Orthopedic Resident Intern Foundations: A Cross-Institutional, Month-Long Skills Training Boot Camp for PGY-1 Residents

Objective

Orthopedic residents are tasked with rapidly acquiring clinical and surgical skills, especially during their PGY-1 year. However, resource constraints and other factors frequently cause skills training to fall short of established guidelines. We aimed to design and evaluate a cross-institutional, month-long curriculum aimed at pooling resources to optimize training.

Design

The O.R.I.F. (Orthopaedic Resident Intern Foundations) Boot Camp was created to teach foundational residency skills and knowledge through daily didactic and simulation-based training covering 6 domains: orthopedic knowledge, orthopedic skills, nonorthopedic clinical knowledge (e.g. radiology), day-to-day hospital tasks, academic research, and social aspects of medicine. Content was based on ACGME milestones and core competencies. The program ran 8 hours each weekday throughout November 2022 and 2023. Before and after the curriculum, participants were administered a 65-question orthopedic knowledge assessment and self-reported competency surveys. Additionally, graduates from the O.R.I.F. 2022 class and a cohort of peer residents from nonparticipating institutions were administered a follow-up survey 1 year after Boot Camp. Comparative testing was performed using Wilcoxon signed-rank analysis (α = 0.05).

Setting

The curriculum was hosted at a Level 1 urban trauma center.

Participants

Over the study period 40 residents from the Chicagoland institutions participated in Bootcamp: 25 PGY-1 residents from 5 programs in 2022 and15 residents from 3 programs in 2023.

Results

Orthopedic assessment scores increased from 45.7 (SD = 8.3) precurriculum to 60.1 (SD = 7.6) postcurriculum (p < 0.001). Additionally, self-rated competence increased in 5/6 domains—all except the social aspects of medicine. One year after O.R.I.F. 2022, a higher proportion of graduates reporting that skills training provided good or very good preparation for intern year and allowed them to network with peers at other institutions compared to non-Boot Camp residents.

Conclusions

The O.R.I.F. Boot Camp improves PGY-1 clinical knowledge and skills in a resource-efficient model while also providing an environment that cultivates cross-institutional camaraderie.