title: Essential hand surgery procedures for mastery by graduating orthopedic surgery residents: a survey of program directors.
abstract: OBJECTIVE
  To establish the essential hand surgery procedures that should be mastered by graduating orthopedic surgery residents. This framework can then be used as a guideline for developing an Objective Structured Assessment of Technical Skill to teach and document technical skill in hand surgery.
  
  
  METHODS
  A select group of 10 expert hand surgeons was surveyed regarding the essential hand surgery procedures that should be mastered by graduating orthopedic surgery residents. The top 10 procedures from this survey were then used to survey all 155 American Council of Graduate Medical Education-approved orthopedic surgery program directors regarding the essential procedures that should be mastered by graduating orthopedic surgery residents.
  
  
  RESULTS
  We had a 39% response rate to the program director survey. The top 8 hand surgery procedures as determined by the orthopedic surgery program directors included open carpal tunnel release, open A1 pulley release, open reduction internal fixation of distal radius fracture, flexor tendon sheath steroid injection, excision of dorsal or volar ganglion, closed reduction and percutaneous pinning of metacarpal fracture, open cubital tunnel release, and incision and drainage of flexor tendon sheath for flexor tenosynovitis.
  
  
  CONCLUSIONS
  Surgical educators need to develop objective methods to teach and document technical skill. The Objective Structured Assessment of Technical Skill is a valid method to accomplish this task. However, there has been no consensus regarding which hand surgery procedures should be mastered by graduating orthopedic surgery residents. We have identified 8 procedures that were overwhelmingly supported by orthopedic surgery program directors. These 8 procedures can be used as a guideline for developing an Objective Structured Assessment of Technical Skill to teach and document technical skill in hand surgery.
  
  
  CONCLUSIONS
  This study addresses the future of orthopedic surgery education as it pertains to hand surgery.
authors: Robert A Chase Hand and Upper Limb Center, Stanford University Hospital, Stanford, CA, USA. tristanhartzell@gmail.com
authors: Shelley S
authors: SS
authors: Noland
authors: Lauren H
authors: LH
authors: Fischer
authors: Gordon K
authors: GK
authors: Lee
authors: Vincent R
authors: VR
authors: Hentz
mesh_terms: D000068:Accreditation; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000592:standards*; D005260:Female; D006225:Hand / Q000601:surgery; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D008297:Male; D009985:Orthopedics / Q000193:education*; D008486:Physician Executives / Q000458:organization & administration*; D015397:Program Evaluation; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States