Prepare well to do well: revising for orthopaedic exams with BJJ LIFE

Listen to Andrew Duckworth, Emma Vodden, Shiraz Sabah, David Limb and Fares Haddad discuss preparing for your orthopaedic qualifying exams with BJJ LIFE, the essential orthopaedic MCQ resource from The Bone & Joint Journal.

Start your preparation today here.

Transcript

[00:00:00] Welcome everyone to our BJJ podcast series. I'm Andrew Duckworth and a warm welcome back to you all from your team here at The Bone & Joint Journal. As always, we'd like to thank you all for your continued comments and support, as well as offering a big gratitude to our many authors and colleagues who take part in our series, that highlights just some of the great work published by our authors each month.

But for this edition, we have a slightly different format to our normal monthly podcast in that we'll be discussing a new educational offering recently released by the society known as BJJ LIFE. I have four colleagues from the Journal joining me today, all of whom have been involved with the development and refinement of this, of this excellent platform.

So firstly, I have the pleasure to welcome back the keystone of our society, the amazing Emma Vodden, who is the Director of Publishing & Innovation here at the Journal and Society. Emma, great to have you back with us. Thanks Andrew. Great to be here. Joining Emma is one of our editorial board colleagues at the Journal and consultant orthopaedic surgeon at Stanmore, the superb Shiraz Sabah.

Shiraz. Thank you take taking the time to join us today. Thanks for having me. Thirdly, I'm delighted to welcome for the first time to our podcast series, Mr David Limb, who's not only the chairman of our council and on our editorial board here at the [00:01:00] Journal, but he is also the former chair of the FRCS question writing committee.

Great to have you with us, David. It's good to be here. Thanks. And finally, last but certainly not least, I have the pleasure of being joined again by our awesome Editor-in-Chief here at the BJJ, Professor Fares Haddad Prof. Great to have you back with us. Andrew, great to be here. Thanks for doing this. So

today we're gonna discuss this exciting new platform the Society has launched called BJJ LIFE. But I thought maybe, maybe Prof and Emma, I'll come to you guys first. And before we move on to the main focus of our of our discussion, I thought it might be useful for our listeners if we can maybe have some background on the role and names of the society, particularly with regards the difference between what many of us generically call the Journal or the BJJ, and how this relates to Bone & Joint Publishing in the society and Council.

So maybe Prof I'd start with yourself with that. Yeah, Andrew, thanks. I think it's a really important distinction that people lose out on, and I'm sure Emma will add some detail in a moment. But the, the society as a whole is a charity that is dedicated to orthopaedic educational, orthopaedic and musculoskeletal [00:02:00] education

worldwide, and that's why our focus has always been the, the whole breadth and depth of orthopaedics. That's, you know, at the core of that has always been the Journal. The, The Bone & Joint Journal is the, the key offering to differentiate high quality methodologically sound research from a lot of what we see out there in the, in the wider world.

But you know, as, as we've developed, there's clearly been a need for expansion within the society to increase our offerings. And that's started, if you like, with Bone & Joint Research so that we could focus the basic science and the basic research in one specific journal. And you know, Chloe Scott's doing a wonderful job heading that up at the moment.

We quickly realised that the attention span of the average orthopaedic surgeon is no longer what it was in David Limb's day. And so we've introduced Bone & Joint 360, which is sort of shepherded by Ben [00:03:00] Ollivere. And, and that is really a digest of what's out there. And more recently we've launched Bone & Joint Open as a open, a gold open access journal that really allows us to still

put out there papers that are submitted to us at the BJJ or in fact papers that are sent there directly. There are methodologically sound, but probably are not of the, the quality or the, the level of innovation that fits in within the BJJ. But then beyond that, we are in an ever-evolving world that is becoming more, more digital and where our, you know, community.

Which, this is the way I like to think of it, has greater needs. And that's where Mrs Vodden and the team have done a tremendous job with OrthoMedia to create a, an offering where meeting digests guidelines, all sorts of things can be housed in a way that are accessible to the average leader reader. And then OrthoSearch for the orthopaedic community to be able to search [00:04:00] orthopaedic-specific things. And, and just continuing with that theme, we then expanded to OrthoPublish and here we are now with BJJ LIFE. So really it's, it's all part of a an expanded role to fit in with our mission, that at the very outset was orthopaedic education.

Sorry, it's such a long answer, but I think it covers an evolution over a very long time of the work that Emma and others have done over the last 20 plus years. No, I, I think that's a, a great, a great overview Prof, and like you say, I think how it has evolved over time and really, like you say with always been the aim to serve our community, you know, and to serve the, our regional listeners.

