Journal of Surgical Education最新文献

{"title":"How Do I Match? A Survey Study on the Impact of Step 1 Becoming Pass/Fail","authors":"","doi":"10.1016/j.jsurg.2024.08.013","DOIUrl":"10.1016/j.jsurg.2024.08.013","url":null,"abstract":"<div><h3>BACKGROUND</h3><p>Step 1 has historically been a major criterion to evaluate students for residency match. With Step 1 now being pass/fail (P/F), students are uncertain how to distinguish their applications. We aim to understand student's opinions surrounding the scoring change as this is the first class of students applying to residency in the P/F era.</p></div><div><h3>MATERIALS AND METHODS</h3><p>An electronic survey was sent to 3rd and 4th year American medical students.</p></div><div><h3>RESULTS</h3><p>Of the 255 students surveyed, 61.6% prefer Step 1 in the P/F format. Students applying for highly competitive specialties (HCS) preferred numerical scoring (55.6%). On a 5-point Likert scale, students entering HCS believed more strongly that they would have a better chance at matching if Step 1 was graded numerically (3.47 vs 2.71) and creates an unfair advantage for those who can afford to pursue a research year (3.46 vs 2.95). Students entering HCS felt finances played a significant role in whether they took a research year and felt added pressure to engage in research. Respondents believe that students from prestigious medical schools, well-connected students, and MD students will benefit most.</p></div><div><h3>CONCLUSIONS</h3><p>While students mostly prefer P/F scoring, there were differences of opinion between those going into HCS and LCS. Students indicated that those who have financial means are at a distinct advantage as they can afford to utilize a research year to distinguish their applications. Future efforts should be made to address student concerns and unintended consequences of the scoring change to create an equitable system.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003921/pdfft?md5=4c4451fa3a31c742052c93608e8a74fa&pid=1-s2.0-S1931720424003921-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serious Illness Communication Training for Surgical Critical Care Fellows: A Pilot Implementation Study","authors":"","doi":"10.1016/j.jsurg.2024.08.027","DOIUrl":"10.1016/j.jsurg.2024.08.027","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>Effective communication about serious illness is pivotal in delivering surgical palliative care—a crucial component of comprehensive surgical critical care (SCC). However, limited educational strategies exist for fellow-level trainees, who are often directing clinical decision-making and building mutual trust with patients and families. This pilot study assess implications of a novel serious illness communication training opportunity tailored specifically for SCC fellows.</p></div><div><h3>DESIGN</h3><p>Prospective implementation of a multimodal training session (1 hour–didactic lecture, 2 hours–live-action simulation), using pre- and postcourse surveys to assess self-perceived confidence.</p></div><div><h3>SETTING</h3><p>University of Michigan in Ann Arbor, Michigan.</p></div><div><h3>PARTICIPANTS</h3><p>Eleven ACGME-accredited SCC fellows during the 2023 to 2024 academic year participated and completed all 3 survey assessments.</p></div><div><h3>RESULTS</h3><p>Following the course, 6 of 7 confidence domains showed improvement, with 2 reaching statistical significance—communication skills to discuss goals of care and/or code status (3.73 vs. 4.36, p = 0.018) and end-of-life care or transition to comfort-focused care (3.36 vs. 4.18, p = 0.023) with a patient or family member. At 6-month follow up, fellows reported further increases in all queried domains, though changes were nonsignificant. Greatest absolute increases were noted in delivering serious news (4.18 vs. 4.55, p = 0.143) and expressing nonverbal empathy (4.09 vs. 4.50, p = 0.197). The majority (91%) of respondents felt more comfortable having serious illness conversations with patients and families due to their training course experience.</p></div><div><h3>CONCLUSION</h3><p>Implementation of a 3-hour training course tailored for SCC fellows significantly boosted both the immediate and long-term confidence in their serious illness communication skills and ability to manage complex care scenarios.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Validity of National Multiassessment System in Postgraduate Surgical Training: A Retrospective Cohort Study","authors":"","doi":"10.1016/j.jsurg.2024.08.008","DOIUrl":"10.1016/j.jsurg.2024.08.008","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to evaluate the validity evidence supporting the use and interpretation of a multifaceted assessment system in the early years of surgical training.