Implementation of Virtual Reality Pain Alleviation Therapeutic into Routine Pediatric Clinical Care: Experiences and Perspectives of Stakeholders.

Virtual reality (VR) needs to be implemented in clinical settings to improve pediatric patient care during painful medical procedures. Engaging doctors and nurses to lead the adoption of new clinical techniques can facilitate the transition from research to routine practice. Integrating VR into routine clinical practice could reduce patient pain and anxiety, making medical procedures smoother and more efficient.

Bridging the Gap: Advocating for Medical Students Without Home Orthopaedic Surgery Programs.

Medical students without a home orthopaedic surgery program face unique challenges due to the absence of institutional connections and mentorship opportunities. This review explores the hurdles faced by these students, including financial constraints, emotional strains, mentorship gaps, and networking hurdles. Drawing from empirical evidence and scholarly research, tailored advocacy strategies to empower these medical students pursuing orthopaedic surgery residency are proposed, including mentorship programs, financial assistance, psychosocial support, and community-building initiatives.

What Is the Representation of Sexual and Gender Minority Identities Among Orthopaedic Professionals in the United States?

Background: There is substantial corroborating evidence that orthopaedic surgery has historically been the least diverse of all medical and surgical specialties in terms of race, ethnicity, and sex. Growing recognition of this deficit and the benefits of a diverse healthcare workforce has motivated policy changes to improve diversity. To measure progress with these efforts, it is important to understand the existing representation of sexual and gender minorities among orthopaedic professionals.

Volar Distal Radius Buckle Fractures: Is Bracing and Home Management Safe?

Background: A removable brace with home management is widely accepted treatment for distal radius buckle fractures, which most commonly involve the dorsal cortex.

Purpose: The purpose of this study is to determine if a removable brace and home management treatment is safe for volar distal radius buckle fractures.

Materials And Methods: Isolated distal radius buckle fractures in children (3-16 years) diagnosed at an acute care visit (April 1, 2019 to May 31, 2022) were identified.

The Impact on Families of Children With Congenital Upper Extremity Differences.

Purpose: To investigate the impact on caregivers of caring for a child with congenital upper extremity differences.

Methods: In this cross-sectional study, caregivers of patients enrolled in the multi-institutional Congenital Upper Limb Difference (CoULD) registry were contacted. Demographic information and the Impact on Family Scale (IOFS), a validated measure of perceived caregiver strain, were collected.

Reducing Rigid Immobilization for Toddler's Fractures: A Quality Improvement Initiative.

Background: Toddler's fractures are one of the most common orthopedic injuries in young walking-age children. They are defined as nondisplaced spiral-type metaphyseal fractures involving only the tibia without any injury to the fibula and are inherently stable. We aimed to use quality improvement methodology to increase the proportion of patients with toddler's fractures treated without cast immobilization at a large tertiary referral pediatric orthopedic center from a baseline of 45.

Workplace Violence in Orthopaedic Surgery: A Survey of Academy of Orthopaedic Surgeons Membership.

Introduction: Workplace violence (WPV) in US health care is increasing, and many workers are likely to experience WPV during their careers. This study aims to assess the scope of WPV in orthopaedics.

Methods: A 20-item survey adopted from the World Health Organization's 'Workplace Violence in the Health Sector Country Case Studies Research Instruments Survey Questionnaire' was sent to Academy of Orthopaedic Surgeons members, including residents and fellows.

How Much Bullying and Discrimination Are Reported by Sexual and Gender Minorities in Orthopaedics?

Background: Discriminatory practices against minority populations are prominent, especially in the workplace. In particular, lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals experience several barriers and stressors more often than individuals who do not identify as LGBTQ+. Mistreatment is common among these individuals in their personal and professional lives.

AOA Critical Issues: A Culture of Safety Across All Orthopaedic Professional Endeavors.

Medical professionals strive for a culture of safety in which error is anticipated, systems are designed to catch an error before it causes harm, and each event is an opportunity for specific clinicians and the system they work in to improve. A culture of safety is based on behavioral ethics, which recognizes that the automatic functions of the human mind can lead good people to misstep, and it incorporates tools such as checklists that embody critical thinking in order to help limit missteps and associated harm. Although the discussion surrounding a culture of safety often focuses on patient care, the social contract between physicians and society involves expectations that physicians will use their expertise to promote the public good in all of their professional endeavors.

Issues in Ethics in Orthopaedic Surgery Following the COVID-19 Pandemic.

The COVID-19 pandemic has caused changes in health care as well as human suffering, and consideration of the principles of ethics can build a foundation to consider dilemmas that have arisen. Diversity, equity, and inclusion have become key issues. Simulation training and the related ethics of its application have taken on new meaning.

