AO Dialogue 1|14 The newsletter for the AO community
The AO Strategy Fund The funding process for supporting important new strategic initiatives within the AO
Olga Harrington, AO Dialogue Launched on December 19, 2013, the AO Strategy Fund has an annual budget of CHF 5 million until 2016. According to Rolf Jeker, CEO and Vice-Chair AO Foundation Board, “Innovation is of the essence and in the last three years our priorities were governance and spending priority changes as well as efficiency measures to reduce overhead; we are now looking to innovation and quality enhancements of which the AO Strategy Fund is one example. This initiative allows us to evaluate the latest trends in technologies to assess what AO needs in the future”. The broad scope of this initiative means that all AO members and employees are eligible to apply for
funding in their own name or on behalf of AO boards, steering committees, commissions or other AO units. The AOFB, who approved the launch of the Strategy Fund and are responsible for evaluating the applications, are eager to finance proposals which are: •
New services, new technologies and
unmet needs
•
New projects enhancing the organiza-
tion’s visibility and brand
•
New ideas to foster cooperation across
Clinical Divisions
•
New initiatives which enhance opera-
tional effectiveness and efficiency
Table of contents AO Strategy Fund My view, James Kellam AO President’s interview From the AO Clinical Divisions
continued on page 2
From the AO Institutes
1-3 3 4-5 6-10 11-14
2
AO Dialogue 1|14
The AO Strategy Fund
Florian Gebhard at the 2nd Exploratory Research Symposium, 2013, Davos
The first deadline to submit pre-proposals for funding in 2014 was January 31, 2014. The response to this first call for applications, in terms of both quality and quantity, was hugely positive. Of the 107 pre-proposals received approximately two-thirds were submitted by AO members and one-third by employees and submissions came from 24 countries. Eleven projects were assessed by the AOFB in March and shortlisted for the next phase. Applicants then submitted a more detailed full proposal for assessment at the AOFB meeting in June and will all receive official feedback in July. The shortlisted project topics include 3D printing, surgery simulation, pre-clinical facilities, an interactive video portal, a research animal models database, trauma prevention, faculty education, pediatric surgery reference, and a clinical trials and regulatory congress. Remarking on the very high response rate, Jeker declared that the AOFB was “overwhelmed by the interest from the members and the community to our first call for applications. The money is obviously not enough to cover all these proposals but we have been able to select eleven of the 107. Our focus is
particularly on areas that we know we have b look into in the future such as 3D printing to and simulation in education so we can address where technology is moving and also where we can enhance the AO brand.” Proposal evaluation begins with the in-depth assessment of the Sub-Committee of the AOFB, which submits its recommendations to the AOFB, as the first step in a rigorous peer review process. The Sub-Committee comprises the following AOFB members: Florian Gebhard (Chair), Jean Pierre Cabassu, Neal Futran. In his role as chair of the sub-committee Dr Gebhard is responsible for setting up the methods of peer reviewing evaluation with Craig Cooper (Manager AO Strategy Fund), monitoring the timelines, moderating the meetings, and bringing his own experience from his scientific education and broad clinical trauma experience to bear on the process. When asked about the quality of first round of pre-proposals that the sub-committee reviewed, Dr Gebhard remarked that he was, “surprised firstly by the large overall number
3
AO Dialogue 1|14
My view James F Kellam Editor-in-Chief james.kellam@aofoundation.org
Competency
Rolf Jeker at the Trustees Meeting 2013 in Lima, Peru
who applied, secondly the high grade of innovative ideas in the final proposals, thirdly the broad spectrum of proposals and finally, the long perspective of the proposals if they are successful.” A second call for pre-proposals was launched on May 28, 2014 with a deadline to submit applications by July 31, 2014. In a recent interview Jeker spoke about how “this second call for applications shows that it is not a first come first served selection, but rather it is decided on a quality basis. We have funds for 2015 and 2016 so whoever has a good proposal should come forward and put their ideas on the table. The AO was a very unique organization when it started, and we continue to be a unique and excellent organization but a lot of people have caught up with us, so we need to make sure that we stay the leader in the different fields where we operate and this is what we are working on with the AO Strategy Fund.” If you have further questions about the AO Strategy Fund, please contact Craig Cooper at craig.cooper@aofoundation.org. To read frequently asked questions about the application, evaluation and funding processes and to apply, members should log in to the AO Strategy Fund on the AO Foundation website. If you are not yet a member but would like to apply for funding from the AO Strategy Fund, please go your Clinical Division website (AOTrauma, AOSpine, AOCMF, AOVET) to become a member.
