Features
Andrew Hall is a T&O SpR (SE Scotland) and PhD Research Fellow at the Scottish Hip Fracture Audit & Golden Jubilee National Hospital. His principal interest is in Sports Orthopaedics, working in professional sports as a Team Doctor for Heart of Midlothian FC and the Scottish Rugby Union.
Advances in digital orthopaedic education: Techniques to enhance learning and avert a generational crisis in orthopaedic training Andrew J Hall, Rosemary J Hackney, Gavin SC Brown and Emily J Baird
Rosie Hackney is in her third year of run-through orthopaedic training. Her main interests include medical education and training, and global surgery.
Gavin Brown is an Honorary Consultant Orthopaedic Surgeon at Edinburgh Orthopaedics, and Senior Clinical Lecturer in Orthopaedics and Digital Education at the University of Edinburgh. His principle academic interest is the development of digital techniques in undergraduate education and surgical training.
34 | JTO | Volume 09 | Issue 04 | December 2021 | boa.ac.uk
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Opportunity in adversity rthopaedics faces a monumental challenge to overcome a doubleedged educational emergency: postgraduate trainees are receiving a lower standard of surgical training as a result of reduced clinical volume, and undergraduate trainees are being discouraged from pursuing careers in surgery1. Many of the problems facing our clinical and educational services were brought about by the COVID-19 pandemic, however this has proved to be a catalyst for innovation. Orthopaedic training in South East Scotland has experienced growth through the adoption of digital solutions in postgraduate and undergraduate settings. Protecting the education of trainees now is key to ensuring an effective surgical workforce for the future. This article considers how advances in educational techniques might solve an impending generational crisis in orthopaedic training.
Postgraduate training Bridging the training gap with simulated surgery In August 2020 a focus group of trainees identified a training gap in arthroplasty procedures resulting from a nationwide decrease in elective surgical
volume as a result of the COVID-19 pandemic2. Junior trainees felt that their position in the latent phase of the learning curve meant that they were affected disproportionately, and that the necessary prioritisation of available cases for senior trainees prevented the development of a sound foundation upon which to build their own competence. A Total Knee Arthroplasty (TKA) Bootcamp was created for junior trainees that employed a multi-modality set of activities. This included short tutorials introducing fundamental knowledge such as indications, anatomy, and basic principles of TKA, followed by an afternoon of higher order activities including interactive workshops on patient selection and clinical discussion, technical tasks using saw-bones (Figure 1) and a VR-mediated TKA simulation (ATTUNE® Knee System VR Module, DePuy Synthes) that has been shown to be effective in arthroplasty training (Figure 2)3,4. A ‘working lunch’ encouraged discussion between trainees and the experienced faculty, and the flattened hierarchy and convivial environment facilitated curiosity-based learning that was more reflective of a clinical setting, rather than a classroom. Trainees that were not accustomed to working with industry representatives found their input especially valuable, and expressed a greater appreciation for the surgeon-rep partnership.
