Finding Value in Surgical Didactics: Longitudinal Resident Feedback From Case-Based and Traditional Lectures in an Orthopaedic Residency.
OBJECTIVE
To evaluate orthopedic resident perceptions of a didactic curriculum presented in traditional and case-based formats.


METHODS
Prospective cohort study using anonymous web-based survey after each conference evaluating resident perceptions of faculty participation, didactic delivery, content, and overall conference value. Conferences were structured as primarily case-based or traditional lecture. Logistic analysis was performed to determine factors predictive of rating a conference as valuable time spent.


METHODS
Orthopedic residency training program at single institution over an academic year.


METHODS
Orthopedic residents in postgraduate training year 1 to 5 attending mandatory didactic conference.


RESULTS
Cased-based conferences received higher Likert ratings on residents' perception of faculty participation, instructor delivery, and improvement in topic understanding when compared to traditional lecture-based conferences (p < 0.0001 for each factor). Residents also were more likely to rate case-based conferences as valuable time spent (p < 0.0001). In our logistic model, factors associated with a negative likelihood of rating a conference as valuable were lecture format (odds ratio [OR] = 0.155, 95% CI: 0.115-0.208), PGY-2 level presenter (OR = 0.288, 95% CI: 0.169-0.490), and PGY-3 level presenter (OR = 0.433, 95% CI: 0.269-0.696). Timing in the year, surgical subspeciality, and conference identity were not significant predictors of conference value rating.


CONCLUSIONS
Longitudinal resident feedback demonstrates highly favorable resident perceptions toward case-based formats in didactic sessions. Junior levels residents are not perceived as effective as senior residents and faculty in presenting material in either format. These methods allow for a dynamic approach to identifying strengths and weaknesses in a resident curriculum as a well as a means for more focused and real-time improvements.
Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina. Electronic address: Jonathanbarnwell@gmail.com.
Jonathan C
JC
Barnwell
Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
Jason J
JJ
Halvorson
Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
Robert D
RD
Teasdall
Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
Eben A
EA
Carroll
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D015331:Cohort Studies; D003162:Competency-Based Education; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration; D005246:Feedback; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D009985:Orthopedics / Q000193:education*; D015397:Program Evaluation; D011446:Prospective Studies
Interpersonal and Communication Skills; Medical Knowledge; Practice-Based Learning and Improvement; case-based learning; graduate medical education; student feedback; teacher evaluation