What does competency mean to you, your patient or your licensing board? It means a surgeon has demonstrated that they are able to perform a task evaluated against some objective criteria. Licensing bodies, hospitals and others are now asking for documented evidence that a surgeon is competent. The old way whereby a teacher declared a student to be competent without documented objective criteria is no longer good enough. Even the certification process of the specialty is not enough. Competency-based education in Canada and the milestone program in the USA are being introduced into surgical training programs to provide a more objective measure of the competency of the trainee as they enter practice. Although many may feel that this impinges on the time-tested methods of surgical training evaluation, it is nonetheless necessary and provides everyone with a more focused and better evaluation of the progress of a trainee. In addition, demonstrating that competency has been maintained is now part of the process for a practicing surgeon to recertify. But what does this have to do with the AO? We are in the field of education and we need to know the results of what we teach—competency to fix a fracture. I would propose that if AO is educating surgeons, we need to be involved in this process of competencybased education and evaluation. AO Education has been focused on this topic for some time leading to the development of several innovative projects. To take this one step further the AO should consider partnering with educational institutions and governing bodies as well as the certifying bodies to develop educational offerings that mesh with competency training as well as providing instruments to help the practicing surgeon demonstrate their competency. The computer-aided testing outcome program is one project that AOCID is developing that will definitely help in this regard. AO has a great opportunity to once again lead the way in a potentially exciting and worthwhile educational process.
4
AO Dialogue  1|14
An interview with AO President Olga Harrington, AO Dialogue
a variety of themes not only related to medicine but also of importance to understanding the complex world of economics, industry or politics as well as issues that touch personal or family life. This special platform is an opportunity for our Institutes to report on their projects and achievements in education, clinical investigation, research and our TK system. Special sessions will focus this year on how surgical skills are acquired and measured and the economic impact, while a talk o barriers to bringing ideas to the market will address the strategies of translational research. Our traditional parallel breakout sessions will bring this year attractive and novel topics such as: smart implants, smart surgeons; patient reported outcomes in the 21st century; avoiding random education planning and ethics in the AO Foundation.
Jaime Quintero at the Trustees Meeting 2013 in Lima, Peru
What is the significance of the annual Trustees Meeting? The annual Trustees Meeting is an essential part of the cycle of our organization. It allows for the mixing and interaction of members of the different clinical divisions which enriches the discussion about the present challenges of the AO Foundation. Past Presidents and Honorary members represent the vast experience and knowledge of the history of the AO which is essential to understand the coming trends and the changes that the AO will face in coming years. It is extremely important that this global organization meets regularly in one of our regions to give our Trustees the opportunity to understand relevant cultural or historical aspects of interest. Having attended 25 Annual Trustees meetings I have many excellent memories of the cultural and medical lectures and keynote speakers that provided
Our closing session this year is dedicated to a premier of a video made by my colleagues in the AO which elaborates on a very special topic that is crucial for the survival of the AO Foundation—the AO fellowships. These are the gateway to the AO world and our best tool to welcome young talent into the AO Family.
What has been the highlight of your AO Presidency? One of the greatest highlight has been the AO people: I have received the full support and trust of my AOFB colleagues, who have offered good advice and strong loyalty. I have an open and permanent relationship with the clinical divisions, with our CEO and the members of the AO Executive Management. I am also proud of the collaborators in the different institutes and units in Davos and Dubendorf who are really committed to the AO. For me the AO people
5
AO Dialogue 1|14
Jaime Quintero also include all the hundreds of colleagues I have met in dozens of trips to several regions and countries to attend conferences, celebrations, regional events, courses or meetings. The important strategic and innovative projects that are currently running (AO Strategy Fund and AO Alliance) are another great highlight of my presidency. The Strategy Fund has been created to support priority projects and programs, which will focus on new innovative initiatives to improve the relevance and importance of the AO and foster cross divisional cooperation, amongst other criteria. One of the topics that will create a lot of impact for the future reputation of the AO Foundation is the AO Alliance Initiative, which after the successful breakout session in Lima has continued to evolve. The AO Alliance is a Foundation for the Less Developed Countries that will continue to build on the extraordinary work of AO SEC but with a new funding concept, including third party funding and new strategies and initiatives. Continuity is essential in the development of these and other projects and I was very happy that Rolf Jeker was reelected for a second by the AOFB. My successor as President of the AO Foundation, Suthorn Bavonratanavech, will be supported by a highly-competent and professional CEO and a most dedicated AOF Board.