And, and, and Emma, you've been very much at the forefront of that, and particularly with our latest innovations. Is there anything you'd want to add to that? Yeah, I think one of the things that really sets us apart and makes us so unique in the current kind of publishing landscape is the fact that we are a truly independent organisation and we are a charity.

You know, we are the only journal that's kind of left in that kind of independent space within orthopaedics. We don't, we are not [00:05:00] published by one of the big publishers like Elsevier and Wolters Kluwer. And I think that really is something that our community probably don't realise because one of the things that we can do is just focus on one specialty.

Whereas, you know, Elsevier's trying to please multiple different disciplines. And so what we've been able to do is provide tools that support our community in every stage of their career. Mm-hmm. And you know, I would say, you know, we are, we are not, we are not here for big profit, obviously we're here for survival, so we have to do it, we have to make money.

But you know, we are Bone & Joint and we are here for orthopaedics. And I'd say our motto is, how can we help? And that's genuinely where we start with, with everything that we're doing. Yeah. No, I think that's a hundred percent right Emma. I think with all the things that have been developed, particularly over the past, how to engage, you see how that is there.

And I think actually, like you say, it very much listen, seems to listen to the community 'cause you know, a lot of these offerings are because there's been a gap in the market or there's been something that the community has said. We need help with this and, and, and the Journal is incredibly, as the society is very good at responding to that.

And that sort of leads us [00:06:00] on well to the main topic of today, really, which is talking about BJJ LIFE. So Emma, if I start with you, how did this sort of idea come about? From, from feedback, basically we had, we had a lot of trainees who were kind of talking about the lack of a, of a revision tool that was aligned with the FRCS.

We did, we did an extensive research project. We spoke to lots of trainees, both in the UK and globally to find out what it was they wanted and needed from a platform like this. We used our expertise within the orthopaedic community and within, you know, the outstanding team that we have at Bone & Joint.

And we have developed this platform, which is an MCQ platform for trainees to revise for their qualifying exams, from the ground up. Yeah. And we've, we've, we've woven in all of the feedback from the, from the trainees where we can. Yeah. So, so what we've developed is a is a mobile on-demand flexible product that is designed for the busy trainee.

We've tried to make it easy to use on a commute or for those 10 minutes between [00:07:00] cases, you can quickly do some questions or indeed, when you are doing a longer revision session, you can sit at your desktop and, and use it and, and actually is optimised for how a trainee is, wants to use it at any given moment.

We've used a kind of layered approach. So the there are questions with explanations, expert audio commentary with links to evidence so that the users are engaged using different learning styles, which then obviously enhances the retention of that information. That's incredible.

And, and I think actually, like you say, it's all been built and, and developed from that feedback and that constant, that amount of information you've gathered from the community itself. Shiraz, if I could come to yourself sort of building what Emma sort of said there, you know, from your own point of view, where do you feel that that place is for BJJ LIFE in our community?

Because I think it, it really does have a big role, particularly at the earlier stages of our, of our career. Yes. So this was a a platform that's been developed by people who are interested in orthopaedics. Yeah. For people interested in orthopaedics. Mm-hmm. And [00:08:00] we've focused for now where you would expect on trainees coming through their orthopaedic programmes from around the world particularly those who like most of us, are cramming for their final exams.

But in the longer term, we're interested in developing an educational resource for anybody interested in orthopaedics. So this will be medical students coming through physiotherapy, students or people looking to revalidate or to refresh on a subject. Mm-hmm. And so for many surgeons, the intercollegiate FRCS is their final exam.

So that's certainly the case for the UK, for Australia, for South Africa and and New Zealand. But really we want this to be a platform that's relevant to orthopaedic surgeons and musculoskeletal health professionals. From around the world and until now, there hasn't been a high quality peer reviewed question bank that is necessarily relevant to worldwide orthopaedic practice.

So from my own [00:09:00] experience, I have used question banks from other suppliers and you know, that often meant going through a dozen or two dozen questions on Little Leaguer's elbow. Mm-hmm. Despite this not being something that I've ever seen in my practice or expect to see in my practice.

Absolutely. So. The other thing to say is that a lot of the other question banks out there ask you sort of simple recall type questions. You either know the answer or you don't. They're not really designed to test higher order thinking. Yeah. A lot of the questions that are on these other platforms are older questions where practice may have moved on.

