Skip to main content
SpringerLink
Log in

A mixed methods analysis of barriers to and facilitators of scholarly education in orthopaedic surgery residency

  • Original Article
  • Published:
Global Surgical Education - Journal of the Association for Surgical Education Aims and scope Submit manuscript

Abstract

Introduction

Scholarship is critical to healthcare advancement yet there is a declining pool of residents choosing to incorporate scholarly work into their eventual careers. Identifying deficiencies in scholarly education is necessary to ensure that residents are engaged, motivated, and adequately supported to conduct scholarly work. This study aimed to answer the following questions: (1) What is the current state of scholarly education in orthopaedic surgery residency training programs (OSRTPs)? and (2) how and why do programs adhere to, or deviate from, best practices identified in the literature?

Methods

A convergent mixed methods study design was employed using a questionnaire and interviews to nationally sample residents and educators, respectively. The quantitative and qualitative data were collected from November 2021 to February 2022 and analyzed separately before being merged to identify themes.

Results

In total, 117 out of 328 residents (36%) from 17 OSRTPS, ranging from post-graduate year one (PGY1) to five (PGY5), responded to the questionnaire. Twelve interviews were conducted with 10 Resident Research Directors and two Program Directors. Combined analysis of the questionnaire results and the interview transcripts revealed five themes: three barriers (insufficient protected time, fragmented educational resources, and unexpected restrictions) and two facilitators (an understanding of unique learner needs and a culture of scholarship) to achieving success in scholarly education.

Discussion

A lack of protected time for scholarly work and fragmented curricular elements were identified as deficiencies in the current approach to scholarly education in orthopaedic surgery residency, while individualized programming and a 'culture of scholarship' were identified as strengths. Addressing the deficiencies and promoting the existing strengths in scholarly education in orthopaedic residency is necessary to support continuous improvement of orthopaedic patient care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Macknin J, Brown A, RE M. Does research participation make a difference in residency training. Clin Orthop Relat Res. 2014;472:370–6. https://doi.org/10.1007/s11999-013-3233-y.

    Article  PubMed  Google Scholar 

  2. Atesok KI, Hurwitz SR, Egol KA, et al. Perspective: Integrating research into surgical residency education: lessons learned from orthopaedic surgery. Acad Med. 2012;87(5):592–7. https://doi.org/10.1097/ACM.0b013e31824d2b57.

    Article  PubMed  Google Scholar 

  3. Cleland JA, Jamieson S, Kusurkar RA, Ramani S, Wilkinson TJ, van Schalkwyk S. Redefining scholarship for health professions education: AMEE Guide No. 142. Med Teacher. 2021;43(7):824–38. https://doi.org/10.1080/0142159X.2021.1900555.

    Article  Google Scholar 

  4. Frank J, Snell L, Sherbino J. CanMEDS 2015. CanMEDS 2015 Physician Competency Framework. http: // www.royalcollege.ca/portal/page/portal/rc/CanMEDS/resources/publications. Published 2015. Accessed November 18, 2020.

  5. ACGME. ACGME Common Program Requirements (Residency). 2017. https: // www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRs_Section VI_with-Background-and-Intent_2017–01.pdf. Accessed September 14, 2020.

  6. The Royal College of Physicians and Surgeons of Canada. General Standards Applicable to All Residency Programs: B Standards. 2007;(January 2011):1–11. http://www.royalcollege.ca/portal/page/portal/rc/common/documents/accreditation/accreditation_blue_book_b_standards_e.pdf.

  7. Clark JM, Hanel DP. The contribution of MD-PhD training to academic orthopaedic faculties. J Orthop Res. 2001;19(4):505–10. https://doi.org/10.1016/S0736-0266(00)00051-6.

    Article  CAS  PubMed  Google Scholar 

  8. Lin JC, Lokhande A, Scott IU, Greenberg PB. Predictors of future research productivity among ophthalmology residents. Semin Ophthalmol. 2021;37:345–50. https://doi.org/10.1080/08820538.2021.1966060.

    Article  PubMed  Google Scholar 

  9. Robbins L, Bostrom M, Marx R, Roberts T, Sculco T. Restructuring the orthopedic resident research curriculum to increase scholarly activity. J Gr Med Educ. 2013;5(4):646–51. https://doi.org/10.4300/JGME-D-12-00303.1.

