Curriculum standardization—
the new framework for Basic and
Advanced Principles courses

In September 2013 a new course framework for AOTrauma Basic and Advanced Principles courses was introduced on a global scale. With the aim of providing the necessary freedom to adapt courses for regional needs, both courses are now grounded in a standardized curriculum for residents.

 

The Residents Education Taskforce was formed with the intention of building a standardized curriculum for the Basic and Advanced Principles courses that could be delivered globally. Until this reworking, courses were offered all over the world with varying content, and it was not always certain which learning objectives would be covered in a given course and which would be left out.

 

Covering the competencies of residents

The taskforce started the redesign process by acknowledging that the Basic and Advanced Principles courses were complementary in nature, with each addressing residents of different experience levels. Twelve competencies form the basis of the course framework (a competency expresses the ability to perform a task such as performing a surgical procedure or assessing a patient). The twelve competencies of the residents' education curriculum were defined based on the specific learning needs of all residents managing trauma patients. Competencies range from explaining the concepts of stability and their influence on bone healing to the assessment and treatment of specific patient problems that residents must deal with. For every competency, measurable learning objectives have been defined.

 

The new framework—consisting of core (mandatory) and optional content—recognizes the need for flexibility on a regional level, yet still satisfies AOTrauma’s goal of high-quality, globally consistent courses.

 

Conscious of the needs of faculty and chairpersons when planning and delivering a course, the implementation of the new curriculum has been facilitated with a range of tools and support services.

 

Comprehensive planning resources

A list of course activities has been compiled for each course, indicating core or optional for each item. This planning resource is very straightforward and provides a quick and easy overview of the many options available for chairpersons to meet the needs of their participants.

 

Other essential resources are the course templates that take the guesswork out of planning, especially for first-time chairpersons and/or those with limited time for planning. Several templates have been prepared to address specific logistical scenarios such as limited practical room resources or working in parallel with the Operating Room Personnel (ORP) course.

 

A large portion of time in both courses is dedicated to interactive activities such as case discussions in small groups, simulations, and workshops—the ready-to-use course templates reflect this with a mix of core and highly recommended optional content in a meaningful sequence, complete with timing for each activity.

 

These course templates as well as all of the other documents and resources mentioned above can be found in the Faculty Support Packages for the Basic and Advanced Principles courses under the AOTrauma Faculty Center (access restricted to registered faculty members only). In addition these support packages also feature:

 

  • cases for small group discussions,
  • PowerPoint templates for practical exercise directors with tailored video clips,
  • prepared PowerPoint lectures,

 

…all contributed by international faculty members.

 

Addition of AO Skills Lab

One of the new interactive core elements of Basic and Advanced Principles courses is the AO Skills Lab (formerly the Playground), a workshop that promotes reflection while offering hands-on experience with the key principles of bone fracture treatment. The integration of the AO Skills Lab as mandatory content speaks of AOTrauma's responsiveness to match appropriate teaching methods to a target audience.

 

In order to find out how the integration of this highly rated activity is progressing, AO Skills Lab Directors were surveyed. One respondent commented: “it was an incredible experience for the participants. Finally they can understand basic skills about their specialty.” And another stated that, “the checklist [for Skills Lab Directors], especially the videos and all the material available [were] very helpful for preparing all faculty.” These checklists and videos can be found in another separate Faculty Support Package that was designed especially for the AO Skills Lab (to be found also under the AOTrauma Faculty Center).

 

Planning course for chairpersons

In order to manage the large amount of support material and correctly apply them to the planning of Basic and Advanced Principles courses, the Chairperson Training Program (CTP) was developed for faculty members assigned to chair a Basic and Advanced Principles courses. Over 5 weeks of online activities and a 1.5-day live event, the chairpersons are encouraged to plan their courses according to the new framework. Experienced faculty members are present to answer their questions and provide detailed information on the usage of the templates.

 

When chairperson George Thomas from India and participant of the recent CTP in Hong Kong (August 16–17) was asked about his comments on the program, he said that he very much enjoyed sharing his experience with the new framework with fellow chairpersons from his region. The program itself was “informative, interactive, friendly and comprehensive."

 

Ensuring educational quality standards

Rooted in evidence-based adult learning theory

Throughout the entire redesign of the Basic and Advanced Principles courses, the Residents Education Taskforce placed strong emphasis on integrating the latest adult educational theory. A backward planning approach was used to steer the redesign process. In medical education, this is considered a best-practice principle. The taskforce started by identifying the desired outcomes and learning objectives before selecting instructional methods and forms of assessment.

 

These courses are part of the AOTrauma Residents Education Program, which among others includes face-to-face events, webinars, eLearning modules and the newly developed interactive learning hub "AOSTaRT". The overall standardization of the Basic and Advanced Principles courses reflects the quality management and the adherence to AO's principles of education that AOTrauma aims for in all its educational activities.

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What is a
competency-based
approach?

 

A competency can be defined as the ability to perform a task such as a surgical procedure or patient assessment.