</p></div><div><h3>Design</h3><p>This was a national retrospective cohort study analyzing the validity and reliability of an assessment process for surgical residents over a 2-year period. Data from all elements of the assessment process was evaluated using Messick's unified validity framework. Assessments were categorized as Workplace-based, Structured assessment performed in the academic center and Multiple Mini Interview.</p></div><div><h3>Setting</h3><p>Our Institution is a health sciences university and the body responsible for the training and certification of all surgeons in our national program. Residents on the Core Surgical Training program undergo multiple assessments over the first 2 years of postgraduate training, both in the workplace and the academic training center, which inform their progression into higher surgical training in their chosen specialty.</p></div><div><h3>Participants</h3><p>Data was collected from 2 cohorts of the entire population of postgraduate trainees nationally (N = 114).</p></div><div><h3>Results</h3><p>Best practice standards for educational testing aligned with the results supporting the use of this assessment process. Findings indicate a robust assessment system, demonstrating validity evidence in content, response process, internal structure, relations to other variables, and consequences. Composite score reliability of the assessment was 0.89 which demonstrates a highly reliable process. Correlation between workplace-based assessments and standardized tests performed in the simulation setting was also very high (0.93).</p></div><div><h3>Conclusions</h3><p>The Core Training Assessment System (CTAS) provides a psychometrically rigorous system to measure trainee competence during the initial years of training. Residency programs of all sizes can replicate the methods described here to demonstrate the validity of their assessment processes, thereby being able to stand over decisions on surgical competency.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003866/pdfft?md5=6a90ed2ea6df3b72af4d09c7f390cae2&pid=1-s2.0-S1931720424003866-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing Resident Vascular Case Volumes Have Not Changed National Numbers of Vascular Fellowship Applications in US General Surgery Residents Over the Past Twenty Years","authors":"","doi":"10.1016/j.jsurg.2024.08.031","DOIUrl":"10.1016/j.jsurg.2024.08.031","url":null,"abstract":"<div><h3>Objectives</h3><p>With an aging workforce and high prevalence of vascular disease, the US is expected to face a pronounced shortage of vascular surgeons over the next 2 decades. This has driven initiatives to expand vascular surgery training positions leading to the rise of integrated residency programs (0 + 5) and the expansion of traditional fellowships (VSFs, 5 + 2). Given the increase in dedicated vascular surgery training positions, there has been a growing concern that general surgery residents (GSRs) are experiencing decreased vascular case volumes. We aim to evaluate trends in vascular surgery specialty choice relative to vascular case volumes for US GSRs over the last 20 years.</p></div><div><h3>Design</h3><p>Using the Accreditation Council for Graduate Medical Education (ACGME) Case Log Graduate Statistics National Report, a retrospective analysis of ACGME-accredited GSR vascular case volumes was performed from academic year 1999-2000 to 2021-2022. Fellowship data was retrospectively reviewed using the available National Resident Matching Program (NRMP) Fellowship Match Data &amp; Reports for 2004-2023.</p></div><div><h3>Results</h3><p>Graduating GSRs logged increasing numbers of major cases between AY 1999-2000 and AY 2021-2022 (p &lt; 0.001) with 2022 graduates logging on average 98 more cases per resident compared to 2000 graduates. Mean total vascular cases decreased (p = 0.005) with 2022 graduates logging approximately 78 fewer vascular cases on average compared to the 2000 graduates, a 40% decrease in vascular case volume. Despite the decrease, US GSRs have applied to VSF at a relatively consistent rate: 8.5% in 2001-2002, 8% in 2011-2012, and 6% in 2021-2022. 2023 demonstrated an increase to 8.3%.</p></div><div><h3>Conclusion</h3><p>Over the past 2 decades, GSRs have experienced a substantial decrease in exposure to vascular surgery cases during their training; however, residents continue to apply for VSF at a relatively constant rate suggesting that interest in the specialty may be related to factors other than exposure to vascular cases.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Student Perspectives on Professionalism in a Third-Year Surgery Clerkship – A Mixed Methods Study","authors":"","doi":"10.1016/j.jsurg.2024.08.018","DOIUrl":"10.1016/j.jsurg.2024.08.018","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>The norms governing surgical training warrant a deeper understanding of students’ experiences and interpretations of professionalism issues in their learning environment. However, there is scant empirical evidence to describe this process. To fill this gap, we analyzed students’ perceptions related to professionalism, moral distress, and communication in the surgical clerkship, particularly regarding their clinical supervisors, whom we refer to as mentors.