Table 2.
Costs of simulation training and assessment in the University of Toronto orthopaedic surgery residency training program before and after the implementation of the competency-based curriculum (CBC)*
| Type of residency training program (with total number of hours dedicated to simulation) | Cadaver specimens† | Artificial models‡ | Skills laboratory labor§ | Associated materials|| | Standardized patients | Total cost | Number of residents | Total cost per resident |
|---|---|---|---|---|---|---|---|---|
| Training program before CBC implementation (2008–2009) | ||||||||
| Teaching sessions (16 hours) | 1140 (USD 1259) | 0 | 2240 (USD 2473) | 6710 (USD 7408) | 0 | 10,090 (USD 11,140) | 12 regular stream | 840 (USD 927) |
| CBC residents separate from regular stream residents (2010–2011) | ||||||||
| Teaching sessions (255 hours) | 24,000 (USD 24,228) | 3440 (USD 3473) | 26,900 (USD 27,156) | 16,810 (USD 16,970) | 0 | 71,160 (USD 71,836) | 6 CBC | 11,860 (USD 11,973) |
| Evaluation sessions (102 hours) | 10,500 (USD 10,600) | 7200 (USD 7268) | 2450 (USD 2473) | 9690 (USD 9782) | 0 | 29,840 (USD 30,124) | 6 CBC | 4970 (USD 5017) |
| Total | 34,500 (USD 34,828) | 10,640 (USD 10,741) | 29,360 (USD 29,639) | 26,500 (USD 26,752) | 0 | 101,000 (USD 101,960) | ||
| CBC residents plus regular stream residents (2012–2013) | ||||||||
| Teaching sessions (215 hours) | 43,500 (USD 44,142) | 6110 (USD 6200) | 21,070 (USD 21,381) | 26,180 (USD 26,566) | 0 | 96,860 (USD 98,288) | 60 (14 CBC + 36 regular stream) | 1610 (USD 1634) |
| Evaluation sessions (102 hours) | 24,000 (USD 24,354) | 7140 (USD 7245) | 8270 (USD 8392) | 16,480 (USD 16,723) | 3000 (USD 3044) | 58,890 (USD 59,758) | 35 (14 CBC + 21 regular stream) | 4210 (USD 4272) |
| Total | 67,500 (USD 68,495) | 13,250 (USD 13,445) | 29,330 (USD 29,763) | 42,660 (USD 43,289) | 3000 (USD 3044) | 155,750 (USD 158, 050) | ||
* All costs are in Canadian dollars; †the cost of a cadaver specimen varied on the anatomic region required; for an isolated upper or lower extremity the cost was CDN 1500; for a whole cadaver the cost was CDN 26000; transport fees were CDN 355 per trip; ‡artificial bone models were purchased from Sawbones®, Pacific Research Laboratories (Vashon, WA, USA); soft tissue models were varied and involved pig skin from a pig limb (cost, CDN 30) or artificial models purchased from the Surgical Skills Centre, Mount Sinai Hospital (cost, CDN 24); §skills laboratory staff labor was CDN 45 per hour; part-time student labor was CDN 19.50 per hour; ||the cost of associated materials was variable and depended on what materials were used. For example, the cost of instrument resterilization was CDN 1,844.39, the cost of saw blades was CDN 54 per blade, the cost of renting a C-arm unit for a half-day session was CDN 1100; ¶standardized patients were paid CDN 30 per hour.