It's not necessarily reflective of contemporary orthopaedics. Yeah. And so we wanted to develop a platform that was modern, that fit in with the intercollegiate FRCS, but had the potential to cover other orthopaedic curricula from around the world. Mm. We wanted the educational resources to tie in with the other platforms that we host within the BJJ.

So with the Journal itself, but also with videos from recent conferences such as with OrthoMedia, with our search engine in [00:10:00] OrthoSearch, we wanted a very convenient educational platform that people wanted to use, enjoyed using, can use in those sort of brief minutes between cases or when commuting to work that they can be interested in and will help them prepare for their exams, but beyond that helps them for the rest of their careers.

Yeah, no, I think that's a really, I. Nice. Like you say, it's, I think, like you said, there is obviously a target, you know, in terms of a key target in terms of the FRCS exam, but it is actually, there's a, there's a lot of information there and anybody who's interested in just learning it really is, it can appeal like all the way through, through that, your training and interest and, and like you say for allied healthcare professionals as well, I think there's a lot that you can, you can learn from the platform.

And David, if I could maybe come to yourself, you know, building on what Shiraz has just said, and obviously from your extensive e expertise in developing, FRCS questions, you know. You know what makes a good question and, and, and like, he's like Shiraz has pointed to FRCS questions have a unique form to them, don't they?

It's not just about the regurgitation or, or, or, or [00:11:00] memory from what you've revised. Abso absolutely. The the exam is designed to, to see that you're a safe to practise in the generality of orthopaedics and trauma. It's not just a test of knowledge, it's a test that you can use that knowledge and apply it to clinical situations.

So, so we don't look at level one questions, the factual regurgitation questions. Yeah. So what, what makes a good question, various aspects to it. It, it has to be relevant and important to practice. So it has to relate to things that are common, where mistakes are commonly made and have consequences, but it also relates to

rare things that you mustn't miss, that you must pick up, you must be able to investigate, manage, and hand on properly. So, so there's a, there's an aspect to it about the curriculum and what you set it to. And, and I would add that many of the ones from around the world, many, many, many orthopaedic training programmes around the world don't actually have a curriculum.

They just learn. Yeah, what they need to know in [00:12:00] orthopaedics without a, a structure to build it on. So, so we need to set it to a curriculum, but also coming back to the, the, the knowledge that's tested. These are multiple choice questions, but there are specific, sort called single best answer questions. And what that means is that, and it can be quite confusing when you meet them for the first time, and, and god forbid if the first time you meet them is in the genuine exam because.

In a single best answer question, you, you have to look at the information that's presented. Mm-hmm. And you look at the choices and all of those choices can be correct in a really well-written question. All of the answers you're presented with could be correct. But you're looking for the one that is the best answer based on the information that you're provided with.

Yeah. And that information may be information that you need to work with to derive the best answer, or it may actually be incomplete. Yeah. So it relies on you having some of that knowledge that we are not testing in your [00:13:00] memory banks to be able to supply it, to use with the information in the question, to, to work out the answer.

So, so, so the, the good FRCS question really is an educationally good question that, that relies on you working with knowledge, not just regurgitating knowledge. And, and that's where some of the other aspects that we touched on already with BJJ LIFE can really come to the fore because, because unlike the exam, which is summative, you just sit it, you get your result, in BJJ LIFE

you can then have feedback, you can look at the information behind in it will link into the other aspects the other electronic products upon which it is built. Yeah, no, I totally agree. David. And, and like you say, I think that's a common thing you, you sort of hear, and you know, I'm, I'm sure I was the same at the beginning of

when you start to do these, these questions, you think actually, well, three of that five could be right. But it's, you know, you've gotta, you've gotta adapt it and, and, and as you say, apply your knowledge I think is really important. And Shiraz if [00:14:00] I could come back to yourself, you know, with that sort of in mind, how did your, you guys go about developing these questions so that they were, like, David has described, you know, reflective of that FRCS type style.

The first thing we looked at was the breadth of questions that would be needed to cover the curriculum. And so we're quite fortunate in the UK that the trauma and orthopaedic curriculum has been quite nicely mapped out. And so the first exercise we did was to map out the orthopaedic curriculum against a taxonomy that we developed within BJJ

to support platforms like OrthoSearch and these two projects tied in very nicely. We then recruited surgeons and trainees from the UK, but also across the world to identify the topics that were really relevant for the exam. We then recruited question writers and trained them to write FRCS-style questions.