</p></div><div><h3>DESIGN</h3><p>We retrospectively evaluated written case vignettes and survey responses from medical students on their surgical clerkships regarding their experiences of cases which raised professionalism concerns. Vignettes and surveys were part of standard curricular exercises and analyzed using both qualitative and quantitative methods.</p></div><div><h3>SETTING</h3><p>Our study was conducted at a private academic medical college in the northeast with an affiliated institute of bioethics.</p></div><div><h3>PARTICIPANTS</h3><p>Two-hundred forty-one third year medical students on their surgical clerkships participated through required curricular submissions of case vignettes and surveys.</p></div><div><h3>RESULTS</h3><p>Vignettes and surveys from all 241 students were collected and analyzed. Of these, 106 (43.9%) were identified by the students as relating to professionalism, whereas the research team identified 148 (61.4%) cases as such. Major subtypes of professionalism concerns were categorized as “not showing proper respect” (38.5%), bias (30.4%) and “failure to meet medical standards of care” (29.1%). In professionalism cases, only 27.7% of students would emulate their mentor, 19.7% shared concerns with the mentor, and 58.8% experienced moral distress, all significantly worse than in nonprofessionalism cases (p &lt; 0.001).</p></div><div><h3>CONCLUSIONS</h3><p>With an abundance of professionalism concerns noted, students experienced high rates of moral distress and were unlikely to share concerns with clinical mentors who they generally did not wish to emulate. Attention should be paid to providing a formal curricular venue in which students can discuss their concerns, as untoward experiences in the learning environment risk harming their learning and professional identity development.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003957/pdfft?md5=5d45d71b9251808415a3f6c6e947633a&pid=1-s2.0-S1931720424003957-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of 1000 Patients With the “Big 5” Orthopaedic Surgery Procedures and the Impact of Residents on Outcome","authors":"","doi":"10.1016/j.jsurg.2024.08.011","DOIUrl":"10.1016/j.jsurg.2024.08.011","url":null,"abstract":"<div><h3>BACKGROUND</h3><p>The study is intended to show that the operative quality of a resident in orthopedic trauma surgery is comparable to that of a senior physician in the most common orthopaedic trauma surgeries (Plate osteosynthesis in ankle fractures and distal radius fractures, ESIN in pediatric forearm fractures, implantation of a proximal femoral nail in pertrochanteric femur fractures and hemiarthroplasty in femoral neck fractures) with appropriate supervision by a senior physician. With only minimal deviations in the operating time, which is becoming increasingly relevant in everyday clinical practice, surgical training of residents could be supported.</p></div><div><h3>MATERIAL AND METHODS</h3><p>200 patients of the above-mentioned fracture patterns each, who were treated surgically between January 1, 2016 and December 31, 2020, were detected and categorized. In particular, a qualitative characteristic was determined for each fracture on the basis of the standard pre and postoperative X-rays taken during surgery and statistically evaluated with the surgery time, the fracture classification and the training status of the anonymized surgeon. Anonymized x-rays were evaluated by 2 senior physicians and 2 residents.</p></div><div><h3>RESULTS</h3><p>Operations were performed by residents in 33.5 % of the cases (ankle fractures 42.0%; distal radius fractures 30.5%; pediatric forearm fractures 30.5%; pertrochanteric femur fractures 50.5%; femoral neck fractures 14.0%). Surgical complication rate was 4.8% in the resident group and 9.0% in the attending surgeon group. Revision surgeries were performed in 2.1% of resident cases, and in 4.1% of attending surgeon cases.</p><p>In the resident group, time of surgery was 7.4 min longer for ankle fractures, 4.4 min for distal radius fractures, 2.8 min for forearm fractures, 2.3 min longer in proximal femur fractures 8.2 min longer for femoral neck fractures. No statistically significant difference in radiological outcome was observed in any of the groups after evaluation of the x-rays.</p></div><div><h3>CONCLUSION</h3><p>This study shows that only slightly more than one third of all mentioned operations are performed by residents, although there is no statistical difference in quality. The operating time is extended on average by only 5 minutes. The surgical complication rate as well as the revision rate is higher in the group of senior physicians, whereby the more complicated fractures were treated by them. Resident involvement in trauma surgery is therefore not associated with increased morbidity or mortality of patients.