What has been the greatest challenge of your Presidency? I took over the Presidency of the AO Foundation in 2012 in complex times. A new industrial partner and a difficult General Assembly left our members and collaborators with open questions and some uncertainties. The Research and Development Review, which began in 2011, had highlighted problems such as multiple sources
for research funding, no clear and visible research strategy, no research registry, among others. As a consequence of the review the Academic Council, the Exploratory Research Board and the AOCID advisory Board were all ceased, a new Research and Development Platform was created, and two new smaller committees were formed—the AO CID Advisory Committee and the ARI Advisory Committee. With respect to the governing side the Trustees also approved the cessation of the Partnership Coordinating Board and the Presidential team. Another challenge was to welcome our new partner DePuy Synthes (DPS) and make the relationship work for both parties. There have been fruitful discussions and negotiations which have contributed to the launch of pilot projects such as AONeuro and AORecon as well as a restructuring of the AOSpine portfolio. All of the above have led to extensive travelling, meetings in different parts of the world, and prolonged absence from daily activities in my hospital and from my family. I very much miss my patients and my surgeries! But despite the challenges and adversities I foresee a brilliant future for the AO. We have four well-structured clinical divisions and well-positioned institutes that have adapted to the ever changing environment. During my travels I have met lots of very motivated people, ready to work hard towards achieving the AO mission. I wish my esteemed colleague Suthorn Bavonratanavech, who takes over the presidency of the AO in July 2014, the best of luck in shepherding the AO through the next two years of its illustrious life.
Holding the presidency’s key at the Trustees Meeting 2013 in Lima, Peru
6
AO Dialogue 1|14
From the Clinical Divisions
AOTrauma A solid international reputation, dedicated to improving patient care with traumatic injuries AOTrauma’s activities remain focused on delivering knowledge in trauma and orthopedic surgery. In 2013, over 23,000 surgeons and ORP globally participated in 329 AOTrauma courses for surgeons and 57 courses for ORP. For 2014–2016, the shift will be from governance and efficiency to innovation and compliance. The changing landscape of professional medical education, the complexities of performing valid and valued clinical research and maintaining our independence will challenge AOTrauma’s delivery model while making it stronger and better positioned for the years to come. Expanded AOTrauma Fellowship Program As the highly popular fellowship program had been operating unchanged for over 40 years, the AOTrauma Education Committee (AOTEC) launched a project to determine how it could be enhanced. The following changes will be implemented in the program: • • • • • •
Regionalized decision-making New “Visit the Expert” fellowship (for experienced surgeons with a clearly defined fellowship goal) Variable stipend Modified selection criteria—trauma must represent an important part of practice New online verification process for host centers New online application and selection process for fellows
mission, contributed over CHF 270,000 to the Country Chapters. For 2014, countries were required to submit their projects to the Commission, which then reviewed and approved the activities. This has provided the necessary transparency and accountability needed to continue this much-appreciated “tradition” within AOTrauma. It affords many of the smaller countries the necessary financial resources to foster and maintain the AOTrauma network. AOTrauma has committed in its mid-term planning to continue this worthwhile initiative, despite financial pressures. AOTrauma Breakout Session 2014 The World Café 2013 gave us the necessary content for the exchanges that mattered. In the AOTrauma Breakout Session 2014, Part 1, the AOTIB Chair and Chair-elect will update the AO Trustees on the results, on the progress made and the way forward. It is vital to maintain ongoing discussions and sharing of knowledge around key issues of relevance to AOTrauma and the AO Foundation. The timing is pertinent as AOTrauma approaches a planned handover in governance. This leads into Part 2: What’s your Gobi—overcoming adversity, managing change. Guest speaker Stéfan
Fellowships
Expanded AOTrauma Fellowship Program: The new AOTrauma Fellowship Program targets surgeons
Danis (Chief Talent Officer & CEO at Mandrake) signed up for a 250-km unaided foot race called the Gobi March in China in 2009 without a running history. Numerous leadership lessons are explored highlighting the triumph of mind over matter and details of failures we bring upon ourselves. The presentation delivers great motivation for all on overcoming obstacles to reach personal goals and business objectives. Therein lies the link to Part 1…
Giving back to the Country Chapters AOTrauma is the only clinical division that directly financially supports the Country Chapters. In 2013, AOTrauma, through the Global Community Development Com-
AOTrauma International Board members Back (left to right): Kodi Kojima, Hazem Azeem, Nikolaus Renner, Klaus Dresing, Rami Mosheiff Front (left to right): Michael Baumgaertner, Mauricio Kfuri, Stephen Sims, Frankie Leung
