Published 12/1/2016
Gerald R. Williams Jr, MD

Turning the AAOS Education Strategy into Reality

In my October column, I explored the ways in which our members' educational needs are changing and outlined the Academy's overarching strategies for meeting those needs. As I noted, the technologies that are now part of our daily lives—including smart phones, tablets, and other handheld devices—have taken the place of many traditional educational platforms as learners' appetites for smaller "bites" of content have grown.

The Academy has responded to new learning styles and delivery systems by converting its educational content into digital formats and making it easier to find and access information via digital learning tools. In addition, to better meet our members' needs, the Board of Directors approved a portfolio-based Education and Publishing Strategy in 2013 that shifts the emphasis from product type (books, videos, or courses) to anatomic content areas.

Sweeping changes such as these require a significant amount of planning, coordination, and collaboration to implement. In this column, I will give you a "peek under the hood" to see how the AAOS is working with orthopaedic specialty societies and other groups to make its strategic education goals a reality.

A shift in infrastructure
One of the most significant changes is the reorganization of the Council on Education's (COE) governance structure. As detailed in "AAOS Enhances Its Education Strategy," (AAOS Now, October 2016), the COE is moving away from its current format-centric committee structure to one based on anatomic content areas. To accomplish this, 10 Content Committees (CCs), each headed by a Content Chair, will focus on the following specialty areas:

  • Hand and Wrist
  • Shoulder and Elbow
  • Adult Reconstruction (Hip and Knee)
  • Foot and Ankle
  • Spine
  • Musculoskeletal Oncology
  • Pediatric Orthopaedics
  • Sports Medicine
  • Trauma
  • Basic Science

Under the new model, which the Academy will officially launch at the 2017 Annual Meeting in San Diego, CCs will be charged with developing a broad body of knowledge for their content areas. In addition, they will identify content gaps by evaluating the Academy's existing education portfolio and carefully considering members' feedback about their learning needs.

The new structure has been carefully developed and planned to draw on the expertise of current volunteers. The AAOS is in the process of populating the committees with liaisons from some of the existing COE committees, including more than 20 volunteers who were in the middle of their terms of service under the former model. These new committees will include representatives from the Journal of the AAOS as well as the Assessment and Examinations, Annual Meeting Program, and Instructional Course committees, and will also have resident member representation. In addition, as part of the Academy's shared planning model for education, specialty societies that correspond to each of the 10 areas covered by the CCs have designated representatives who will share their expertise as liaisons to the appropriate CC.

To help ensure the success of this portfolio-based approach to developing AAOS educational offerings, the Academy is currently conducting a clinical needs assessment that uses quantitative methodology to survey members in every career stage and specialty area regarding their wants and needs in clinical education. This needs assessment will provide crucial insights to inform the efforts of volunteers and staff members.

Another key step in preparing for this shift in strategy was the creation of a pilot CC. The group—assembled by Evan L. Flatow, MD, COE chair—began reviewing existing Academy content and identifying gaps in key shoulder and elbow content in August. Currently, they are developing final recommendations to the COE regarding new packages or content bundles in this area to be delivered via the new learning platform.

Developing and delivering educational content
Implementing changes as sweeping as those described thus far requires use of the proper tools. As such, the Academy saw the need to begin using a learning content management system (LCMS), a tool employed "behind the scenes" to assist staff members in designing and developing content. In a nutshell, an LCMS manages what is learned. For the past year, the LCMS has facilitated staff members' efforts to create new online learning courses.

The LCMS will serve as a repository of existing digital content, such as DVDs and online courses, that have been converted to make them available to our members for mobile and online use. As staff members have worked to accomplish significant goals—such as making more than 100 books available in ebook format—they have also ensured the material is focused and searchable.

In contrast to an LCMS, a learning management system (LMS) provides a convenient way for learners to obtain knowledge and manages learners' engagement with educational content. The AAOS has begun working with an LMS vendor to create a learning portal that will personalize each Academy member's learning experience. When members log on to www.aaos.org, available content will be accessible on individualized dashboards. The LMS will, among other things, make it easy for members to share knowledge, track their progress in the American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification (MOC) process, and manage their professional development at every stage of their careers.

Education available via subscription models will also be an important part of the Academy's future. Currently, the Orthopaedic Video Theater (OVT) offers more than 500 peer-reviewed videos via an annual subscription. These videos are available in the AAOS Access app and in the AAOS Video Gallery on the AAOS website. We also expect to make the OVT available via the new LMS. The Academy will make a variety of content bundles available to members via the LMS.

The AAOS is in the process of evaluating and developing various other subscription platforms for our expanded audiences—including international and institutional segments—that will make content easily accessible and available on a variety of devices, such as smart phones and tablets. These subscription models will address fellows' expressed needs for easy access to information on unfamiliar topics and treatment options as well as convenient tracking of continuing medical education.

Key collaborations
The success of these efforts depends on continuing our partnerships with orthopaedic specialty societies to produce top-notch orthopaedic education. That is why it is so crucial that, under our new COE governance structure, each CC has representation from appropriate corresponding specialty societies. The Academy understands that business models that align the incentives of both the AAOS and the individual specialty societies will be the most successful.

The AAOS greatly values its relationships with publishers such as Wolters Kluwer and Jones & Bartlett Learning, the latter of which has long worked with the AAOS to publish Emergency Care and Transportation of the Sick and Injured (Orange Book) and various related offerings.

Other collaborations are much more recent. In March, the AAOS approved a strategic investment in the parent company of Orthobullets.com, Lineage Medical LLC. Orthobullets is a technology platform for online orthopaedic education developed and designed by orthopaedic surgeons. The AAOS investment is part of a continuing effort to provide members with high-quality products and programs via accessible channels of delivery that best meet their lifelong learning needs.

"The Academy has long been the primary source for unbiased, peer-reviewed musculoskeletal education," said AAOS Immediate Past President David D. Teuscher, MD. "This new strategic relationship with Orthobullets will enable us to build on that strength and better serve our resident members as well as the entire global membership of the Academy, by being a part of the development and delivery of a new generation of products accessible via new technology and platforms."

Orthobullets.com, a self-paced learning platform that was developed for residents who were frustrated with "mass memorization" resources, provides easy-to-access content and lessens the financial burden of training and preparing for board exams. Residents also write content for the platform, which provides an opportunity for them to expand their knowledge.

The AAOS has worked with Orthobullets founder Derek Moore, MD, and his team to add thousands of the Academy's exam questions to the site, which is used by more than 125,000 physicians and has an average of more than 5 million page views each month. The Academy will continue to explore more ways to ensure its members have access to trusted AAOS content through a variety of channels.

The future of education
No matter how the educational landscape changes, the AAOS will always be mindful that it was founded as an educational organization. The Academy has recognized the enormous changes occurring in how content is created, delivered, and consumed, and has made substantial investments to update its educational offerings. Moving forward, the AAOS will continue to explore potential relationships with external educational providers that align with our mission and educational offerings.

In the future, the Academy's ability to meet members' learning needs will depend on the quality of the products developed by our talented volunteers, the efficiency with which they are produced, expanded engagement with specialty societies, and the ability to form strategic external partnerships. Most importantly of all, this organization's future depends on receiving the continuing support of the members it exists to serve.