Finding Value in Surgical Didactics: Longitudinal Resident Feedback From Case-Based and Traditional Lectures in an Orthopaedic Residency

OBJECTIVE: To evaluate orthopedic resident perceptions of a didactic curriculum presented in traditional and case based formats. DESIGN: Prospective cohort study using anonymous web based survey after each conference evaluating resident perceptions of faculty participation, didactic delivery, content, and overall conference value. Conferences were structured as primarily case-based or traditional lecture. Logistic analysis was performed to determine factors predictive of rating a conference as valuable time spent. SETTING: Orthopedic residency training program at single institution over an academic year. PARTICIPANTS: Orthopedic residents in postgraduate training year 1 to 5 attending mandatory didactic conference. RESULTS: Cased-based conferences received higher Likert ratings on residents' perception of faculty participation, instructor delivery, and improvement in topic understanding when compared to traditional lecture-based conferences (p < 0.0001 for each factor). Residents also were more likely to rate case-based conferences as valuable time spent (p < 0.0001). In our logistic model, factors associated with a negative likelihood of rating a conference as valuable were lecture format (odds ratio [OR] = 0.155, 95% CI: 0.115-0.208), PGY-2 level presenter (OR = 0.288, 95% CI: 0.169-0.490), and PGY-3 level presenter (OR = 0.433, 95% CI: 0.269-0.696). Timing in the year, surgical subspeciality, and conference identity were not significant predictors of conference value rating. CONCLUSIONS: Longitudinal resident feedback demonstrates highly favorable resident perceptions toward case based formats in didactic sessions. Junior levels residents are not perceived as effective as senior residents and faculty in presenting material in either format. These methods allow for a dynamic approach to identifying strengths and weaknesses in a resident curriculum as a well as a means for more focused and real-time improvements. ((C) 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)