of competency-based training.</div></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":"82 8","pages":"Article 103550"},"PeriodicalIF":2.6000,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Education","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S193172042500131X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Surgical training systems worldwide are undertaking reforms to incorporate competency-based education. There is little published evidence on how competency-based surgical training curricula can be effectively implemented and evaluated.

Summary of Work

We describe an evaluation of the impact of the re-design of the Australian Orthopedic Association national surgical training program, which transitioned from a time-based apprenticeship model to a competency-based model in 2017. We used a mixed-methods research approach with a combination of quantitative analysis of in-training portfolio data and qualitative thematic analysis of survey responses and focus group transcripts.

Results

Survey responses from trainees, recent graduates and training faculty revealed alignment in most areas but divergent opinions in some. Detailed discussion of these discrepancies with the focus groups enabled better understanding of the impact of the re-designed program on them and other interested parties. A national core curriculum, programmatic assessment with workplace-based tools, a formal teaching syllabus and appropriate supervision were identified as strengths of the new program. Variability in the delivery of several aspects of the curriculum and use of assessment tools were noted as ongoing challenges.

Discussion

Trainee exposure to teaching and learning of professional skills was variable, as was clinical experience in all orthopaedic pathology domains. Assessment of competence in clinical and professional skills was perceived to be onerous for both trainees and trainers. A better supported faculty development process and enhanced engagement with all participants was recommended to improve buy-in to the educational aims of the program and improve assessment.

Conclusion

The program evaluation panel concluded that many of the original aims of the re-design process were implemented successfully but several challenges emerged, echoing common issues encountered globally in organizational change projects in healthcare and the implementation of competency-based training.

查看原文本刊更多论文

基于能力的骨科手术培训：对2017-2021年澳大利亚骨科协会培训计划的评估

世界各地的外科培训系统正在进行改革，以纳入以能力为基础的教育。关于如何有效地实施和评估以能力为基础的外科培训课程，发表的证据很少。我们描述了对澳大利亚骨科协会国家外科培训计划重新设计的影响的评估，该计划于2017年从基于时间的学徒模式转变为基于能力的模式。我们采用了一种混合方法的研究方法，结合了对培训组合数据的定量分析和对调查反馈和焦点小组记录的定性专题分析。调查结果来自学员、应届毕业生和培训教师的反馈显示，在大多数领域意见一致，但在某些领域意见分歧。与焦点小组详细讨论这些差异，可以更好地了解重新设计的项目对他们和其他相关方的影响。国家核心课程、基于工作场所工具的计划性评估、正式的教学大纲和适当的监督被确定为新项目的优势。会议指出，课程若干方面的教学和评价工具的使用存在差异，这是目前面临的挑战。学员接触到的专业技能的教学和学习是可变的，就像所有骨科病理学领域的临床经验一样。临床和专业技能能力的评估被认为对受训人员和培训人员都是繁重的。建议更好地支持教师发展过程，并加强与所有参与者的接触，以提高对项目教育目标的认同，并改善评估。项目评估小组得出结论，重新设计过程的许多最初目标都成功实施了，但也出现了一些挑战，这与全球在医疗保健组织变革项目和实施基于能力的培训中遇到的常见问题相呼应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.