    Article  Google Scholar 

  10. Boucher A, Frank J, Van Melle E, Oandasan I, Touchie C. Competency Based Medical Education: A White Paper Commissioned by the AFMC Board of Directors. 2017.

  11. Royal College of Physicians and Surgeons of Canada. Entrustable Professional Activities for Orthopedic Surgery. https://www.royalcollege.ca/rcsite/cbd/implementation/cbd-milestones-epas-e. Published 2020. Accessed November 18, 2020.

  12. Stevenson MD, Smigielski EM, Naifeh MM, Abramson EL, Todd C, Li STT. Increasing scholarly activity productivity during residency: a systematic review. Acad Med. 2017;92(2):250–66. https://doi.org/10.1097/ACM.0000000000001169.

    Article  PubMed  Google Scholar 

  13. Osborn P, Ames S, Turner N, et al. An analysis of research quality and productivity at six academic orthopaedic residencies. J Surg Educ. 2018;75(6):1635–42. https://doi.org/10.1016/j.jsurg.2018.04.022.

    Article  PubMed  Google Scholar 

  14. Campbell S, Kang J, Bishop J. What makes journal club effective? A survey of orthopaedic residents and faculty. J Surg Educ. 2018;75(3):722–9. https://doi.org/10.1016/j.jsurg.2017.07.026.

    Article  PubMed  Google Scholar 

  15. Carter S, Liew S, Brown G, AK M. Barriers to completion of research projects among orthopaedic trainees. J Surg Educ. 2018;75(6):1630–4. https://doi.org/10.1016/j.jsurg.2018.04.008.

    Article  PubMed  Google Scholar 

  16. Hogan MCV, Ahn J, Egol KA, Mittwede PN. Research during orthopaedic training. J Am Acad Orthop Surg. 2022;30(4):e461–9. https://doi.org/10.5435/JAAOS-D-21-00455.

    Article  PubMed  Google Scholar 

  17. Rosier RN. Institutional barriers to the orthopaedic clinician-scientist. Clin Orthop Relat Res. 2006;449(449):159–64. https://doi.org/10.1097/01.blo.0000229286.83603.ce.

    Article  PubMed  Google Scholar 

  18. Creswell JW, Plano Clark VL. Designing and conducting mixed methods research. 3rd ed. Inc: SAGE Publications; 2017.

    Google Scholar 

  19. Dewey J. The Pattern of Inquiry. Log Theory Inq. 1938.

  20. Kaushik V, Walsh CA. Pragmatism as a research paradigm and its implications for social work research. Soc Sci. 2019;8:255. https://doi.org/10.3390/SOCSCI8090255.

    Article  Google Scholar 

  21. Clarke E, Visser J. Pragmatic research methodology in education: possibilities and pitfalls. Int J Res Method Educ. 2019;42(5):455–69. https://doi.org/10.1080/1743727X.2018.1524866/FORMAT/EPUB.

    Article  Google Scholar 

  22. Messick S. Validity of test interpretation and use. ETS Res Rep Ser. 1990;1990(1):1487–95. https://doi.org/10.1002/j.2333-8504.1990.tb01343.x.

    Article  Google Scholar 

  23. Chan RKW, Lockyer J, Hutchison C. Block to succeed: the Canadian orthopedic resident research experience. Can J Surg. 2009;52(3):187–95.

    PubMed  PubMed Central  Google Scholar 

  24. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. https://doi.org/10.1191/1478088706qp063oa.

    Article  Google Scholar 

  25. Birt L, Scott S, Cavers D, Campbell C, Walter F. Member checking: a tool to enhance trustworthiness or merely a nod to validation? Qual Health Res. 2016;26(13):1802–11. https://doi.org/10.1177/1049732316654870.

    Article  PubMed  Google Scholar 

  26. Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs - Principles and practices. Health Serv Res. 2013;48(6):2134–56. https://doi.org/10.1111/1475-6773.12117.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Namdari S, Jani S, Baldwin K, Mehta S. What is the relationship between number of publications during orthopaedic residency and selection of an academic career? J Bone Jt Surg - Ser A. 2013;95(7):1–6. https://doi.org/10.2106/JBJS.J.00516.

