Background: In the face of the COVID-19 pandemic and a country-wide lockdown, the University of the Philippines College of Medicine halted face-to-face teaching in exchange for online learning for its students. For the Learning Unit VI students, clinical rotations shifted to hybrid activities to continue learning activities while minimizing exposure risk. The Philippine General Hospital Department of Orthopedics introduced the following hybrid activities in its curriculum for Learning Unit VI students: 1) Online Lectures, 2) Online Departmental Conference, 3) Online Division Rounds, 4) Online SGDs, 5) Written Case, 6) Online Exams, 7) Preceptorship, Demo, Return Demo, and 8) Online OSCE. The department used a variety of platforms including synchronous sessions, asynchronous pre-recorded lectures, and face-to-face teaching, as appropriate. Objectives: The study compared the faculty and student course evaluations of activities in the hybrid ORTHO 251 course. Methodology: Faculty and students were asked to evaluate each activity according to the Course Evaluation By Students (CEBS), the standard questionnaire used by the college, to determine the overall rating of each activity as well as any differences between the two groups. Results: The hybrid activities conducted in the ORTHO 251 course were rated as good or excellent by the faculty and students, with differences in a few activities. Consultants rated online exams as being less effectively integrated and that there was inadequate time allotment for online SGDs, written cases, and online exams. Meanwhile, students rated all activities higher in terms of stimulating self-directed learning. Conclusion With good to excellent outcomes, this study found that it has at least satisfactorily matched the learning platform to the learning component. While knowledge may be taught via asynchronous recorded lectures or reading materials, attitude and thinking processes are better formed through synchronous discussion. Skills in medical education, including Orthopedics, are still best taught via face-to-face demoreturn demo. With this information, the department can investigate the causes of these differences and improve on the identified weaknesses.
Orthopedics ; Education, Distance ; Education, Medical

PURPOSE: The purpose of this study was to evaluate the questions pertaining to the foot and ankle on the Korean Orthopedic In-Training Examination (KOITE) between 2012 and 2016. MATERIALS AND METHODS: Questions regarding the foot and ankle on KOITE during the five-year period (2012∼2016) were analyzed. Number of foot and ankle questions, topics, taxonomic classification, imaging modalities, and cited references related to each question were analyzed. RESULTS: The average number of foot and ankle questions was 35, accounting for 7.0% (35/500) of all KOITE questions. All questions were categorized into three topic areas: disease (51.4%, 18/35), trauma (31.4%, 11/35), and basics (17.1%, 6/35). Taxonomy 3 (decision-making type questions) was the most common (42.9%, 15/35). References that are commonly used for each question were Campbell's Operative Orthopedics (100%, 35/35) and the textbook of The Korean Orthopaedic Association (74.3%, 26/35). CONCLUSION: This analysis can be valuable to not only orthopaedic surgery residents to improve their knowledge of orthopedics, but also to instructors for optimizing their education programs.
Ankle ; Classification ; Education ; Foot* ; Orthopedics*

PURPOSE: The purpose of this study was to analyze the questions in the hip and pelvis section of the Korean Orthopaedic In-Training Examination (KOITE). MATERIALS AND METHODS: We analyzed all KOITE questions pertaining to hip and pelvis surgery between 2010 and 2014. A thorough analysis of the contents was performed after categorizing as tested topics, imaging modalities used, taxonomic classification, and recommended references. We also analyzed the scores of the hip and pelvis section of the KOITE. RESULTS: Seventy-five of five-hundred questions (weight, 15.0%) were related to the hip and pelvis. Trauma including fracture and dislocation (26/75, 34.7%) was asked more commonly than disease and basics. The description-only questions (65/75, 86.7%) were the most frequently asked. According to taxonomic classification, taxonomy 3 (decision; 39/75, 52.0%) was most frequently asked. Campbell's Operative Orthopedics (52/75, 69.3%) was the reference that covered most of the questions. CONCLUSION: This analysis of the hip and pelvis section of KOITE could be used for resident training programs in teaching hospitals.
Classification ; Dislocations ; Education ; Hip* ; Hospitals, Teaching ; Orthopedics* ; Pelvis*

