title: Evaluation of the Plastic Surgery In-Service Training Exam: Lower Extremity Questions.
abstract: OBJECTIVE
  To facilitate the training of plastic surgery residents, we analyzed a knowledge-based curriculum for plastic and reconstructive surgery of the lower extremity.
  
  
  METHODS
  The Plastic Surgery In-Service Training Exam (PSITE) is a commonly used tool to assess medical knowledge in plastic surgery. We reviewed the lower extremity content on 6 consecutive score keys (2008-2013). Questions were classified by taxonomy, anatomy, and subject. Answer references were quantified by source and relative year of publication.
  
  
  RESULTS
  Totally, 107 questions related to the lower extremity (9.1% of all questions) and 14 questions had an associated image (13.1%). Questions required decision making (49%) over interpretation (36%) and direct recall (15%) skills (p < 0.001). Conditions of the leg (42.1%) and thigh (24.3%) constituted most of the questions. Subject matter focused on flap reconstruction (38.3%), nerve injury (8.4%), and congenital deformity (6.5%). Analysis of 263 citations to 66 unique journals showed that Plastic and Reconstructive Surgery (54.9%) was the highest yield primary source. The median year of publication relative to PSITE administration was 6 (range: 1-58) with a mode of 2 years. Plastic Surgery by Mathes et al. was the most referenced textbook (21.9%).
  
  
  CONCLUSIONS
  These data establish a benchmark for lower extremity training during plastic surgery residency. Study efforts focused on the most common topics and references will enhance trainee preparation for lower extremity PSITE questions.
authors.affiliation: Division of Plastic Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: Jason.silvestre@uphs.upenn.edu.
authors.forename: Jason
authors.initials: J
authors.lastname: Silvestre
authors.affiliation: Division of Plastic Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Marten N
authors.initials: MN
authors.lastname: Basta
authors.affiliation: Division of Plastic Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Serletti
authors.affiliation: Division of Plastic Surgery, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Chang
mesh_terms: D003479:Curriculum; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D035002:Lower Extremity / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000193:education; D013518:Surgery, Plastic / Q000193:education*
keywords: Medical Knowledge; PSITE; Patient Care; Practice-Based Learning and Improvement; curriculum; education; examination; foot; residency