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Late June each year, the Department’s PGY1s begin residency with a great interest in their chosen field of orthopaedics. However, they are armed with only the limited knowledge that they received in medical school. Stepping into this newfound role as physicians in training, first-year residents lack critical orthopaedic surgery skills to perform direct patient care on Day 1. UNC Orthopaedics joins specialties across UNC School of Medicine (SOM) that facilitate a specialty-intensive “boot camp” when a new class of interns arrives in late June to begin their training.

Welcoming its 2022-2023 PGY1s the last week of June, UNC Orthopaedics facilitated a two-day boot camp for the Department’s five interns. At UNC’s state-of-the-art 700-square-foot Orthopaedic Skills Lab in the UNC SOM Houpt Building. This year’s interns trained for eight hours each day in fundamental skills, techniques, and best practices. The wide range of skills interns acquire at boot camp is critical for learning and performing direct patient care in general and orthopaedic surgery. Primary skills taught at the 2022 UNC Orthopaedics boot camp included: sterile techniques, instrument identification, knot tying, suturing, traction, external fixation, compartment syndrome identification, arthroscopy, casting/splinting, ultrasound, introduction to ORIF (open reduction and internal fixation) hip fracture simulation, radiology safety, and a wellness presentation.

At boot camp, UNC Orthopaedics interns hone their skills and prepare for the OR and clinical procedures by availing themselves of all the Orthopaedic Skills Lab has to offer, including simulation training (SIM Labs). The Orthopaedic Skills Lab houses a simulator with exercises developed by the University of Iowa that score interns at boot camp following their demonstration of a range of skills, including hip pinning in adults, placement of sacroiliac screws, and using a model to perform pinning of pediatric supracondylar humerus fractures. Compartment syndrome simulation additionally shows new trainees how to correctly measure pressures in the four compartments of the lower leg. Industry support enables boot camp facilitators to additionally teach interns dry arthroscopy using simulation models.

As PGY1s progress in their training, small group interactions with clinical faculty mentors help accelerate each intern’s mastery of newly introduced orthopaedic surgery skills at two SIM Labs per month. The Orthopaedic Skills Lab hosts Sawbone (composite bone model) and cadaver labs specific to spine, hip, knee and forearm. They are also introduced to arthroscopy with SIM Lab models as they advance to wet arthroscopy with cadavers.

UNC Orthopaedics Skills Lab Director and Professor of Orthopaedic Surgery Robert Ostrum, MD, develops curriculum for and oversees the Department’s yearly new resident boot camp.

Dr. Ostrum noted: “The old paradigm of ‘see one, do one, teach one’ has been replaced by simulation prior to performing operative procedures. Studies have shown an increased proficiency in residents using simulation. In addition to the performance of exercises, considerable time at SIM Lab sessions is invested in indications, possible complications, and pearls, as well as pitfalls. Residents and interns uniformly rate their SIM Lab experiences as excellent. We continue to improve our residents over five years of training and watch them progress as they become competent and confident orthopaedic surgeons.”

Top Photo (L to R): PGY1s Abigail Smith, Jackson Perry, Anthony Paterno, “Ramses”, Daniel Whittingslow, Reyanne Strong