PURPOSE: To evaluate the questions of hand and wrist section of Korean orthopedic in-training examination (KOITE). METHODS: We analyzed questions of hand and wrist section of KOITE between 2010 and 2014. The weight of hand and wrist section was calculated and topics were thoroughly analyzed. The construct of questions were evaluated and taxonomic classifications were also performed. The frequency of presentations of physical examinations and radiologic evaluations in diagnosis and treatment related questions were analyzed. The coverage of available references which were recommended by Korean Orthopedic Association (KOA) were analyzed. RESULTS: Sixty one out of 500 questions (weight: 12.2%) were related with hand and wrist section. Disease (30/61, 48.2%) was more commonly asked than trauma, however most frequently asked topic with a broad classification was fractures and dislocations (19/61, 31.1%). The description only questions (46/61, 75.4%) were most commonly asked construct of question. According to taxonomic classification, taxonomy B (diagnosis; 27/61, 44.3%) was most frequently asked. The Campbell's operative orthopedics (54/61, 88.5%) and textbook of KOA (53/61, 86.9%) were representative references covering questions most widely. CONCLUSION: This analysis of hand and wrist section of KOITE could be used as the check-up tools for resident training programs of each training hospitals.
Classification ; Diagnosis ; Dislocations ; Education ; Hand* ; Korea ; Orthopedics* ; Physical Examination ; Wrist*

This study tried to the answer to the question : "How does the human communication happen between clinical nurse and patient?" To answer that, a micro-ethnographic research method was used and I performed field work at the orthopedic ward in one Korean metropolitan city. After analysis of interview data, observational data and field notes, I could understand that clinical nurse-patient communication performed for clinical decision making, providing patient education and emotional support. Prepared nurse communicate with patient more effectively, eventually can establish more trust relationship with patient. Conclusively I discussed about the way of nurse's skill acquisition, need of collaborative conference with doctor and nurse, and curriculum development to promote nurses's understanding of human.
Anthropology, Cultural ; Curriculum ; Decision Making ; Humans* ; Orthopedics ; Patient Education as Topic

BACKGROUND: Red blood cell (RBC) transfusion is an essential practice during surgery to accommodate for bleeding. As such, there are efforts being made to allow for a safe and appropriate transfusion due to shortages of blood components and to minimize transfusion-related adverse reactions. However, a conventional transfusion decision with relatively high hemoglobin (Hb) threshold is still performed in clinical setting. In this study, we investigated the threshold of Hblevel and appropriateness of RBC transfusion in patients receiving perioperative RBC transfusion in surgical departments. METHODS: We investigated the pre-transfusion Hb level of 1,379 patients (2,170 episodes) receiving perioperative RBC transfusion in five surgical departments, including cardiothoracic surgery (CS), general surgery (GS), neurosurgery (NS), obstetrics and gynecology (OBGY), and orthopedics (OS), between June 2017 and March 2018. The appropriateness of transfusion was evaluated with two criteria: 1) pretransfusion Hb level ≤10 g/dL and 2) posttransfusion Hb level ≤10 g/dL. RESULTS: The median pretransfusion Hb level was 8.5 g/dL (interquartile range 7.7~9.4); that of each department was as follows: 8.6 g/dL (7.9~9.2) in CS, 7.9 g/dL (7.3~8.6) in GS, 9.1 g/dL (8.5~9.8) in NS, 8.5 g/dL (7.7~9.8) in OBGY, and 8.7 g/dL (7.9~9.7) in OS. With a criteria of pretransfusion of Hb level ≤10 g/dL, 85.4% of total episodes were appropriate. With criteria of post-transfusion of Hb level ≤10 g/dL, 44.7% were appropriate. CONCLUSION: This study presents a fundamental data observing the trend of RBC transfusion in a single institution. A significant proportion of inappropriate RBC transfusion are still being conducted in surgical setting. Continuous and effective education of clinicians and implementation of monitoring systems to assess the appropriateness of RBC transfusion may be necessary.
Education ; Erythrocyte Transfusion ; Erythrocytes ; Gynecology ; Hemorrhage ; Humans ; Neurosurgery ; Obstetrics ; Orthopedics

