A Novel Orthopaedic Resident Education Curriculum: Implementation of the Academy of Orthopaedic Surgeons Resident Orthopaedic Core Knowledge Platform.

Abstract

Traditional orthopaedic residency educational approaches rely on unstandardized lecture series and self-directed study, which can lead to inconsistencies in knowledge acquisition. The Residency Orthopaedic Core Knowledge (ROCK) curriculum, introduced by the American Academy of Orthopaedic Surgeons in 2022, is a structured, comprehensive framework designed to standardize orthopaedic education. This study evaluates resident satisfaction with implementation of the ROCK curriculum within a single orthopaedic residency program and its association with resident performance on the Orthopaedic In-Training Examination (OITE). A 2-year residency didactics curriculum was designed to incorporate the ROCK curriculum at a single, urban academic orthopaedic residency program with a wider breadth of topics starting in the 2023 to 2024 academic year. To assess pre-/post-implementation response to this change, a survey assessing resident attitudes toward lectures/study patterns was designed. This was administered at the end of the 2022-23 academic year (pre-ROCK), with responses also collected 1 (2023-24) and 2 (2024-25) years after implementation. The survey captured resident demographics, attendance patterns, content satisfaction, and study habits. Questionnaire answers and OITE scores were compared between the year 2022 to 2023 (pre-ROCK) and the years 2023 to 2025 (post-ROCK). A total of 78 responses were recorded over the 3 years (63% male) out of a potential 135 respondents. The proportion of residents who agreed that conferences were high quality (93% vs. 70%, p = 0.013) and were satisfied with conferences (91% vs. 65%, p = 0.006) was greater with the ROCK curriculum. In addition, residents felt there was a more appropriate balance of case-/didactic-based lectures after implementation (86% vs. 57%, p = 0.006). With the new curriculum, program OITE percentile increased from 68th percentile in 2022 (pre-ROCK) to 79th percentile in both 2023 and 2024 to 83rd percentile in 2025. Integrating the ROCK curriculum into an orthopaedic residency didactics curriculum led to high resident satisfaction and an overall trend toward higher OITE scores. These results support the use of the ROCK curriculum to augment resident education. Orthopaedic program directors and education leaders alike can replicate or adapt our proposed lecture schedule.