Development of a Spine Surgical Skills and Written Assessment for Orthopaedic Surgery Residents.

OBJECTIVE: The objective of this study was to develop an assessment module for orthopaedic spine surgery residents which is cost-effective and can reliably test knowledge and surgical skills. DESIGN: A ten-question multiple choice question and hands-on spine sawbones combination assessment was prospectively administered to consenting PGY-3 and PGY-4 residents before and after their 8-week spine rotation. Pre- and postrotation scores were compared using the paired t-test. SETTING: The Department of Orthopaedics, The Ohio State University Wexner Medical Center, a large academic medical centre providing primary and tertiary care. PARTICIPANTS: Orthopaedic resident physicians. RESULTS: A total of 21 residents (15 PGY-3, 6 PGY-4) participated in the study. The mean pre- and postrotation written test score was 7.38 ± 1.53 and 9.24 ± 0.83, respectively (p < 0.001). Corresponding surgical skills assessment scores were 95.4% ± 4.7 and 97.1% ± 2.6, respectively (p = 0.10). Overall, the postrotation written and surgical scores improved and showed less variation about the mean. CONCLUSIONS: This combination assessment measured improvement in below-average scoring residents and maintenance or improvement in residents with average and above average prerotation scores.

Comparative study of perioperative complication rates of cervical laminoplasty performed by residents and teaching neurosurgeons.

Early surgical education is required for neurosurgical residents to learn many surgical procedures. However, the participation of less experienced residents may increase perioperative complication rates. Perioperative complication studies in the field of neurosurgery are being increasingly published; however, studies have not yet focused on cervical laminoplasty. The study population included 193 consecutive patients who underwent cervical laminoplasty in Tokyo Metropolitan Neurological Hospital between 2008 and 2014. Patient and surgeon background factors, as well as perioperative complication rates were retrospectively compared between resident and board-certified spine neurosurgeon groups. Deteriorated or newly developed neurological deficits and surgical site complications within 30days of cervical laminoplasty were defined as perioperative complications. Out of 193 patients, 123 (64%) were operated on by residents as the first operator and 70 (36%) by board-certified spine neurosurgeons. No significant differences were observed in patient and surgeon factors between the two groups, except for hyperlipidemia (13 vs 17, p=0.02). Furthermore, no significant differences were noted in perioperative complication rates between the two groups (7 [5.7%] vs 4 [5.7%], p=1). Cervical laminoplasty performed in a standardized manner by residents who received their surgical training in our hospital did not increase perioperative complication rates, and ensured the safety of patients.