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Objective: Due to limited musculoskeletal education, students pursuing orthopaedic surgery often feel unprepared for residency. Clinical rotations provide some education; however, prior to the development of the Ortho Acting-Intern Coordinated Clinical Education and Surgical Skills (OrthoACCESS) curriculum in 2019, no standardized didactic curriculum existed. Over time, students desired interactive, case-based learning opportunities. Our objective was to design a flipped-classroom, blended learning curriculum and evaluate its ability to improve medical student orthopaedic knowledge., Design: OrthoACCESS 2.0 is a 16-week, open-access curriculum consisting of didactic lectures, case discussions, and learning resources. The curriculum was evaluated using pre-curriculum, post-case discussion, and post-curriculum surveys. Likert-item questions were evaluated with paired Wilcoxon signed-rank analysis. Free text responses were reviewed for emerging themes., Setting: Lectures were presented weekly in-person for students at OrthoACCESS institutions with pre-recorded lectures available for non-rotating students. Faculty-led virtual case discussions consisted of 3 case presentations and breakout rooms for discussion. Learning resources (e.g., Anki Cards, "scut sheets") were posted to the website., Participants: OrthoACCESS 2.0 was hosted from June to October 2023 with 35 participating institutions. All 226 student registrants completed the pre-curriculum survey and 69 completed the post-curriculum survey. Forty students attended at least 8/16 case discussions., Results: In the post-curriculum survey, 68% of participants reported "quite" or "extremely" strong orthopedic knowledge, compared to 23% beforehand (p < 0.001). Postcase discussion surveys revealed significant increases in knowledge associated with each lecture and case discussion (p < 0.001). The greatest student-reported benefits were the broad coverage of orthopedic topics (n=41) and learning how to think like an orthopaedic surgeon (n=20). The greatest barrier to attendance was clinical obligations during case discussions (n=44)., Conclusions: This flipped-classroom, blended learning curriculum has improved medical student foundational orthopaedic knowledge nationally. This model may be valuable for other specialties with limited undergraduate medical exposure., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Introduction: Disparity in access to emergency care among minority groups continues to exist despite growing awareness of the effect of implicit bias on public health. In this study, we evaluated ethnicity-based differences in time between admission and surgery for patients undergoing emergent procedures at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program., Methods: We conducted a retrospective review of 249,296 National Surgical Quality Improvement Program cases from 2006 to 2018 involving general, orthopaedic, and vascular surgeries. Analysis of variance was used to compare "time to operating room" (OR) between ethnic groups., Results: Notable differences in time to OR were noted among general and vascular surgeries but not orthopaedic surgery. Post hoc comparison identified notable variation in general surgery between White and Black/African Americans. In vascular surgery, notable variations were identified between White and Black/African Americans and White and Native Hawaiian/Pacific Islanders., Discussion: These findings suggest that certain surgical subspecialties continue to exhibit disparities in care that may manifest as surgical delay, most notably between White and Black/African Americans. Interestingly, variation in time to OR for patients treated by orthopaedic surgery was not notable. Overall, these results highlight the need for additional research into the role of implicit bias in emergent surgical care in the United States., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

Competing Interests: The authors report no conflict of interest.