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PURPOSE: To determine whether a mixed course on the Oxford unicompartmental knee arthroplasty (UKA) could improve the non-technical (cognitive) skills of performing UKA. METHODS: 120 delegates consisting of consultant orthopaedic surgeons and advanced surgical trainees attended a 2-day course. 104 (87%) of the delegates had performed total knee arthroplasties, whereas 79 (66%) had performed UKAs. The course consisted of didactic lectures, interactive surgical demonstrations, and practical dry-bone skills workshops. Cognitive skills were assessed at the start (day 1) and end (day 2) of the course using 10 multiple-choice questions. The maximum test score was 10. Multilevel modelling was used to compare the pre- and post-course test scores. The pairings of pre- and post-course scores were not known because of a confidentiality clause. RESULTS: Of the 120 delegates, 71 (59%) took the pre-course test and 120 (100%) took the post-course test. The median score improved significantly from 2 (interquartile range [IQR], 0.5-3.5) to 6 (IQR, 4.5- 7.5) [bootstrap p<0.0001] for every single one of the randomly allocated pairings. Most delegates had poor cognitive skills for the UKA before the course and improved significantly after the course. Sub-analysis of each question topic showed significant improvement in scores for all topics after the course (bootstrap p<0.0001). Nonetheless, the extent to which individual topic scores improved varied widely. The odds ratio for the pre- versus post-course total test score was 4.36. CONCLUSION: A mixed continuing medical education course could enhance the non-technical (cognitive) skills for UKA.

Original publication




Journal article


J Orthop Surg (Hong Kong)

Publication Date





356 - 360


Adult, Arthroplasty, Replacement, Knee, Clinical Competence, Cognition, Decision Making, Education, Medical, Continuing, Humans, Orthopedics, Task Performance and Analysis