Simulation Training in Orthopaedic Surgery.

Simulation training encompasses all methods of learning technical skills that do not require practicing on a live patient. Surgical training typically uses an apprenticeship model, in which responsibility is gradually shifted from attending surgeon to the trainee over years of experiences with live patients. Skill acquisition from simulation modalities can prevent unnecessary harm to patients if trainees have practice and experience from simulation before participation in live surgeries.

Impact of opioid law on prescriptions and satisfaction of pediatric burn and orthopedic patients: An epidemiologic study.

Objectives: The objective of this study was to determine the reduction in prescribed opioid pain dosage units to pediatric patients experiencing acute pain and to assess patient satisfaction with pain control 90-day post discharge following the 2017 Ohio opioid prescribing cap law.

Methods: The retrospective chart review included 960 pediatric (age 0-18 years) burn injury and knee arthroscopy patients treated between August 1, 2015-August 31, 2019. Prospectively, legal guardians completed a survey for a convenience sample of 50 patients.

A Quality Improvement Initiative to Screen for Bullying in Pediatric Orthopedic Outpatient Clinics.

Unlabelled: Bullying annually affects 20%-25% of middle- and high-school children. Persistent bullying can lead to feelings of isolation, rejection, and despair and trigger depression and anxiety. In addition, pediatric patients have presented to outpatient orthopedic clinics with injuries consistent with physical bullying.

Presentation and Management of the Pediatric Trigger Finger: A Multicenter Retrospective Cohort Study.

Purpose: Pediatric trigger finger (PTF) is an acquired condition that is uncommon and anatomically complex. Currently, the literature is characterized by a small number of retrospective case series with limited sample sizes. This investigation sought to evaluate the presentation, management, and treatment outcomes of PTF in a large, multicenter cohort.

In-Office Amoxicillin to Increase Graded-Dose Challenges at Initial Evaluation for Penicillin Allergy.

Background: More than 90% of pediatric patients labeled with a penicillin allergy can tolerate subsequent treatment courses without reaction. Graded-dose challenges (GDCs) are an important tool to clarify reported penicillin allergy.

Objective: To increase the use of same-day amoxicillin GDCs among patients with a low-risk penicillin allergy history who presented for outpatient allergy office evaluation from 2% to 15% and sustain for 6 months.

Policies, Practices, and Attitudes Related to Parental Leave for Practicing Pediatric Orthopaedic Surgeons.

Background: Parental leave impacts family engagement, bonding, stress, and happiness. Because parental leave benefits are important to all surgeons regardless of sex, understanding parental leave practices in pediatric orthopaedic surgery is critical to promote equity within the profession and supporting balance in work and family life. The aim of this study was to survey pediatric orthopaedic surgeons about their knowledge of parental leave policies, attitudes towards parental leave, and their individual experiences taking leave.

AOA Critical Issues Symposium: Mind the Gap: Addressing Confidence, Imposter Syndrome, and Perfectionism in Surgical Training.

Orthopaedic surgeons in training and in their careers can experience a lack of confidence and imposter syndrome. Confidence is built early through continuous improvement, accomplishments, support, and reinforcement. Although it is normal to lack confidence at times, the goal is to recognize this issue, work on visualizing success, and know when to seek help.

Effect of Race and Geography on Patient- and Parent-Reported Quality of Life for Children With Congenital Upper Limb Differences.

Purpose: Patient beliefs about health and disability are shaped by many social factors and are a key determinant in their ultimate outcome. We hypothesized that pediatric and parent-reported outcome measures regarding a child's congenital upper limb difference will be affected by geographic location, parent education, sex, ethnicity, race, age, and presence of additional medical comorbidities.

Methods: Patients enrolled in the multicenter Congenital Upper Limb Difference registry were included.

LGBTQ+ Perspective in Hand Surgery: Surgeon and Patient.

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals and patients face high levels of discrimination both in the workplace and in the clinic setting, with more than 25% of LGBTQ+ people experiencing discrimination in the workplace due to their sexual orientation. Hand Surgery stands to continue to advance by encouraging the brightest students into the field no matter their background. LGBTQ+ patients also have specific needs within the field of Hand Surgery, where we are uniquely positioned to treat them or guide them by being well versed in the needs of the community.

Coaching, Separate from Mentoring, May Provide Skill Acquisition, Improved Well-Being, and Career Advancement in Orthopaedic Surgery: AOA Critical Issues.

Coaching is separate from mentoring, and can include life coaching, skills coaching, and behavior coaching. Life coaching can focus on purpose, work-life balance, well-being, and career path. Skills coaching encourages mastery and promotes autonomy.