Analysis of the Musculoskeletal Trauma Section of the Orthopaedic In-Training Examination (OITE)

Objective: To analyze the musculoskeletal trauma content domain of the Orthopaedic In-Training Examination (OITE) over a 5-year period (2005-2009) to better understand the question content and distribution of references cited. Methods: The questions, answers, and recommended readings from the musculoskeletal trauma portion (as defined by the American Academy of Orthopaedic Surgeons) of the OITE were reviewed from the five examinations. The total number of questions, presence/modality of images, topics covered, taxonomic classification, and references listed were compiled and analyzed. Results: Two hundred fifty-four of 1351 questions (18.8%) were included in the musculoskeletal trauma domain. Imaging modalities were included with 28% of questions with plain radiographs alone being most common (83%). Fifty-six percent of the questions required the test taker to recall facts directly from the orthopaedic literature (taxonomy 1). The remaining 44% involved the interpretation of data, making a diagnosis, or formulating a treatment plan (taxonomies 2 and 3). No taxonomy 1 question was accompanied by a medical image. Upper extremity injuries were included in 25%, pelvis and acetabulum in 15%, and the lower extremity in 60% of the questions. The Journal of Orthopaedic Trauma was the most frequently cited reference source (24.1%) followed by the Journal of Bone and Joint Surgery, American Volume (20.8%). Conclusions: The musculoskeletal trauma section of the OITE remains the largest of the 12 content domains. Questions with associated images require a higher cognitive taxonomy. The Journal of Orthopaedic Trauma was the most cited reference. This analysis may help test question writers, future test takers, and faculty involved with resident education to better understand and prepare for this portion of the OITE.