Evaluation of the Plastic Surgery In-Service Training Exam: Lower Extremity Questions

OBJECTIVE: To facilitate the training of plastic surgery residents, we analyzed a knowledge-based curriculum for plastic and reconstructive surgery of the lower extremity. DESIGN: The Plastic Surgery In-Service Training Exam (PSITE) is a commonly used tool to assess medical knowledge in plastic surgery. We reviewed the lower extremity content on 6 consecutive score keys (2008-2013). Questions were classified by taxonomy, anatomy, and subject. Answer references were quantified by source and relative year of publication. RESULTS: Totally, 107 questions related to the lower extremity (9.1% of all questions) and 14 questions had an associated image (13.1%). Questions required decision making (49%) over interpretation (36%) and direct recall (15%) skills (p < 0.001). Conditions of the leg (42.1%) and thigh (24.3%) constituted most of the questions. Subject matter focused on flap reconstruction (38.3%), nerve injury (8.4%), and congenital deformity (6.5%). Analysis of 263 citations to 66 unique journals showed that Plastic and Reconstructive Surgery (54.9%) was the highest yield primary source. The median year of publication relative to PSITE administration was 6 (range: 1-58) with a mode of 2 years. Plastic Surgery by Mathes et al. was the most referenced textbook (21.9%). CONCLUSIONS: These data establish a benchmark for lower extremity training during plastic surgery residency. Study efforts focused on the most common topics and references will enhance trainee preparation for lower extremity PSITE questions. (C) 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.