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A Basic S urgical S kills C urriculum for PGY1 Training

A Basic S urgical S kills C urriculum for PGY1 Training. Our 2012 experience. M. Daniel Wongworawat , MD Professor and Program Director Loma Linda University. Disclosures. Committee/Board Appointments AAOS Chair, Central Evaluations Committee (OITE/OSAE/OSIE) ASSH

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A Basic S urgical S kills C urriculum for PGY1 Training

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  1. A Basic Surgical Skills Curriculum for PGY1 Training Our 2012 experience M. Daniel Wongworawat, MD Professorand Program Director Loma Linda University

  2. Disclosures • Committee/Board Appointments • AAOS • Chair, Central Evaluations Committee (OITE/OSAE/OSIE) • ASSH • Self-Assessment Examination Committee • San Bernardino County Medical Society • Vice President • ABOS/AAOS/AOA/CORD • PGY-1 Surgical Skills Taskforce • Editorial Board • Senior Editor, Clinical Orthopaedics and Related Research • Stock ownership • Stryker, Medtronic, Amgen

  3. Overview • Needs assessment based on semi-annual program evaluation meeting in 2011/2012 • Focus on low-tech options • Course objectives • Perform sharp and dull dissection • Place deep, dermal, subcuticular sutures and secure knots • Operate power drill, saw, wire driver • Place K-wires, lag screws, compression plates, locking plates, tension bands • Operate basic arthroscopy equipment

  4. Methods • Content divided into four modules • Supervised by faculty members • Tasks deconstructed into components • One day per week, over four weeks • Modules Soft tissue handling Power tool operation Bone handling Arthroscopy

  5. Soft tissue handling • Fresh pork belly

  6. Soft tissue handling • Fresh pork belly • Muscle fascial planes • Dermal layer • Incision • Scissor dissection along planes • Suture placements • Simple • Mattresses • Inverted dermals • Subcuticular • Knot tying

  7. Power tool operation • Introduction to: • Stryker cordless • K-wire driver/collets • Drill chuck • Quick release chuck • Oscillating saw

  8. Basic bone handling • K-wire and oscillating saw skills • 10-cc syringe Numbers as targets Transverse wire placement Oblique wire placement Sawbones humerus Saw cuts Neck fractures Supracondylar fractures Wire fixation Visualized Under towel-wrapped envelope

  9. Basic bone handling • Concepts discussion • Screw placement • Lag technique • Plate fixation • Neutralization • Compression • Locked • Tension band placement

  10. Basic arthroscopy • Scope operation • 30° angle • Triangulation • Instrument handling • Knot tying board • Visualized knot tying • Visualized through clear cannula • Visualized on monitor

  11. Post course evaluations, 2012 • Good feedback from learners • Goals met • Suggestions for improvement • Include closed reduction techniques • Include splinting and casting • Expand modules • Increase time dedication

  12. Future direction • Expansion of modules • Dedicated month • Improvement of assessments checklist • Checklist validation • … introduction to PGY-1 Surgical Skills Taskforce • Joint project of AAOS/ABOS/AOA/CORD • Led by J. Lawrence Marsh

  13. Thank You

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