So this involved teaching sessions from people like David Limb to explain, you know, what was necessary to develop an FRCS type question. And then each [00:15:00] question was peer reviewed, usually by an expert in the field and revised until we were happy with it. And we tried to mirror the same set of standards that you expect from the Journals.

So if you send a manuscript in, you expect to receive it back with corrections after peer review. And the same was true for each question and each explanation that was sent into BJJ LIFE. Mm. So as we've said above, nearly all the questions in the bank now are designed to test higher order thinking and current relevant orthopaedic knowledge rather than simple recall.

Yeah, absolutely Shiraz. And in terms of, you know, you've alluded to already, I mean, it's amazing the amount of work like you've described, just going even into a single, single question there. But you know, apart from the sort of questions that are on there, what are the other sort of unique features of the platform that you'd listeners would, you'd like our listeners to really know about?

So as we've said earlier that this, the question bank is the first part of this educational delivery from BJJ LIFE. Already we have things like 'Expert Insights'. So these [00:16:00] are, we know it's pretty dreary going through question after question in preparation for an exam, so we're trying to make

learning interesting. We're trying to impart facts and ideas that students and trainees can take through for the rest of their careers. So where relevant we've got an expert to provide their insight into a question to indicate which answers are correct and why others are not correct. This will mean you'll hear Professor Haddad talking about robotic knees.

Matt Costa explaining about clinical trials. Dan Perry updating you on the latest practices in children's orthopaedics. So there are these little Easter eggs or Christmas crackers after, you know, each question to try to maintain your interest and you know, kind of keep it going from one question to the next.

Absolutely. Absolutely. And, and David, if I sort of come back to you with that, you know, in for your experience of the platform now, and I think we should probably say as well, I'm, I'm sure Emma might mention it, is that it is continuously evolving, isn't it? And there is continuous feedback that we get from the people using it.

Do you [00:17:00] feel that, you know, you've obviously looked at a lot of questions in your time, David, do you feel this is one of the most, if not the most reflective of, of that type of question that is on there? Oh, absolutely. I, I, I mean the. One of the beauties of the intercollegiate exam is that it evolves. The, the questions that you sit in an exam are not necessarily, well, they aren't all used to derive the mark because the performance of the questions in the exam is reviewed, and only good performing questions are used for your final mark.

And in the same way BJJ LIFE can look at the user statistics, look at the feedback from within. Evolve questions and evolve the feedback that we give with them as well. So I think the way that they are written and the way that Shiraz has developed this is, is so, so like the intercollegiate exam that they, they, they, they are equivalent

if you are revising for the FRCS ortho exam, then you are using the right sort of questions if you're using BJJ LIFE for it. [00:18:00] And I think it also reflects practice in the UK and Europe, better than some of the offerings that are available that are based on healthcare systems where you might need to be a practice manager as well as an orthopaedic surgeon.

So the questions you get are about the practice of trauma and orthopaedic surgery. And, and so I would add that with my European experience, the EBOT exam is, is evolved from the intercollegiate exam. And I think it is a perfect platform for for not just the UK, not just Europe, but most of the world.

That that's, that's really interesting, David, and really, really reassuring. And I think before we sort of wrap up, Emma, if I could come back to yourself, you know, we've mentioned it a little bit already, but where do you see and the platform sort of developing and evolving over the next few years?

What are your hopes for it? Well, I'd like to see it become, you know, the go-to revision tool as a, as the primary aim across the world. You know, right now we are focusing on expanding the [00:19:00] question bank to make sure we're really secure in the, in the breadth and depth. We are obviously focusing on getting more and more Expert Insights onto the question bank.

'Cause they're, you know, they're really popular already. We were lucky enough to launch just before the November exam, and we've already had some positive feedback from candidates that used it. Obviously, they don't know whether they've passed yet, but they, they've, they've been positive in terms of their experience of using it.

That's one of the things that's really valuable, I think with the way that we work and being kind of positioned as we are, you know, the feedback we've had so far have been, you know, some of it's been requests for new features. Some of those are already live. Others are already being worked on. So we are, we are really lucky we can be adaptable and kind of try and make it as useful as possible.

You know, we've got big plans for this platform but I can, I can guarantee that one thing we'll be doing is evolving it with the needs of the, of the trainees to, to try and help them as much as we can and support them in their in their endeavors whilst then looking further ahead to kind of help support the orthopaedic surgeon as [00:20:00] they move through their practice.

Yeah, that's, that's incredible. And I, and I have no doubt it, it will evolve as, as the years go on. And maybe just to sort of, as we start to wrap up, I'm just gonna ask my three clinical colleagues on the call. Just if you could give, I'll start with, with you, Shiraz, then David, then Ware, we'll finish up. If you could give your your your trainees or colleagues one piece of advice for the exam, what would it be?

