Orthopedic residency programs are currently producing a group of orthopedic surgeons unlike any other. Today’s residents rely less on the traditional textbook and more on technology, they learn more surgical skills through simulation and they work within strict work-hour restrictions — all of which have affected residency program curricula and teaching styles.
Work-hour restrictions have forced residency programs to become more efficient, and teaching styles have been adjusted to meet the learning styles of today’s residents.
“You cannot run a residency program the way you did 10 years ago, but do it in 80 hours per week,” William N. Levine, MD, Frank E. Stinchfield Professor and Chairman of Clinical Orthopedic Surgery at New York Presbyterian/Columbia University Medical Center, told Orthopedics Today. “Residency program directors, department chairs and faculty have to become much more efficient in the way they educate. Every hour should be valued as a critical hour in the resident’s week, and if it is not serving a strict educational purpose, then you need to do things differently.”
“The ‘next generation of orthopedic surgeons’ is an exceptionally talented group when you look at their academic credentials,” Thomas Kuivila, MD,vice chairman for education and residency program director in the Department of Orthopedic Surgery at the Cleveland Clinic, told Orthopedics Today. “The Part I U.S. Medical Licensing Examination scores are through the roof. A lot of these people have also participated in some fairly substantial research, so they are coming in with a good sense of what constitutes good research.”
Changes in teaching style
Current orthopedic trainees are similar to previous generations in terms of learning and retaining material, according to Kuivila. “The way we teach is not dramatically different in terms of presenting material and trying to assess how they have grasped the material,” he said. “I do not think millennials have a different attention span, but our teaching style has changed to one to which this current generation is accustomed in terms of how they are able to access reference material.”
Today’s trainees are more “tech-savvy” than those in previous years, according to Ann E. Van Heest, MD, professor and vice chair of education in the Department of Orthopaedic Surgery at University of Minnesota. “They have a low dependence on traditional textbooks and paper copies of journals and articles, and they have a significantly higher reliance on PubMed and electronic access for textbooks and articles.”
Educators have adjusted their teaching style to incorporate millennials’ different learning style, but also because of a better understanding of how adults learn, according to Levine. Rather than the typical PowerPoint lecture, Levine’s lectures involve interactive question-and-answer discussions and case examples. “Every single person in the lecture is involved because they have to be,” he said. “These types of lectures compel the residents to be as prepared as they can be for the lecture because they are going to be asked questions. There is a different level of preparation, a different level of engagement and therefore a different level of retention of knowledge.”
