Video Review as a Tool to Improve Orthopedic Residents׳ Performance of Closed Manipulative Reductions.
OBJECTIVE
Orthopedic residents commonly perform closed manipulative reductions as a part of their training. Traditionally, this skill is taught early in training but difficult to simulate. Proficiency is achieved through repetition and experience; faculty observation and instruction is unfortunately often limited. Direct resident teaching has been shown to increase competency, comfort, and long-term skill retention. We hypothesize that video review of closed fracture reductions will provide an inexpensive and valuable tool for resident education and improve skill performance.


METHODS
Closed reductions performed by orthopaedic residents were recorded using a secured mobile tablet device in the emergency department (ED). Video review sessions were performed with both peer and faculty feedback/analysis of reduction technique. Anonymous resident and faculty surveys were completed following each session to evaluate the usage and perceived benefit of the program.


METHODS
University-based Level I Trauma Center.


METHODS
Orthopedic surgery residents and faculty.


RESULTS
All junior orthopedic residents (postgraduate year [PGY] 1-3) reported that direct video observation by faculty was beneficial. Furthermore, 97% of junior resident and 100% of faculty responses reported that they would use this educational technology in the future. Residents and faculty both strongly agreed that video review was more useful than other methods, improved resident preparation for ED fracture care, and felt this technique would improve patient care and outcomes. Compared with senior residents (PGY 4-5), PGY-1s believed that this technique helped them prepare for ED fracture care (p = 0.02).


CONCLUSIONS
Video review provides a useful, innovative, and inexpensive method to improve resident competency in closed fracture reduction-a critical skill in orthopedic patient care. These procedures are uncommonly available for direct faculty observation. We have demonstrated that both residents and faculty were satisfied with the ability to review procedures, identify weaknesses, and obtain or provide direct feedback on this skill. Additionally, fracture reduction video review may help residents meet and achieve clinical milestones, an area of future investigation.
Department of Orthopaedic Surgery, University of California, Irvine, Orange, California.
Nickul S
NS
Jain
Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York University Langone Medical Center, New York, New York.
Ran
R
Schwarzkopf
Department of Orthopaedic Surgery, University of California, Irvine, Orange, California. Electronic address: jscolaro@uci.edu.
John A
JA
Scolaro
D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005246:Feedback; D005592:Fracture Fixation / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D009985:Orthopedics / Q000193:education*; D014193:Trauma Centers; D014741:Video Recording
Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; feedback; fracture; orthopedics; reduction; technology; video