Does the Preferred Study Source Impact Orthopedic In-Training Examination Performance?

Jeffrey J. Theismann, Erik J Solberg, Julie Agel, George S. Dyer, Kenneth A. Egol, Craig L. Israelite, Matthew D. Karam, Hubert Kim, Sandra E. Klein, Christopher Y. Kweon, Dawn M. LaPorte, Ann Van Heest

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


OBJECTIVE: This study examines the role of electronic learning platforms for medical knowledge acquisition in orthopedic surgery residency training. This study hypothesizes that all methods of medical knowledge acquisition will achieve similar levels of improvement in medical knowledge as measured by change in orthopedic in-training examination (OITE) percentile scores. Our secondary hypothesis is that residents will equally value all study resources for usefulness in acquisition of medical knowledge, preparation for the OITE, and preparation for surgical practice.

DESIGN: 9 ACGME accredited orthopedic surgery programs participated with 95% survey completion rate. Survey ranked sources of medical knowledge acquisition and study habits for OITE preparation. Survey results were compared to OITE percentile rank scores.

PARTICIPANTS: 386 orthopedic surgery residents SETTING: 9 ACGME accredited orthopaedic surgery residency programs RESULTS: 82% of participants were utilizing online learning resources (Orthobullets, ResStudy, or JBJS Clinical Classroom) as primary sources of learning. All primary resources showed a primary positive change in OITE score from 2018 to 2019. No specific primary source improved performance more than any other sources. JBJS clinical classroom rated highest for improved medical knowledge and becoming a better surgeon while journal reading was rated highest for OITE preparation. Orthopedic surgery residents' expectation for OITE performance on the 2019 examination was a statistically significant predictor of their change (decrease, stay the same, improve) in OITE percentile scores (p<0.001).

CONCLUSIONS: Our results showed that no specific preferred study source outperformed other sources. Significantly 82% of residents listed an online learning platform as their primary source which is a significant shift over the last decade. Further investigation into effectiveness of methodologies for electronic learning platforms in medical knowledge acquisition and in improving surgical competency is warranted.

Original languageEnglish (US)
Pages (from-to)266-273
Number of pages8
JournalJournal of surgical education
Issue number1
Early online dateSep 8 2021
StatePublished - Jan 1 2022

Bibliographical note

Funding Information:
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Publisher Copyright:
© 2021 Association of Program Directors in Surgery


  • Orthopaedic in-training examination
  • medical knowledge
  • online learning
  • resident curriculum
  • study sources


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