7
AO Dialogue 1|14
From the Clinical Divisions
AOSpine AOSpine World Forum for Spine Research success in Xi’an, 2014 On May 15-17, 2014, more than 200 registered participants (among these many surgeons, engineers, scientists, veterinarians and invited speakers) from 35 countries gathered in Xi’an, China, to exchange knowledge on the recent advances on the intervertebral disc during the fourth World Forum for Spine Research (WFSR). AOSpine Annual Global Spine Congress, Buenos Aires, 2015 Following on from the success of the previous Global Spine Congress (GSC) in 2013 in Hong Kong, the AOSpine International Board decided in 2014 that henceforth this event will take place annually as an important step towards academic recognition. This annual congress provides a great opportunity for interaction between participants during parallel scientific sessions and symposia which are delivered by distinguished spine specialists from around the globe.
World Forum for Spine Research, Xi’an May 2014
Save the date
The fourth GSC, which will take place in Buenos Aires, Argentina in May 2015, will be a truly global event offering participants the opportunity to experience a stimulating and innovative environment and forge friendships with peers worldwide. The Congress represents a unique academic platform that is open to all surgeons, spine practitioners and researchers and offers an exciting program of outstanding scientific quality, presenting the very cutting-edge of spine care and featuring the world’s most renowned faculty.
Global Spine Congress 2015 May 20–23, 2015 | Buenos Aires, Argentina www.gsc2015.org
organized by
AOSpine Annual Global Spine Congress and World Forum for Spine Research, Dubai, 2016 The GSC and the WFSR will take place together as an integrated event in Dubai, Saudi Arabia in 2016. AOSpine organizes the annual GSC and the WFSR as unique global events which aim to educate, stimulate debate, and advance the field of spine care. Clinicians, researchers and colleagues from all spine care disciplines highly appreciate these platforms to present the latest results of their clinical studies and basic research to a truly global audience. Both GSC and WFSR are where the global spine community meets, where new connections are made, and where emerging technologies are presented. These events are peer-reviewed and supported by multiple sponsors.
The Global Spine Congress heads to Latin America, join us! The Executive Committee of the Global Spine Congress 2015 would like to invite you to attend the fourth edition of the GSC, which will take place in Buenos Aires on May 20-23. Following the success of the previous GSC in 2013 in Hong Kong, the format of the congress will encourage interaction between participants, both with parallel scientific sessions and symposia delivered by distinguished spine specialists from all over the world.
Abstract submission opens: July 2014 Registration opens: August 1, 2014 Executive Committee
Jeff Wang Chair
Germán Ochoa Scientific Chair
www.gsc2015.org © 2014 AOSpine International. All rights reserved. E & OE.
Michael Grevitt Scientific Co-Chair
Marcelo Gruenberg Local Host
organized by
Ernesto Berusky Local Host
8
AO Dialogue 1|14
From the Clinical Divisions
AOCMF Clinical Priority Program Imaging and Planning in Surgery (CPP IPS) Following the decision that the AO Foundation should focus its research activities in four clinical priority programs (CPPs), the AOCMF International Board decided in 2005 that AOCMF’s CPP should be developed around “Imaging and Planning in Surgery” in order to promote relevant, highquality research in this field. Imaging and Planning in Surgery: A Guide to Research The Board decided that it needed a document to launch this research program and in March 2006, Imaging and Planning in Surgery: A Guide to Research was initiated. Its two editors, Adrian Sugar and Michael Ehrenfeld, set about creating a guide to the state-of-the-art in imaging and planning in surgery, together with a comprehensive review of the existing literature. In contrast to other CPPs, it was intended to be a very open approach to this field. Twenty four authors, chosen on the basis of their own research record and expertise, were asked to summarize the state-of-the-art in their designated field with up-to-date literature. Some of the authors have been involved with AO for many years and their work on
this subject is well known and recognized. Others were not connected to the AO but are recognized internationally as experts and researchers in these areas. Imaging and Planning in Surgery: A Guide to Research was completed in May 2009. Program Committee chaired by Anders Westermark At the same time, a subcommittee of the AOCMF R&D Commission (the CPP IPS Committee) was established to coordinate and supervise the program, and a first call for proposals was launched; a second call followed in 2010, with a third and final call for proposals in 2011. Second and final conference to be held in September in Prague The 1st AOCMF Conference—Imaging and Planning in Surgery took place in May 2011, Freiburg (DE) with Michael Ehrenfeld, Adrian Sugar, and Anders Westermark in attendance. The second and final conference will be held on September 22, 2014 in Prague (CZ). This global research forum, where over 20 global researchers will present their project results, has been designed for those involved and interested in imaging and planning in surgery.