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003891/pdfft?md5=24d97a79a649783502e2cf8a39507670&pid=1-s2.0-S1931720424003891-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Numeric Versus Pass/Fail USMLE Step 1 Scores in the Integrated Plastic Surgery 2023-2024 Match Cycle: A Single Institution Study","authors":"","doi":"10.1016/j.jsurg.2024.08.025","DOIUrl":"10.1016/j.jsurg.2024.08.025","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>The USMLE Step 1 exam, an important metric in the integrated plastic surgery match, transitioned to pass/fail scoring in January 2022. No previous studies have investigated the impact of this new scoring system on the process of ranking applicants in the integrated plastic surgery match.</p></div><div><h3>DESIGN</h3><p>330 Plastic Surgery Common Applications (PSCAs) were submitted to a single academic center in the 2023-2024 match cycle. Applicants were sorted into tiers via a holistic review process, and quantifiable data, including USMLE Step 1 scores, were then compared between tiers.</p></div><div><h3>SETTING</h3><p>Our Institution's Integrated Plastic Surgery Residency Program.</p></div><div><h3>PARTICIPANTS</h3><p>Integrated Plastic Surgery applicants in the 2023-2024 match cycle.</p></div><div><h3>RESULTS</h3><p>317 of 330 PSCAs were analyzed in this study, excluding applicants who did an elective rotation at our institution. Applicants were sorted into 3 tiers: high (n = 100), middle (n = 118) and low (n = 99), with a significant difference in match rate per tier, respectively (88.0%, 58.5%, 30.3%, p &lt; 0.0001). The majority of USMLE Step 1 scores were reported as pass/fail (186/317, 58.7%). There was a significant difference (p &lt; 0.0001) between the average USMLE Step 1 score between the high (mean 250.5, SD 10.4), middle (mean 241, SD 14.6), and low tiers (mean 235.5, SD 16.5). More applicants in the low tier (50%) and high tier (40%) reported numeric USMLE Step 1 scores than those in the middle tier (35%, p = 0.0734). Stepwise logistic regression revealed USMLE Step 1 score to be an independent predictor of tier placement between the high and middle tier (p = 0.0030) and high and low tier (p = 0.0001). Lastly, 3 applicants reported their USMLE Step 1 score as ‘pass’ instead of their given numeric score.</p></div><div><h3>CONCLUSIONS</h3><p>Comparing applicants with numeric USMLE Step 1 scores to those with pass/fail scores can have a significant impact on the ranking of those applicants and should be carefully considered during the plastic surgery match process.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1931720424003969/pdfft?md5=1a5328faa6af575c3b477e6e1500b7fb&pid=1-s2.0-S1931720424003969-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conscientious Objection to Gender-Affirming Surgery: A Cross-Sectional Analysis of Plastic Surgery and Urology Residency Programs","authors":"","doi":"10.1016/j.jsurg.2024.08.022","DOIUrl":"10.1016/j.jsurg.2024.08.022","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>Medical conscientious objection is a federally protected right of physicians to refuse participation in medically indicated services or research activities that are incompatible with their ethical, moral, or religious beliefs. Individual provider objections to gender-affirming surgery have been documented, however the prevalence of such objections is unknown. Our study aimed to characterize physician objections to gender-affirming surgery in plastic surgery and urology residencies and to assess related institutional policies.</p></div><div><h3>DESIGN, SETTING, PARTICIPANTS</h3><p>A cross-sectional electronic survey was administered to program leadership of 239 accredited US plastic surgery and urology residencies from February to October 2023. Trainee exposure to gender-affirming surgery, programmatic experience with objections, and presence and content of institutional objection policies were collected. Bivariate analyses were performed to determine associations with objectors.</p></div><div><h3>RESULTS</h3><p>One-hundred and twenty-four plastic surgery (n = 59) and urology (n = 65) residencies completed the survey, representing a 52% response rate. Most programs included didactic training (n = 107, 86%) and direct clinical exposure (n = 98, 79%) to gender-affirming surgery. Few (n = 24, 19%) endorsed existent objection policies. Sixteen programs (13%) experienced objections to gender-affirming surgery by trainees (n = 15), faculty (n = 6), and staff (n = 1). Neither geographic region, exposure to gender-affirming surgery, nor presence of objection policies significantly contributed to programmatic objections. Programs with formal objection policies reported increased confidence in addressing future objection events (p = 0.017).