Did a Minimum Case Requirement Improve Resident Surgical Volume for Closed Wrist and Forearm Fracture Treatment in Orthopedic Surgery?

Mikhail A. Klimstra, Nicholas A. Beck, Mary L. Forte, Ann E. Van Heest

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

OBJECTIVE: The purpose of this study is to determine whether the 2013 implementation of ACGME minimum case requirements was associated with increased documented case volume of closed manipulation of forearm and wrist fractures (CMFWF) for graduating orthopedic surgery residents. DESIGN: We reviewed ACGME case log data for CMFWF among graduating orthopedic surgery residents from 2007 to 2016. Annual national mean, and median number of CMFWF performed by residents in the 10th, 30th, 50th, and 90th case volume percentile were evaluated. Preminimum (2007-2010) data was compared to postminimum (2013-2016) values to assess the impact of ACGME minimum requirements on resident case volume. SETTING: Review of publically available ACMGE Orthopedic Surgery Residency Program case log data. PARTICIPANTS: ACGME case log data for orthopedic surgery residents graduating between 2007 and 2016. RESULTS: National mean number of CMFWF increased significantly pre- to postminimum requirement (30.0 ± 2.84 to 45.0 ± 3.36, p < 0.001). Between 2010 and 2016 there was a 1100%, 300%, 83%, and 9% increase in the median number of CMFWF within the 10th, 30th, 50th, and 90th percentiles, respectively. CONCLUSIONS: ACGME's 2013 case minimum requirement corresponded to an increase in case counts for CMFWF; the greatest increase occurred in residents below the 50th percentile of case volume. Implementation of case minimum requirements may allow for more accurate depiction of resident experience and program strengths with regards to procedural exposure. However, the current case log system measures only case quantity, which may inaccurately depict mastery of given procedures. Future work should focus not only on improving case counts in underperforming residents and training sites, but also on refining metrics that ensure accurate assessment of resident skill for essential orthopedic procedures prior to graduation.

Original languageEnglish (US)
Pages (from-to)1153-1160
Number of pages8
JournalJournal of surgical education
Volume76
Issue number4
DOIs
StatePublished - Mar 11 2019

Bibliographical note

Publisher Copyright:
© 2019 Association of Program Directors in Surgery

Keywords

  • ACGME
  • Accreditation Council for Graduate Medical Education
  • CMFWF
  • Case minimums
  • Closed manipulation of forearm and wrist fractures
  • Patient Care
  • case volume
  • orthopedics
  • resident

PubMed: MeSH publication types

  • Journal Article

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