For the better success in the society, it is important to collect opinions from members. The progress was slow before because it was hard to collect the opinions from each member. But since we have opened the web site it gets easier to evolve with the society for microsurgery, and expect to have active participations from the members. We make 20 questions in three different groups. The researches are made on participation, development in science council that starting from 2005 October to 2007 June, education on training with member's preference to thesis and individuality and suggestion. Thus we have results following to that research. 1. 75% of the members vote for the lecture has to be substantial, and also want the atmosphere of the council to be more sincere. 46.2% of members want the council to be not only exchange information but also the place to experience the social intercourse. 2. When the thesis is present and submitted that will also connect to main society. It will be counted as equal as board thesis, only if the thesis can count in both plastic & reconstructive surgery and orthopedic surgery. Then it will be scored as same as examination of board, and will be a receipt of paper by home page 3. The information-oriented project on our council is slower than what members expected. 100% of members voted yes to online thesis examination, and 66.7% of members voted for preference of web site. We need to make improvements on our web pages as soon as possible such as online payment with credit card. 4. According to the result of questionnaire, our web site helps member's participation in council and eventually become a bridge between members. We hope the questionnaires would help us to develop the council and eventually would help us to society with each other in the council. We also hope this council would be the one that connect all of us in society.
Atmosphere ; Education ; Hope ; Individuality ; Microsurgery* ; Orthopedics ; Plastics ; Surveys and Questionnaires*

Academic Medical Centers ; Curriculum ; Delivery of Health Care ; Education, Medical, Undergraduate ; Humans ; Orthopedics ; education ; Singapore

BACKGROUND: Preoperative autologous blood donation is utilized to reduce the risk of transfusion associated infections and transfusion reactions using homologous blood. We analyzed our experiences of autologous blood donations in Kyung Hee University Hospital. METHODS: From Jan. 1996 to Feb. 1997, we analyzed 213 patients who visited the blood donation room for autologous blood donation. RESULTS: Among 213 patients, 32 patients(15%) were rejected because of unfittedness with donor criteria. The majority of donor were orthopedic patients(95.4%). 14 patients(8%) could not finish the donation during the blood collection period because of donor reaction. The major cause was anemia(6 cases, 43%). During the donation period, mean of hemoglobin level was decreased by 1.3g/dL. Less than 1.5g/dL of hemoglobin reduction was observed in 117 patients(64.6%). In the use of donated blood, 43% used only autologous blood, 40.5% used autologous blood and additional homologous blood, and 16.5% were diacarded. The seropositive rates of HBsAg, anti-HCV, anti-HIV, and VDRL were 7%, 0.6%, 0%, and 0.6%, respectively. Simultaneously seropositive rate of HBsAg & anti-HCV was 0.6%. CONCLUSION: Autologous blood donation can be a good transfusion practice for elective surgery. Physician education programs are needed to avoid necessary homologous blood and unnececessary autologous blood donation.
Blood Donors* ; Blood Group Incompatibility ; Education ; Hepatitis B Surface Antigens ; Humans ; Orthopedics ; Tissue Donors

The aim of this study was to investigate the adjustment amount for outpatient services of clinics and to identify the factors affecting the variation of the cost between clinics in National Health Insurance in South Korea. Adjustment rate in the process of claims data review was defined as the percentage of the adjusted amount in the total claimed amount. From a total of 23,593 clinics in South Korea, 4,160 clinics accounting for 17.6% of total were selected for the study. The National Health Insurance claim data were collected during April 2007. To identify factors affecting the variation in adjustment rate between clinics, multiple regression method was used for the analysis. Older physicians were more likely to have high adjustment rate. General practitioners, orthopedic surgeons, and family physicians were more likely to have higher adjustment rate than those of internists. Physicians who have practiced between 1 and 10 years and physicians practicing in metropolitan areas had lower than their counterparts. There was a great variation in adjustment rate among physicians and the variation was affected by physicians' clinical behaviors as well as the characteristics of the clinics. Therefore, introduction of an effective management scheme for physicians' clinical behaviors is essential. Since many review adjustment occur due to the incomplete understanding about the review criteria and rules and procedure of claiming, continuing education will be a way of preventing these unnecessary review adjustments. The fact that no review adjustments were found even from the close-review implies that the current two-tiered review system (close-review and indicator-review) is an efficient way of review. Future studies are needed to classify possible cause of review adjustment such as simple errors, errors in applying the benefit scheme, and over use of services.
Accounting ; Education, Continuing ; General Practitioners ; Humans ; National Health Programs ; Orthopedics ; Outpatients ; Physicians, Family ; Republic of Korea