Analysis of the Pediatric Orthopedic Surgery Questions on the Orthopaedic In-Training Examination, 2002 through 2006

BACKGROUNDPediatric orthopedics has been a frequently tested topic on the Orthopaedic In-Training Examination (OITE). Our goal was to provide direction for resident education efforts by(1) analyzing the examʼs number, topics, and types of pediatric orthopedic surgery questions; (2) examining references cited in the postexam answer packet supplied by the American Academy of Orthopaedic Surgeons; and (3) examining the efficacy of the Orthopaedic Knowledge Update (OKU)Pediatrics 3 book as a source for answers to the pediatric orthopedic questions. METHODSWe reviewed 5 years (2002 through 2006) of OITEs and the associated American Academy of Orthopaedic Surgeonsʼ answer packets and assessed the OKUPediatrics 3 book for topic relativity. Each question was classified into 1 of 6 categories and labeled with a cognitive taxonomy level1 (simple recall), 2 (interpretation of data), or 3 (advanced problem-solving). The 6 categories included(1) pediatric orthopedic knowledge; (2) knowledge of treatment modalities; (3) diagnosis; (4) diagnosis with recognition of associated conditions; (5) diagnosis with further studies; and (6) diagnosis with treatment. RESULTSThe overall percentage of pediatric questions was 14.1%. The most commonly addressed were pediatric elbow fractures, osteomyelitis, and scoliosis. The most common question types were categories 1 (pediatric orthopedic knowledge) and 6 (diagnosis with treatment). The most frequently referenced textbooks were Lovell and Winterʼs Pediatric Orthopaedics (31%) and Tachdjianʼs Pediatric Orthopaedics (16%). The most frequently referenced journals were the Journal of Pediatric Orthopaedics (American) (29%) and the Journal of Bone and Joint Surgery (American) (19%). Using only the OKUPediatrics 3 review textbook, 65% of the questions could be answered. CONCLUSIONSKnowledge of the topics more likely to be tested may help the orthopedic educator direct a didactic curriculum geared toward the OITE and American Board of Surgery examinations. Although the OKUPediatrics 3 book seems to be a good, concise resource for studying for the board examination and OITE, residents should be encouraged to supplement their studying with primary sources. LEVEL OF EVIDENCENot applicable.