Excellent research with significant results has been generated, creating a pathway for future researchers and providing a source of knowledge valued by practitioners across the world. During the conference participants will have the opportunity to benefit from diverse presentations and active discussions by sharing and hearing the final research results achieved within the CPP IPS, referencing 3D software, digital workflow, virtual planning, prediction techniques, advances in 3D, MRI, CT, and laser scanning. A highlight of this conference will be the keynote speech by James LeFanu, doctor, columnist, social commentator and historian of science and medicine who will share insights from his book on The Rise and Fall of Modern Medicine with the audience. This conference immediately precedes the XXII Congress of the European Association for Cranio-Maxillo-Facial Surgery (EACMFS) in Prague and during this week AOCMF also offers three courses and a symposium. For course details and to register please go to www.aocmf.org.
The 1st AOCMF Conference—Imaging and Planning in Surgery in May 2011, Freiburg (DE)
9
AO Dialogue 1|14
From the Clinical Divisions
AONeuro Initiative A Cranial Neurological Sciences Initiative of the AO Foundation AONeuro is a unique worldwide multispecialty community that includes cranial neurosurgeons, neurologists, neuro-intensivists, neuro anesthesiologists, neuro traumatologists and neurological professionals who are involved in cranial brain trauma, cranial oncologic and cerebrovascular surgery, cranial reconstruction and cranial congenital anomalies surgery. AONeuro arose out of the interests of members of the TK Expert Group in creating an AO organization which would stimulate international collaboration and treatment progress in the cranial neurological sciences. The AO Cranial Neuro Faculty initially dedicated themselves to improving patient care for those who have suffered a devastating traumatic brain injury (TBI). TBI is an area of profound complexity, and one desperately in need in global health improvements. Literally millions suffer the injury annually. It is an injury that has the potential to disable working individuals, and in doing so may devastate an entire family, in fact it is the number one cause of permanent disability among working adults. Rapid and precise interventions
can dramatically change outcomes, and the worldwide scope and resources of the AO Foundation are especially well organized to communicate this information on a global scale to a wide variety of neurological professionals. Once TBI injuries occur, rapid transportation and evaluation allow early patient evaluation and stabilization, and permit classification of the injury according to a group of parameters. Then, programs are instituted which often utilize intracranial monitoring to guide treatment actions to control harmful sequelae like increased intracranial pressure, hypoxia, and hypotention. These programs minimize the primary injury by supporting remaining brain metabolism, and prevent additional secondary brain injury. Increasingly, multimodal monitoring is utilized to better understand this complex injury in the most complicated organ—the brain. Finally, decompressive craniectomy can be performed to relieve elevated intracranial pressure that is unresponsive to medical treatment. The large bone flap removed is stored in situ or frozen, then returned at a later date when the intracranial pressure has reached safe levels. Rocco Armondo gives excellent discussions of these advances in two lectures which are available on
the AONeuro pages on the AO Foundation website. The initiative also has resources directed at prevention of concussions and head injuries, especially as a result of sporting activities. Stephen Lewis gives an excellent overview of this topic on the AONeuro pages. Simple solutions such as wearing a helmet can prevent 75% of impact head injuries in bicycle accidents—the most common cause of head injuries to males in sport. You do not need to lose consciousness to suffer a concussion; there much discussion about taking players who suffer a concussion during a game off the playing field, and the relationship between chronic repetitive concussions and late organic brain injury. Geoffrey T Manley is also involved in leading TRACK-TBI (Transforming Research and Clinical Knowledge in Traumatic Brain Injury), an international research study that seeks to improve the classification of TBI by identifying new imaging, proteomic, and genetic biomarkers. We hope you will join your AO colleagues in supporting these deserving educators and potential partners as they seek to develop and establish their role in the AO Foundation.