    Article  Google Scholar 

  28. Cabana MD, Cheng TL, Bauer AJ, et al. Promoting education, mentorship, and support for pediatric research. Pediatrics. 2014;133(5):943–9. https://doi.org/10.1542/PEDS.2014-0448.

    Article  Google Scholar 

  29. Bilal M, Hernandez-Barco YG, Parupudi S, Sonstein L, Szauter K, Powell DW. Institution of a novel curriculum increases scholarly output among internal medicine residents. Dig Dis Sci. 2020;65(4):937–41. https://doi.org/10.1007/S10620-020-06048-1/FIGURES/1.

    Article  PubMed  Google Scholar 

  30. Cook CR, Kilgus SP, Burns MK. Advancing the science and practice of precision education to enhance student outcomes. J Sch Psychol. 2018;66:4–10. https://doi.org/10.1016/j.jsp.2017.11.004.

    Article  PubMed  Google Scholar 

  31. Yang TC, Liu YL, Wang LC. Using and institutional research perspective to predict undergraduate student’ career decisions in the practice of precision education. Educ Technol Soc. 2021;24(1):280–96.

    Google Scholar 

  32. Williams B, Agel J, Van Heest A. Protected time for research during orthopaedic residency correlates with an increased number of resident publications. J Bone Jt Surg Am. 2017;99(73):1–6. https://doi.org/10.2106/JBJS.16.00983.

    Article  Google Scholar 

  33. Sambunjak D, Straus SE, Marušić A. Mentoring in academic medicine: a systematic review. JAMA. 2006;296(9):1103–15. https://doi.org/10.1001/JAMA.296.9.1103.

    Article  CAS  PubMed  Google Scholar 

  34. Franks AM, Petrany SM. Building a culture of scholarship within a family medicine department: a successful eight-year journey of incremental interventions following a historical perspective of family medicine research. Med Sci Educ. 2021;31(1):75–80. https://doi.org/10.1007/s40670-020-01107-8.

    Article  PubMed  Google Scholar 

  35. Kollias CM, Okoro T, Tufescu TV, Wadey V. Distress in orthopedic trainees and attending surgeons: a Canadian national survey. Can J Surg. 2020;6(3):E190–5. https://doi.org/10.1503/CJS.004319.

    Article  Google Scholar 

  36. Grimm P. Social desirability bias. Wiley Int Encycl Mark. https://doi.org/10.1002/9781444316568.WIEM02057 2010.

  37. Hebert RS, Levine RB, Smith CG, Wright SM. A systematic review of resident research curricula. Acad Med. 2003;78(1):61–8. https://doi.org/10.1097/00001888-200301000-00012.

    Article  PubMed  Google Scholar 

  38. Caniano DA, Hamstra SJ. Program strengths and opportunities for improvement identified by residents during ACGME site visits in 5 surgical specialties. J Grad Med Educ. 2016;8(2):208–13. https://doi.org/10.4300/JGME-D-15-00322.1.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Van Der Vleuten CPM, Schuwirth LWT, Driessen EW, Govaerts MJB, Heeneman & S. Twelve Tips for programmatic assessment. 37:641-646. https://doi.org/10.3109/0142159X.2014.973388. 2015

Download references

Funding

Supported by Calgary Orthopaedic Research Education Fund Grant ($5,000).

Author information

Authors and Affiliations

  1. Department of Surgery, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada

    Laura J. Morrison, Molly H. Joffe, Claire Temple-Oberle, Elizabeth Oddone Paolucci & Prism Schneider

  2. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Molly H. Joffe, Aliya Kassam & Elizabeth Oddone Paolucci

Authors
  1. Laura J. Morrison
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Molly H. Joffe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aliya Kassam
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claire Temple-Oberle
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elizabeth Oddone Paolucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Prism Schneider
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laura J. Morrison.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Morrison, L.J., Joffe, M.H., Kassam, A. et al. A mixed methods analysis of barriers to and facilitators of scholarly education in orthopaedic surgery residency. Global Surg Educ 3, 75 (2024). https://doi.org/10.1007/s44186-024-00274-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s44186-024-00274-1

Keywords

Search

Navigation