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Published 10/1/2016
Gerald R. Williams Jr, MD

Education Challenges and Opportunities

From its beginnings in 1933, your AAOS has always been the leading educational or­ganization for orthopaedic surgeons. Education is one of the seven domains in the Academy's strategic plan, and most activities—from the Annual Meeting to webinars—are geared to meeting your educational needs. More than 2,500 volunteers are involved in education-oriented activities, as authors, reviewers, faculty, and committee members.

But education content and delivery have changed dramatically in the years since I was a resident. We have moved from printed books and journals to digital content on the Internet. Slide presentations and the occasional cadaver lab have been replaced by streaming videos and cloud-based courses. Computers are everywhere, even in exam rooms. Hand-held devices such as tablets and smart phones have replaced traditional learning platforms.

For the AAOS, making the transition from traditional educational products to new learning models is essential. Your Academy has invested substantial resources, both financial and human, into converting current educational content into digital formats accessible by any device—from laptop to smart phone. Along the way, we've been dividing this material into focused, individually searchable content, so it will be easier to find and use. We've also been working with specialty societies, our critical partners in content development, and we've been identifying potential partners for joint ventures. The result will be a more robust educational platform driven by content geared to your needs.

Making the conversion
This is no easy task. The AAOS Board of Directors approved this education strategy late in 2013; the business plan for digital products was approved in October 2015. All current educational publications have already been converted to ebooks. CD-ROM and DVD products are also being converted for mobile and online use. More than 500 peer-reviewed videos in the Orthopaedic Video Theater are ready for viewing in the AAOS Access App and in the AAOS Video Gallery on the AAOS website.

But the content must be functional, as well as educational. The key is being able to find and access all this content—or the specific information you need—when you need it. The AAOS has a number of apps designed to help you do just that. For example, the My Academy app, the mobile companion for the AAOS Annual Meeting, gives attendees full access to the complete program, faculty, exhibitor, attendee, and other information. The OrthoGuidelines app puts all of the clinical practice guidelines and appropriate use criteria at your fingertips.

The Academy's Access App, released last year, has been functionally enhanced to enable you to download and annotate ebooks, just as you would print editions. Soon, we will be releasing an update that will improve your user experience and include mixed content bundles. We also are building a version of this app for users of the Android operating system. And, we are developing an app that extends many of the features of the AAOS website surrounding member engagement, allowing members to manage many of their account details, search a member directory, manage their transcripts, and more. We even have several apps designed for physical exams—demonstrating how to do an exam—and patient education.

In moving to digital formats and content, we are changing the way we present material to meet the ways that people learn. People no longer have time to sit down and devour medical tomes. Learners have become "snackers," looking for smaller "bites" of content with major impact. Breaking concepts down into smaller chunks means the information is easier to understand and assimilate. It also means that information can be pulled together in different ways to enhance learning.

Improving the old…
Even tried-and-true learning experiences can be enhanced. If you have not yet experienced a surgical skills course at the new OLC Education and Conference Center, I urge you to do so. It is an amazing educational venue that sets a new standard for optimal, unbiased surgical training. With state-of-the-art technology, easy access to conference rooms and meeting spaces, high definition production and viewing capabilities, fully equipped workstations, and separate demonstration areas, the OLC combines the best of both old and new learning technologies. We each owe thanks to those members and organizational partners whose efforts during the capital campaign made this educational resource possible.

The "yellow journal"—The Journal of the AAOS (JAAOS)—is another example of how your Academy is enriching current products. Last year, JAAOS added a research section, focused on original scientific studies and case reports. This year, "open access" became a reality, giving authors the option of paying a fee to allow perpetual unrestricted online access to their published article to readers globally, immediately upon publication. It's no wonder that JAAOS is the number one most read orthopaedic journal.

Although your AAOS has brought orthopaedic education to the world stage for many years, the Internet is changing our international education strategy. We will continue to provide faculty and present courses in countries around the world. This year, courses are running in diverse locations such as Romania, Mexico, India, and China. But we will also use the World Wide Web to enable orthopaedic surgeons—wherever they are—to access Academy-sponsored materials. This will not only improve the practice of orthopaedics around the world, it will also provide new revenue streams that can be used to support educational development.

Late in 2014, the AAOS Board of Directors approved an international growth strategy. Today, we have three full-time staff working with partner firms on rights and distribution around the world. Approximately 25 agents and distributors in more than 85 countries represent the AAOS. Our goal is to shift to a subscription platform and sales model that will not only generate revenue to sustain the organization, but also increase outreach to several international markets.

A subscription permits time-limited access to a defined set of content. Subscriptions can be individual or institutional; they can even be country-wide, such as a medical library outside the United States purchasing access to and making available AAOS content. Last year, the global sales effort resulted in a 60 percent increase in sales over 2014 and the AAOS reached more than 6,000 international surgeons.

Responding to the new…
At a recent AAOS Board of Directors workshop, James McQuivey, PhD, vice president and principal analyst for Forrester Research, discussed the importance of building digital relationships—and the impact of digital disrupters. Both of these relatively new concepts have huge implications for your Academy.

For example, in the past, content development has been driven by the product—courses, books, video, assessment exams. But the Internet enables today's learners to search by topic across all types of learning tools. For example, a search for "shoulder replacement" might result in a listing of videos, scientific articles, images appropriate for patient and physician education, book chapters, and more. To meet this need, the entire infrastructure for content development must change.

Therefore, the AAOS has approved a shift in the organization of the Council on Education. Instead of committees based on products (Publications, CME Courses), the new structure will have 10 anatomic "content committees," which would follow a shared planning model and help build a body of knowledge by specialty area (See "AAOS Enhances its Education Strategy"). This will enable the AAOS to develop and deliver content in multiple digital formats.

Council of Education members have been closely involved with the design and development of this new model, which we anticipate will roll out next year. An oversight group—composed of the chairs of the Annual Meeting, Evaluations, CME Courses, and the Online Learning and Publishing committees as well as the editors-in-chief of JAAOS and OrthoInfo, and under the direction of the Council chair—will ensure coordination in our shared planning model. Each of the content committees will have several participants and subcommittees, including an educational liaison from the appropriate specialty.

My next column will focus on how the AAOS plans to implement these broad changes—and how your Academy is using new and ongoing relationships to bring you the best in orthopaedic education.