Stephen Lewis teaching at the Davos Courses
Rocco Armondo teaching at the Davos Courses
Geoffrey T Manley teaching at the San Francisco Neuro Surgeons Trauma Course
10
AO Dialogue 1|14
From the Clinical Divisions
AOVET
Small Animal Courses in South Africa In 2012, the first AOVET Course—Principles in Small Animal Fracture Management chaired by Fredrik Danielsson (SE) and Marthinus Hartman (ZA) was organized in conjunction with the 11th World Congress of Veterinary Anaesthesiology at the Cape Town International Convention Centre (CTICC). The course was very well received by the 60 participants—a waiting list of 20, dispelled any concerns that the courses places might not be filled. With a lot to live up to since its first success, AOVET is organizing two courses in Cape Town on September 15-18, 2014. The first AOVET Course—Advances in Small Animal Fracture Management will be chaired by Rico Vannini (CH) and Marthinus Hartman. The second AOVET Course—Principles in Small Animal Fracture Management will again be chaired by Fredrik Danielsson and Marthinus Hartman. Bruno Peirone (IT), Günter Schwarz (AT), Claudio Venzin (CH), Richard Whitelock (GB), Gert Coetzee (ZA), and Greg Irvine-Smith (ZA) are the faculty members who will be delivering the courses. First Equine Webinars The first AOVET Equine Webinars to be transmitted on June 20, 2014 will deal with the fracture management of the head region. Part I: Mandible—what can be done? Jörg Auer and Anton Fürst (CH) will discuss principles of minimally invasive fracture repair,
present the outcome of data evaluating differences between minimally invasive and traditional fracture repair, and show clinical cases using minimally invasive fracture repair to demonstrate decision-making, application and outcome. After the webinar, participants will know different techniques for the fixation of mandible fractures, and how to use the locking compression plate for the fixation of complicate mandible fractures. The second in the series of Equine Webinars (Part II: Skull—what can be done?) is planned for September 26, 2014. Insights Vet—Everything Veterinary in one place In 2013, AOVET and Medical Insights AG teamed up to bring everything veterinary in one professionally designed iPad app: Insights Veterinary (also referred to as Insights Vet). After its successful launch at the Davos Courses 2013, the iPad app had been downloaded over 2,500 times in the first quarter of 2014. On June 3, version 1.1.0 was released, introducing new functionalities. With the Medical Insights’ Institutional Full-Text Access, users may now use their library login credentials at their Institution or University to get immediate access to the full-text of articles most relevant to them. Through Journal Club partnerships from around the world users can see what others are reading and the Insights Vet event calendar helps users find and plan for the events, courses, seminars and congresses of their interest.
11
AO Dialogue 1|14
From the AO Institutes
AOCID
Participants on the Roadmap to Research course in Seoul discussing clinical research with Beate Hanson
Providers of clinical research education AOCID has a long tradition of offering specialized courses in clinical research. The Roadmap to Research course developed by AOCID Director Beate Hanson was the first. This course, available in a variety of formats, has been given to thousands of surgeons across the world since its premiere at the AO Davos Courses in 2003. It is the first brush with evidence-based medicine for many attendees. The underlying principles are universal—roadmap courses have already been given in Australia and South Korea this year. Attendance at a Good Clinical Practice (GCP) course is a legal requirement in many countries for surgeons who wish to conduct clinical research. AOCID has offered a Swissmedic accredited GCP course since 2011. The next GCP course will be run in Prague (CZ) in September on behalf of AOCMF. Interested parties should visit the AOCMF website for more information.
In 2012, AOCID launched its annual three day course for study coordinators. The concept grew out of previous shorter courses offered and AOCID’s excellent experience in dealing with study coordinators on clinical investigations. Registration is open for this year’s course at the Queen Mary Hospital in Hong Kong from 2–4 October 2014. The AOCID Clinical Research Fellowship program was established with the goal of allowing surgeons to train in all phases of clinical research (study planning, monitoring, data analysis and publication). This three month in-house fellowship is quite unique and places are highly sought after. The fellows so far this year have come from Argentina (Luciano Rossi, AOTrauma) and India (Aijaz Naik, AOCMF).