Shiraz, I'll start with you. So many cliches around the exam that I try to avoid one or many of those. But the exam is all about preparation. Yeah. And BJJ LIFE is, you know, the perfect tool to prepare well for the exam. And if you prepare well then you will do well. You know, we are very keen to get people through their exams, but more than that, we're keen to support surgeons and other health professionals throughout their careers and this is the platform for that.

Excellent. And David. I, I, I think that things like BJJ LIFE should be used as a community because I think one important part of the exam that, [00:21:00] that is tested, that people don't realize is communication. And I think discussing answers with colleagues is often as a better way of learning than sitting down with a book.

Yeah. So I think that, that getting together with your mates. With your questions, your feedback and discussing them is an ideal way of preparing for the exam. No, I, I totally agree, David, and I think one piece of advice I would, well, maybe not advice but sort of insight it would be is I, I, I wish BJJ LIFE had been around when I had taken my exam because I think, like you have both described very well is actually a lot of the platforms out there are, are some use, but they're just not as reflective of, of the FRCS exam.

And I think this is really where BJJ LIFE comes into its own in terms of how it is so reflective of the exam and, and the content and the type of question we're trying to, they're trying to ask, but also the knowledge associated with that and how that is evidence. I think it, it really is key, Prof and if I finish up with you the same question in terms of advice, and then I'll, I've got one final question for you after that.

I think start early, work with [00:22:00] others and know what material to trust and you know, in, in, in reality, I think BJJ LIFE will, will deliver that because it's interconnected and will lead you to the key bits of the literature and opinions from those who actually understand the subject. Subject.

Absolutely Prof. I'm just gonna ask Emma, Emma wants to say one last thing before I let you wrap up. I did wanna say one last thing. So you don't often see the incredible amount of time and effort that goes in behind the scenes to these things, and I just wanted to pay a tribute to the incredible staff at Bone & Joint.

We are a small but mighty team, and BJJ LIFE has been a huge collaborative project across the whole society. We're also incredibly lucky to have some of the most inspiring and world renowned orthopaedic surgeons on our board. And they've been so engaged and helpful over the last 18 months of development that we couldn't have done it without them, obviously.

It's also important to acknowledge the contribution of Mr Babar Kayani who was instrumental in getting a great team of question writers together [00:23:00] and getting the getting the question bank together in the first place.

His contribution has been extraordinary and, you know, we are all truly grateful for that. 

And finally, to all of the trainees we interviewed our question writers, the peer reviewers, and our testers. We are forever grateful for your time and input and we probably aren't done with you yet. But thank you for your help so far. That's very nice, Emma. But I think, I think it'd be fair to say everybody on the call would agree that I think your leadership on it is, is everything actually and has directed it to where it is, is is now. Prof

if I could just maybe finish up with yourself. You know, we obviously talked about BJJ LIFE, but now just, just to summarise, you know, the whole Bone & Joint offering, now, you know what the platform that, as you described at the beginning of the community that is there and that we're developing, you know, you know, the amount of investment in time and money to develop these.

These projects and, and, and platforms. It's, it's really quite inspiring, isn't it? And I think really now it does offer something for everybody and for every need really in the orthopaedic community. You're spot on. You've, [00:24:00] you've kind of summarised it well. In reality, what we are trying to do is create something that serves anyone interested in orthopaedics anywhere in the world with a way of differentiating, if you like, call it truth, call it something you can trust from this information overload.

That is out there. Mm-hmm. And different people will engage with different parts of the offering, be that the journals or the electronic offerings, or the increasingly popular digital products. But I think BJJ LIFE is just one part of the bigger jigsaw that will continue to expand. As Emma said, we've got an incredible team at every level who are working hard, evolving, adapting, and just hoping to continue to serve our community as best we can.

Absolutely. Well, team, thank you so much for taking the time to join us. And congratulations to all of you, but particularly Emma and her amazing team, as we've said at the Journal. On another incredible addition to the society's offering. I I really do think they're catering for our whole community. And I think we should be very grateful for that.

And [00:25:00] I, I encourage all our listeners and particularly our trainee colleagues do take a look and I'd sign up as soon as you can 'cause I think it really does make a difference, particularly when you're coming up to the exam. And finally, to you all for listening, we hope you've enjoyed joining us. And thanks again for all of your support.

We really do appreciate it. Take care everyone.