John M. Flynn, MD

Imagine earning 17 continuing medical education (CME) credits without ever leaving home or missing a day of practice. That’s what participants in a totally new type of online and home study course developed by the AAOS were able to do earlier this year.

“Complications in Total Hip Arthroplasty,” held Jan. 8–Feb. 22, 2013, incorporated both online tools and home study assignments. A grant from the AAOS Education Enhancement Fund offset the registration fee.

Course directors Amar S. Ranawat, MD, and Scott M. Sporer, MD, recruited the faculty and planned the program, which included the following:

• four webinars
• two case reviews and discussion sessions
• video reviews (three required, eight optional)
• journal reviews (four articles)
• a review of the AAOS/American Dental Association Evidence-Based “Guideline on the Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures”
• two multimedia cases

Webinars were held approximately every 2 weeks. The webinars included traditional lectures, case reviews, video demonstrations, polling, and participant question-and-answer sessions and lasted about 1 hour 15 minutes each. Content focused on complications during and after the surgical procedure. At the end of each webinar, participants received a home study assignment, coordinated with the content for the next webinar.

The 1-hour case discussions, held after the first and third webinars, were conducted by teleconference. During the calls, a faculty member and eight course participants took part in a small-group interactive discussion, focused on cases submitted by course participants as well as faculty-reviewed cases and journal articles. The result was similar to a journal club atmosphere, which generated an enthusiastic response from participants.

“Instead of the usual didactic ‘one-way’ format of most lectures and CME courses, this format forced me to interact in different ways with regard to the materials being presented,” said one participant.

Program evaluation
Of the 80 course participants, 98 percent indicated the program met or exceeded their expectations. Many reported making changes in their practices as a result of their participation.

“I can put my cups in a lower degree of abduction. I used to shoot for 45 degrees of abduction; now I’m aiming for less than 40 degrees, and the outcomes are better,” said one participant.

Another participant reported that he’s become “more aggressive in washing out, getting deep cultures, early wound drainage after total hip replacements.”

Although not required, course directors and faculty encouraged the pursuit of additional study. About half of the participants reported conducting web searches, discussions with colleagues, and reviews of patient charts and radiographs.

The extended life of the course minimized the need for participants to modify their schedules so they could take part in the course sessions. Those who did need to make adjustments reported that they were “modest,” such as adjusting call schedules and personal matters.

Participants were grateful for the flexibility that the new learning format provided. One expressed appreciation for “the accessibility of having the course ‘come to me,’ so I could listen at home while I made dinner and have access to review the lectures for parts I missed or wanted to hear again.”

More online courses in 2014
The results from this pilot effort were reviewed during the most recent meeting of the CME Courses Committee. Based on the enthusiastic responses, the committee decided to present two programs in 2014, and planning for them is now underway. Drs. Ranawat and Sporer will lead a course on complications in total knee arthroplasty, and Jeffrey Anglen, MD, and John T. Gorczyca, MD, will lead a course on fracture malunion and nonunion. Details on the 2014 courses will be available later this year.

John M. Flynn, MD, chairs the CME Courses Committee. He can be reached at flynnj@email.chop.edu