AOTrauma sponsored event was very much a hands-on course with participants able to work on and improve their grant applications with the assistance of the experienced faculty members. AOSpine requested a new Study Set-Up course which was given for the first time in China in May. The goal of this course is to impart the necessary know-how, theoretical and technical, needed to start a clinical investigation. AOCID is currently working on an AO Medical Writing course which is expected to be launched in the near future. Publication of a clinical study is often underestimated. This course will equip surgeons with the building blocks required to create a scientific publication.
New courses in 2014 The AO Grant Writing course was given for the first time in Prague in January. This
It is also possible to book all of these courses for your own institute or event. More information can be found on www.aocid.org.
12
AO Dialogue 1|14
From the AO Institutes
ARI
Dr Ursula Menzel from ARI shows cells in a cell culture flask to the BioBone workshop participants.
Participants at the trauma course for engineering students at ARI
Hands-on training for engineering students and biomaterials scientists Two educational workshops were organized at ARI in 2014, both providing a combination of lectures with practical training in cell biology, tissue engineering, fracture treatment and skeletal repair. Trauma course for engineering students Students from the Swiss Federal Institute of Technology Zürich (ETHZ) and the University of Applied Sciences Winterthur (ZHAW) joined the popular trauma course. The goal of this two-day course, organized by Dr Sibylle Grad and Christoph Sprecher under ARI Director Geoff Richards, is to provide insight into the principles of fracture treatment and current ARI activities. Instructed by Dr Jan Benthien from the Davos hospital, Dr Raphael Jenni and other qualified surgeons, all the future engineers operated on artificial bone models using
typical surgical instruments, by creating and fixing various fractures with accurate implants. This osteosynthesis exercise is a highlight of the course, combining surgeon’s expertise, biomechanical understanding and manual skills. The course also involved instructive lectures and guided tours through the ARI. Ultimately, the course demonstrates the connection between biomedical and technical sciences, which are increasingly required for engineers focusing on medical technology. Workshop “Cell-material interactions” The “Cell-material interactions” workshop was organised by Dr Marianna Peroglio, Christoph Sprecher and Daniela Schraner as part of the European FP7 project BioBone (bioceramics for bone repair). Ana-Maria Stanciuc (PhD student, ARI) and Elena Littmann (PhD student, Imperial College London) led young scientist events. BioBone is funded by the FP7 initial training
network (ITN) Marie Curie Actions, and the ARI work package is led by Prof Mauro Alini. The goal of this workshop was to teach engineers basic principles of cell-material interactions. A balance of lectures and practical exercises made the workshop (application of osteosynthesis principles on synthetic bones and cell biology concepts demonstrated in the laboratory) attractive to the participants. Prof Geoff Richards gave an inspiring talk on the influence of implant surface in trauma, and renowned invited speakers—Dr Rainer Detsch (University of Erlangen-Nuremberg, DE), Dr Marcy Zenobi-Wong (ETH Zürich, CH) and Dr Daniel Hartmann (University of Lyon, FR)—shared their views on bone, stem cells and extracellular matrix. Clinical and industrial perspectives were integral parts: Dr Jan Benthien introduced osteosynthesis principles and Dr Alan Porporati (Ceramtec, DE) explained bioceramics for hip implants.
13
AO Dialogue 1|14
From the AO Institutes
AO Education Institute
All AOTrauma resources are accessible for reference during the case reviews and provide a deeper insight into the topic.
Expert AO faculty members present cases in a highly interactive way. Users are invited to answer questions and to draw their own conclusions and decisions.
AOTrauma STaRT goes online—The AO eLearning hub for residents After almost three years of work the new online learning and assessment hub for orthopedic residents is launched in June 2014. Following an intense needs analysis conducted with focus groups of orthopedic residents in Latin America (BR), Europe (DE), and Middle East (SA) the AOTrauma Education Commission decided to invest in an online environment that matches the evolving educational needs at a distance. Matching the eLearning needs All three groups identified interactive case discussions and multiple choice tests as their preferred ways to learn and prepare for their board exams. There was also a desire to use audiovisual media, access the learning hub during downtime in the hospital and interact at their own pace. In addition the groups felt that a structured access to all AO educational resources (videos, recorded lectures, surgery
reference) in the context of the learning experience would be of highest benefit. Based on this input AOTrauma STaRT (Surgical training and assessment for residents) was born as an independent platform, accessible free of charge with registration. International editorial teams The core content of the learning platform is delivered through interactive case discussions that are presented by AO expert faculty from all over the world. Facilitated by the AO Education Institute, surgeon teams from all continents contributed cases of differing complexity and added multiple choice questions to make them an educational experience. The learner can also test his or her knowledge by working through the multiple choice questions, simulating an exam situation. As a resource a comprehensive “AO Wiki” offers quick access to book chapters, videos, and additional learning modules in the context of the case library.