</p></div><div><h3>CONCLUSIONS</h3><p>Objection to gender-affirming surgery is a rare, but plausible occurrence amongst plastic surgery and urology trainees. Residency programs should consider anticipatory policies to protect patients and, when feasible, provide reasonable accommodations for objecting trainees.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socratic Artificial Intelligence Learning (SAIL): The Role of a Virtual Voice Assistant in Learning Orthopedic Knowledge","authors":"","doi":"10.1016/j.jsurg.2024.08.006","DOIUrl":"10.1016/j.jsurg.2024.08.006","url":null,"abstract":"<div><h3>Objective</h3><p>We hypothesized that learning through multiple sensory modalities would improve knowledge recall and recognition in orthopedic surgery residents and medical students.</p></div><div><h3>Design</h3><p>We developed a virtual study assistant, named Socratic Artificial Intelligence Learning (SAIL), based on a custom-built natural language processing algorithm. SAIL draws from practice questions approved by the American Board of Orthopaedic Surgery and quizzes users through a conversational, voice-enabled Web interface. We performed a randomized controlled study using a within-subjects, repeated measures design.</p></div><div><h3>Setting</h3><p>Participants first took a pretest to assess their baseline knowledge. They then underwent 10 days of spaced repetition training with practice questions using 3 modalities: oral response, typed response, and multiple-choice. Recall and recognition of the practiced knowledge were assessed via a post-test administered on the first day, first week, and 2 months after the training period.</p></div><div><h3>Participants</h3><p>Twenty-four volunteers, who were medical students and orthopedic surgery residents at multiple US medical institutions.</p></div><div><h3>Results</h3><p>The oral, typed, and multiple-choice modalities produced similar recall and recognition rates. Although participants preferred using the traditional multiple-choice modality to study for standardized examinations, many were interested in supplementing their study routine with SAIL and believe that SAIL may improve their performance on written and oral examinations.</p></div><div><h3>Conclusions</h3><p>SAIL is not inferior to the multiple-choice modality for learning orthopedic core knowledge. These results indicate that SAIL can be used to supplement traditional study methods.</p></div><div><h3>Competencies</h3><p>medical knowledge; practice-based learning and improvement.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Orthopaedics: Performance of ChatGPT on Text and Image Questions on a Complete AAOS Orthopaedic In-Training Examination (OITE)","authors":"","doi":"10.1016/j.jsurg.2024.08.002","DOIUrl":"10.1016/j.jsurg.2024.08.002","url":null,"abstract":"<div><h3>OBJECTIVE</h3><p>Artificial intelligence (AI) is capable of answering complex medical examination questions, offering the potential to revolutionize medical education and healthcare delivery. In this study we aimed to assess ChatGPT, a model that has demonstrated exceptional performance on standardized exams. Specifically, our focus was on evaluating ChatGPT's performance on the complete 2019 Orthopaedic In-Training Examination (OITE), including questions with an image component. Furthermore, we explored difference in performance when questions varied by text only or text with an associated image, including whether the image was described using AI or a trained orthopaedist.</p></div><div><h3>DESIGN And SETTING</h3><p>Questions from the 2019 OITE were input into ChatGPT version 4.0 (GPT-4) using 3 response variants. As the capacity to input or interpret images is not publicly available in ChatGPT at the time of this study, questions with an image component were described and added to the OITE question using descriptions generated by Microsoft Azure AI Vision Studio or authors of the study.</p></div><div><h3>RESULTS</h3><p>ChatGPT performed equally on OITE questions with or without imaging components, with an average correct answer choice of 49% and 48% across all 3 input methods. Performance dropped by 6% when using image descriptions generated by AI. When using single answer multiple-choice input methods, ChatGPT performed nearly double the rate of random guessing, answering 49% of questions correctly. The performance of ChatGPT was worse than all resident classes on the 2019 exam, scoring 4% lower than PGY-1 residents.</p></div><div><h3>DISCUSSION</h3><p>ChatGT performed below all resident classes on the 2019 OITE. Performance on text only questions and questions with images was nearly equal if the image was described by a trained orthopaedic specialist but decreased when using an AI generated description. Recognizing the performance abilities of AI software may provide insight into the current and future applications of this technology into medical education.</p></div>","PeriodicalId":50033,"journal":{"name":"Journal of Surgical Education","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}