April 2002 Bulletin

Education Council taking on challenges

Meeting members’ changing needs

By Carolyn Rogers

In an age when technology can be rendered ‘obsolete’ seemingly overnight, you know that information is advancing at unprecedented rates. In such a changeable environment, meeting the educational needs of orthopaedic surgeons calls for a more responsive, informed and forward-thinking group of individuals than ever before.

Fortunately, the Academy’s current Council on Education ‘fills the bill’ and is meeting the challenge head-on.

Joseph D. Zuckerman, MD, chair of the department of orthopaedic surgery at NYU-Hospital for Joint Diseases, NYU Medical Center, has served as chair of the 14- member Council on Education since 1999. Dr. Zuckerman believes the Council faces three significant "challenges" at this time. While they vary, each challenge requires the Council to react to changing circumstances in a swift but judicious manner.

Electronic Education

"Our first challenge is to respond to changing methods of education in a way that allows us to continue to be the premier provider of orthopaedic education for our members," Dr. Zuckerman says. "We have to be responsive to the members’ needs. Right now this means, in part, focusing on the use of electronic education—the Internet."

The Council has made great strides in electronic education in the last few years, a prime example being the development of Orthopaedic Knowledge Online (OKO). The ambitious new online education program reinforces the Academy’s reputation as a leader in continuing medical education.

"Significant resources have been authorized by the Board in support of OKO," Dr. Zuckerman says. "We’re confident it will rapidly become the premier site for online orthopaedic education."

OKO is an innovative, 24-hour web site that provides members and subscribers with immediate access to orthopaedic information and current surgical techniques. It features video demonstrations, images, and text-based information regarding the diagnosis, treatment, and management of musculoskeletal disorders.

More than 5,000 individual users have visited OKO since its Oct. 15, 2001 launch—many lavishing it with praise.

Dr. Zuckerman says it’s important to note that although OKO is provided as member benefit, the site also has paid subscribers. "These individuals recognize OKO’s value and are willing to pay for it," he adds.

OKO’s layered design enables users to spend just a few minutes retrieving a piece of information, or hours reviewing new information in the field, as well as classic concepts. The site is constantly evolving, with new topics added and updates provided on an ongoing basis.

The 10 topics currently posted include: meniscal tears, ACL tears, hallux valgus; rotator cuff tears; supracondylar fractures of the humerous in children; ankle sprains; femoral shaft fractures; hyaluronic therapy for osteoarthritis; anterior glenohumeral instability; and scaphoid fractures.

OKO co-editors-in-chief William Fitzgerald, MD, and Robert H. Fitzgerald, Jr., MD, hope to have more than 20 topics online by the end of 2002.

"So our first challenge is to respond changing methods of education effectively and in a way that benefits our members," Dr. Zuckerman summarized. "We think we have a mechanism for doing that with OKO."

Changing views on physician education

The second challenge facing the Council, according to Dr. Zuckerman, is recognizing that within medical education—including orthopaedics—there is a changing view of the qualities that are valued in a physician.

"The American Board of Medical Specialties (ABMS) has come up with general competencies for physicians. They’ve brought forth a number of issues that address the maintenance of competency and the concept of life-long learning. We have to evaluate these issues and determine how to respond."

ABMS—of which the American Board of Orthopaedic Surgery is a member—along with the Accreditation Council for Graduate Medical Education (ACGME), which oversees residency education, are advocating that residents and physicians be specifically educated in a number of "general competency" areas.

The ACGME is incorporating six general competencies into their requirements for residents.

"The first competency area is ‘medical knowledge’—which, it is clear to us, we do quite well," Dr. Zuckerman says. "The second area is ‘patient care,’ which is also important for us, and is something we do well."

Additional competency areas include ‘practice-based learning and improvement,’ and ‘interpersonal and communication skills.’

"Two years ago, the Academy identified patient-physician communication as a high priority for the orthopaedic practice," Dr. Zuckerman says. "We’ve developed a number programs to enhance patient-physician interactions, so it’s gratifying to see that certifying organizations now recognize it as a priority as well."

The fifth area of competency relates to the physician’s ability to work in a ‘systems-based practice.’ This competency calls for the doctor to demonstrate an awareness of, and responsiveness to, the larger context and system of health care. It requires the physician to call on system resources effectively in order to provide optimal care.

"‘Professionalism’ is the last competency area," Dr. Zuckerman says. "This topic has become a focus of the Academy as well, in terms of how we demonstrate our commitment to ethical principles, to diversity, relationships with industry, etc."

Dr. Zuckerman says the Council needs to explore the issues of ‘maintenance of competence,’ and ‘life-long learning’ in order to develop an appropriate response.

Maintaining core programs

While the Council is directing much of its effort and focus toward moving ahead with electronic education, its commitment to the Academy’s core programs remains essential. Striking the right balance between the two is the Council’s third "challenge."

"It’s imperative that we continue to provide the quality education programs we’ve been offering all along," Dr. Zuckerman says. "And we have to continue to reshape those programs to meet the needs of our members."

"Orthopaedic Knowledge Update (OKU), for instance, recently came out with its 7th edition," Dr. Zuckerman says.

"OKU continues to be the Academy’s most popular text," he adds. "It’s used by all orthopaedic residents and by many of our members. While the print edition continues to be the core product, OKU is also now available in CD-ROM and in excerpt form online."

Keeping up with other aspects of technology as it relates to the practice of orthopaedics is also part of the Council’s commitment to the members, Dr. Zuckerman says.

"That’s why we sponsored a new ‘technology pavilion’ at this year’s Annual Meeting," he says. "We brought together all the latest technologies and products that orthopaedic surgeons can use to enhance their practices, and presented numerous demonstration sessions on the use of personal digital assistants, the Internet, Power Point and digital imaging."

"So, we’re responding to challenges in many areas," he concludes.

Fortunately, Dr. Zuckerman says, the Board of Directors continues to affirm that education is of the highest priority to the Academy.

The value the Academy places on education is evidenced by the Board’s actions, Dr. Zuckerman says. "This includes their unwavering commitment to OKO, their decision to offer the Journal of Bone and Joint Surgery as a member benefit, and their willingness to allow the Council on Education to be as innovative as we need to be in order to maintain our commitment to the members.

"Clearly, education remains the Academy’s highest priority."

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