Final installment of a "behind the scenes" look at the creation of a surgical skills program
By Carolyn Rogers
The Orthopaedic Learning Center (OLC) was abuzz with activity on Friday, Oct. 25, 2002the first day of the two-and-a half-day surgical skills course, "Current Techniques in Knee Arthroplasty: Unicondylar, Primary and Revision." The course had reached full capacity nearly two months earlier and as the program got underway, every one of the 96 registrants was present and accounted for.
Although the scene was bustling, the day was unfolding precisely as plannedthanks to two-plus years of preparation by the course co-chairmen, course operations department staff and OLC staff.
This article is the last in a three-part series that looks "behind the scenes" at the "Making of an OLC course." This final installment reviews the course experience, listens in on the post-course "debriefing" and provides a sneak peek at plans for the 2003 course.
Morning of the course
By 6 a.m. Friday morning, most of the "key players"course chairmen, coordinators and facultyhad already gathered at the OLC for last-minute preparations. Within an hour, a majority of the course participants had arrived as well.
The immediate challenge the group faced that morning was how best to make use of the available space and equipment.
"When a course is full like this, the OLC resources are stretched to the limit," explains course co-chair Daniel J. Berry, MD. "We have to optimize the amount of equipment available and make the best use of the space, which can be a challenge."
Maximizing available space and equipment was made even more difficult this year due to the introduction of a new course format. In previous years, participants were divided into two groups for the hands-on skills labs, but the new format called for all registrants to participate in these labs simultaneouslytwo stations to a lab table, two participants to a station.
Although a shortage of equipment was somewhat of a concern, most participants and faculty seemed to appreciate the new format.
Long days, high energy
To the casual observer, the two-and-a half-day course flies by in a whirl of activity. Anyone envisioning long days in a lecture room is in for a surprisethis course provides a truly "hands-on" learning experience.
The programs first two 10-hour days are broken up into brief lectures, live and videotaped surgical demonstrations as well as substantial time devoted to hands-on skills labs. Sundays sessionjust three hours longis dedicated to discussion of complications and special problems.
Although the long days can be grueling for everyone involved, surprisingly, the high level of energy generated by both faculty and participants never wavers. Questions volley back and forth; labs are punctuated by loud bursts of laughter, and animated side conversations repeatedly break out. Its a lively sceneone faculty member leans over a lab station, interacting with a rapt group of participants while another group intently practices a newly demonstrated technique. Still others pepper their instructor with questions.
Throughout the course, participants exhibit a strong sense of camaraderie and the overall impression is that of a dynamic, fruitful educational experience.
The impression that truly matters, of course, is that of the participants and course organizers. Thats whythroughout the hectic daysthe course coordinator is quietly taking notes and making observations that will assist in the overall evaluation of the course.
"The evaluation of a course really begins on-site," explains Ann ONeill, CME course manager. "The course coordinator will start hearing comments from participants, shell notice how well a lab is running, how it might be improved, or a chairman may remark on how something should be done differently," she says. "The evaluation process continues afterward at the post-course wrap-up and later at the CME Committee meetings. The goal is to use this information to make improvements to future programs."
Immediately following the course, the course chairmen and course coordinators sit down to share their initial reactions"the good, the bad and the ugly"at a post-course "debriefing."
The Sunday, Oct. 27, 2002 session included Dr. Berry; course chairman Thomas S. Thornhill, MD; surgical skills coordinator Ro Simon; and course coordinator Jeri Busch.
"Dr. Thornhill and Dr. Berry felt the course was well received and that the new format worked well," Busch reports. "And now that the companies who provide the equipment know what to expect in the lab, we believe the 2003 course will be an even bigger success."
Clearly, most of the participants enjoyed the course and were very pleased with the educational quality, Dr. Berry says. Of course, every program has some minor hitches. "Like any other course, you always see things you can improve."
One of those "hitches" involved the equipment provided by industry.
"The companies were asked to provide equipment manuals for participants to review priorto arriving at the course," Busch explains. "However, only a couple of the companies sent the manuals, so many participants arrived on-site with no information on the Total Knee system to which they were assigned. Because of this they werent comfortable or familiar with the equipment, which can lead to a disorganized lab."
Being sensitive to participants instrumentation preferences is always a challenge, Dr. Berry says.
"The participants want to use the specific instrumentation theyre most familiar with, and we try to accommodate thembut its not always easy," he says. "It continues to be difficult to strike a balance between the number of people who want certain instruments, the companies that are willing to provide that equipment, and the faculty members who are most familiar with it."
Participant feedback: "Excellent"
Feedback provided by participants course evaluation forms always plays a vital role in the post-course analysis.
According to the statistical results as well as the participants written comments, the "Current Techniques in Arthroplasty" course continues to rank highly with participants, with the majority of respondents rating all lectures, labs and panels as "excellent."
"The participants really value having access to faculty with such vast experience," Busch reports. "Some wrote that this alone is worth the cost of the course."
Labs and case presentations also scored high, and participants clearly value the "pearls" of wisdom shared by the faculty.
The final step in the evaluation process is the development of an executive summarya "critique" produced for the benefit of future chairmen. The report is a compilation of comments, thoughts and course experiences from all of the "key players." This summary is nearing completion.
In the meantime, Dr. Berrywho will take the reins as chairman of the 2003 "Current Techniques in Arthroplasty" programis looking ahead to the Oct. 10-12, 2003 course.
In fact, as early as January 2003 Dr. Berry was already brainstorming with his new co-chair Kelly G. Vince, MD, about ways to improve the program based on the 2002 experience. They met with surgical skills coordinator Ro Simon during the Annual Meeting in New Orleans to review plans for the 2003 course and made preliminary arrangements for equipment and other materials.
So how might the 2003 "Current Techniques in Arthroplasty: Unicondylar, Primary and Revision" course be different?
In addition to a potential increase in faculty numbers, Dr. Berry offers a few other possibilities.
"Theres a lot of interest in unicompartmental arthroplasty of the knee, so well probably expand the labs in that area a little, " he says. "Also, participants really enjoy the live surgical demonstrations, so Id like to increase the number of those."
Further "tweaking" and fine-tuning of the course will no doubt take place between now and the October 2003 course, Dr. Berry adds.
"We always try to respond to the changing scene," he says. "Were continuously making adjustments to the course based on physician interests and input."
Academy thanks volunteers
The "Current Techniques in Arthroplasty" course highlighted in this series is just one of 13 surgical skills courses the Academy presents in a given year. As this series of articles has demonstrated, presenting just one course is no small undertaking. Without the 500 Academy members who volunteer as chairman, co-chairman and faculty for Academy CME courses every year, the programs would not be possible at all.
The Academy gratefully acknowledges those individuals who generously volunteer considerable time and effort to plan, organize and present Academy courses. The course chair, co-chair and faculty (AAOS members) do not receive financial remuneration or honoraria for their participation. The AAOS appreciates their dedication to teaching, their support of the Academys mission and their significant contribution to the educational success of these courses.