Effect of a surgical skills month on intern performance in the orthopaedic in-training examination

Background: The orthopaedic in-training examination (OITE) is an annual national assessment of knowledge in orthopaedic surgery residents. Our primary aim was to determine if intern performance in the OITE (measured by correct answers) differed before and after the adoption of a formal surgical skills month (SSM) in the residency curriculum. A secondary aim was to evaluate the relationship between intern OITE and post-graduate year two (PGY-2) scores. Methods: A single institution retrospective cohort study was performed, comparing orthopaedic surgery interns who took the OITE before (15 residents) and after (16 residents) the year 2013 (when an SSM was introduced). De-identified OITE raw and percentage correct scores were obtained from all resident records. Statistical testing included independent sample t test and linear regression, with a significance level of 0.05. Results: Comparison of OITE percentage of correct answers overall, between interns before and after 2013, showed a significant increase after initiating the SSM (44.8%±4.13% vs. 49.9%±8.44%, P=0.0414). In addition, regression analysis demonstrated a positive linear relationship between intern and PGY-2 OITE scores after the SSM was implemented (R 2=0.380, P=0.011, β=0.424, CI: 0.1135341 –1.190913). Conclusion: Implementation of an SSM led to increased intern OITE scores. Moreover, intern OITE scores were more predictive of PGY-2 scores after SSM implementation. Earlier education (such as a surgical skills month) for orthopaedic surgery interns can aid knowledge acquisition and career development at the beginning of their training. Level of Evidence: Level III.