 

Competencies are sets of observable and measurable knowledge, skills, and/or attitudes that enable a surgeon to perform effectively in their practice and meet the standards of the profession. The Residents Education Taskforce has identified twelve competencies for resident education. These competencies were used to build the curriculum for the Basic and Advanced Principles courses, the corresponding assessment, relevant resources, and supporting faculty development activities.

 

To inform participants which courses follow a curriculum that was developed using this competency-based approach, AOTrauma has created a visual mark. In the future this so-called "competency-based curriculum stamp" will be put on all course programs that are in line with a competency-based curriculum to indicate the careful planning process that was applied in the design of the respective course.

 

All course programs featuring this stamp are in line with a competency-based curriculum.

 

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Interview with Thomas S. Müller MD, Chairperson of the 2014 AOTrauma Course—Basic Principles of Fracture Management for Swiss Surgeons in Davos:

 

"As a chairperson I find the flexibility within this framework absolutely perfect."

 

 

Thomas Müller MD, Chairperson of the 2014 AOTrauma Course—Basic Principles of Fracture Management for Swiss Surgeons in Davos, talks about the challenging process of modifying the Swiss Residents Course to meet AOTrauma’s new framework. Taking place in December 2014, this will be the first offering of the adapted course.

 

Can you give us some background about the Swiss Residents Course?

The Swiss Residents Course in Davos has been offered and developed since the 1960s and is well established now. Of course it has changed over the years to address the needs of today's residents.

 

How was planning this year’s course¬, considering that you had to integrate the new framework?

It has been a challenge to combine the new internationally standardized framework with the long-established course and create something new. Some of our previous course material was no longer core content; it became optional or got abandoned altogether. On the other hand, there is now some new core content which has not been dealt with so far. That is why the planning committee felt a certain emotional obligation to the Swiss faculty, who expected that everything would continue as before. It was necessary to have phone calls and meetings with individual faculty to prepare them. But finally, our program for this year's course has now been set.

 

Who was involved in the Swiss Residents course adaptation?

Michele Arigoni and myself as Chairmen of the Basic Principles Course of Fracture Management for Swiss Surgeons have made the adaptations, aiming to integrate various aspects of this new framework, which was presented to us for the first time during the Davos courses 2013. Getting together with Kodi Kojima and the entire medical education staff in Davos was quite taxing for everyone involved because we had to voice some individual needs with staying within the framework.

 

For example?

One example is the emergency treatment of pelvic fractures. We know that the Swiss Residents Course participants are undergoing their first year of training. No resident during his or her first year of training would ever treat a pelvic fracture alone in a Swiss hospital. This might be different in other countries, where this is more likely to happen. Consequently, we also asserted that it makes no sense to spend 15 minutes on this or any additional, optional content if it is never being applied in our country. I believe we should confront the young residents with content that they will use during the next one to two years of their education.

 

What did the new framework achieve?

We have seen the addition of new aspects such as the MIPO and MIO techniques. The former course could be seen as a patchwork that evolved over time. The new framework is standardized with clearly structured content, which is very advantageous from a teaching point of view. Participants have to complete modules about defined topics. I believe that this will make it easier for them to learn about different treatment options, for example, joint fracture versus shaft fracture. These two topics are taught separately now, even on different days, and consequently it is a lot easier for participants to consider them.

 

What are your thoughts on "core" and "optional" content?

In principle, I welcome this elective system. Besides exceptions such as radiation hazard or pelvic fractures, I approve of the core content and find the selection good. The range and possibility of optional content has certainly been ideally chosen. We have added one or two more, but there is nothing that I would consider to be missing. As a chairperson I find the flexibility within this framework absolutely perfect.

 

Do you anticipate any cultural issues that could impact the success of the standardized courses around the world?

The concept is very adaptive to individual local needs. At the same time I consider it important to convey AO knowledge in the same form and format globally. From my experience at international courses, I see that the need for such a framework is substantial. But cultural differences and different levels of expertise have to be considered when communicating the changes the framework demands.

 

Where do you see potential for further development?

I think it is important that the framework be responsive to developments in trauma surgery. This might involve turning certain optional content into core content. I am thinking about MIPO/MIO and the fact that at least in Central Europe more and more osteosyntheses are performed using these minimally invasive techniques.

 

Do you see benefits resulting from the integration of the AO Skills Lab?

I have had a lot of experience with the AO Skills Lab, working intensively with it over the past years, including collaboration on its further development and international promotion. I consider this one of the milestones in the development of AO education. I think it very important that the AO Skills Lab has now become core content in every Basic Principles course. I am extremely pleased about this.

 

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About Thomas S. Müller MD

Deputy Chief of Trauma Surgery at the Graubünden Kanton Hospital in Chur, Switzerland. Thomas S. Müller is the chairperson of the upcoming Davos AOTrauma Course—Basic Principles of Fracture Management for Swiss Surgeons offered in December 2014.

 

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Read an interview with 
Thomas S. Müller, MD.

 

“This standardized framework gives us assurance that we are providing content that is relevant to the majority of our course participants regardless of geography. Plus it still allows the regions to be responsive to their unique needs.”

 

   —Kodi Kojima,

AOTrauma Education Commission Chairperson

AOTrauma

www.aotrauma.com | education@aotrauma.org

 

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