The multiple choice test questions can be run in a “quiz mode” to simulate an exam situation.
Educational research embedded The new platform will be launched gradually to ensure that bandwidth and technical infrastructure are capable of delivering at a user-friendly speed and with no technical issues. The launch will be closely monitored and the goal is to collect user data and feedback from the outset to learn about user preferences and usage patterns. This will allow us to adapt the platform immediately to the needs and preferences. AO StaRT will help us to better understand the learning needs of orthopedic residents and hopefully also serve as a platform for educational research projects. To access AOTrauma Start just enter http://www.aotrauma.org/STaRT in your webbrowser.
14
AO Dialogue 1|14
From the AO Institutes
AO Technical Commission (AOTK)
Plenary session at AOTK Strategy Retreat in spring 2014
The role of surgeons in today’s health care environment Should a medical company listen to doctors today? After all doctors have decreasing or even no budgetary influence in the decision making anymore. The clear answer is: Yes! Sure, we all notice that the decision making power regarding investments, negotiations with companies and suppliers, as well as budgetary allowances are shifting towards hospital administration. Still measurable quality of patient care, outcome and hospital reputation play an increasing role in a more and more competitive health providers market. Therefore the physician’s responsibility towards the patient and individual treatment decisions continues to play a crucial role for the entire treatment process, especially when taking ethics, liability and quality into account. Just like in the early 1960’s when Mathys or Straumann were “boutique companies” in today’s terminology, today other small
companies, based on individual physician’s advice and input, take over technology leadership in a remarkable number of sectors. This indicates that the “old” model still works under present basic conditions. An open question is how this direct, patient-triggered surgeon-company relationship can be transformed into the reality of a multinational, market-leader company’s environment with a global perspective. AOTK Strategy Retreat 2014 The merger of Synthes with DePuy companies in 2013, as well as rapidly changing conditions in healthcare systems all over the world led to a gap between the expected needs, as seen by the medical specialists within the AO TK System, and the reality of development capacities and support. Consequently an extraordinary meeting of the AOTK Chairmen and additional key opinion leaders was set up this spring to explore the reality of the healthcare environment as seen by practicing medical specialists to-
gether with possible forecasts of needs and directions under a worldwide and specialty specific view. The format of the meeting provided a free exchange of thoughts and the formulation of concrete proposals, free from current organizational limitations. A structured group discussion included given topics (healthcare environment, market/technology leader obligations, and crossover opportunities) and self-generated topics. The findings were discussed and structured in plenary sessions, including cross specialty and regional needs and possible short and midterm forecasts. As always, please contact the publication’s editors for comments and feedback at AOTK@aofoundation.org.
Plenary session at AOTK Strategy Retreat in Impressum AO Dialogue 1|14 Editor-in-Chief: James F Kellam Managing Editor: Olga Harrington Publisher: AO Foundation Design and typesetting: Manuel Kurth Editorial contact address: AO Foundation, Clavadelerstrasse 8, 7270 Davos, Switzerland Phone: +41 81 414 28 14 Fax: +41 81 414 22 97 E-mail: dialogue@aofoundation.org www.aofoundation.org Copyright © 2014, AO Foundation, Switzerland
All rights reserved. Any rep roduction, whole or in part, without the publisher’s written consent is prohibited. Great care has been taken to maintain the accuracy of the information contained in this publication. However, the publisher, and/or the distributor and/or the editors, and/or the authors cannot be held responsible for errors or any consequences arising from the use of the information contained in this publication. Some of the products, names, instruments, treatments, logos, designs, etc. referred to in this publication are also protected by patents and trademarks or by other intellectual property protection laws (eg, “AO”, “TRIANGLE/GLOBE Logo” are registered trademarks) even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name, instrument, etc. without designation as proprietary is not to be construed as a representation by the publisher that is in the public domain.