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Annual Report 2018

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The AO is the world's leading education provider to health care professionals working in the fields of trauma and musculoskeletal disorders. Each year it offers over 830 educational events around the world, supported by nearly 9,000 faculty, and attended by over 58,000 participants.

With hands-on exercises, discussions, and a diverse range of courses covering key fields in trauma, spine, CMF, veterinary, and reconstructive surgery, the AO's flagship educational event, the AO Davos Courses, is a gateway to excellence.

Back to our roots

The AO's founders understood the importance of education as they developed a comprehensive new approach to fracture care and treatment.

Nurses during a lecture at the first Operating Room Personnel (ORP) Davos Course 1961

Education remains at the core of the AO's global work to improve patient outcomes. To date more than 600,000 health care professionals in over 124 countries have participated in AO courses.

In 2018, most events were held in Europe and Southern Africa, closely followed by Asia Pacific, Latin America, North America, and then the Middle East and Northern Africa.

AO education 2018
58,118 participants
832 educational events
22,311 faculty days
8,798 faculty—worldwide

The AO Davos Courses are its flagship educational event. It is there that participants from all fields have the opportunity to find out about the newest approaches to education, training, and treatment, meet leaders in their fields, and also to share experiences and learn from each other. People who have participated in AO courses around the world, come to Davos, Switzerland for an unforgettable experience that acts as a gateway to excellence in their field.

AO Technical Commission Meet the Experts at the AO Davos Courses 2018, Pitt Voss and Alexander Schramm

New generations, new challenges

Inspired by the rigor of the approach taken by the AO's founders 60 years ago, in 2018, AO Spine launched a major re-appraisal of its global activities and research, led by its new Chairperson Shanmuganathan Rajasekaran. It involves an assessment of what works and what can be improved or modified in order to deliver better results. By questioning underlying assumptions, AO Spine will ensure it is better able to meet health care professionals' needs.

Ongoing generational shifts give rise to several challenges as the AO works to remain relevant to today's generation, and future generations. One change is a decrease in institutional loyalty as people working in this area are more likely to take up training and education opportunities that respond to their interests and needs—wherever those opportunities lie—rather than being motivated by allegiance to a particular organization, society, or institution.

Curriculum development—by experts, for experts

Almost 250 expert surgeons from 22 clinical areas are now involved in various stages of curriculum development and implementation. Supported by four experts in the principles and methods of teaching from the AO Education Institute, these groups base all educational activities on addressing patient problems. They are responsible for defining the quality criteria for awarding the AO Competency-based Curriculum stamp to programs and for continuous improvement based on evaluation data.

Curricula under development in 2018:

  • AO Trauma (Residents, Orthogeriatrics, Pediatrics, Pelvis and Acetabulum, Foot and Ankle, Hand and Wrist, Upper Extremity, and Lower Extremity Educational Taskforces)
  • AO Trauma Intramedullary Nailing, External Fixation, and Infection Education Working Groups
  • AO Trauma and AO Recon Periprosthetic Fractures
  • AO Recon Hip and Knee Principles and Complex
  • AO Recon Shoulder Principles
  • AO Recon Joint Preservation
  • AO Spine and AO Spine Minimally Invasive Spine Surgery (MISS)
  • AO CMF (Management of Facial Trauma)
  • AO VET (Principles in Small Animal Fracture Management, Advanced Techniques in Small Animal Fracture Management)
  • AO Foundation Soft Tissue Initiative
  • AO AO Strategy Fund: Limb Surgery in Disasters and Conflicts
  • AO Foundation Imaging
  • AO Program for Education and Excellence in Research (AOPEER)
  • AO Alliance (Focused Courses)

Retaining a leadership position

For AO Spine to retain its leading position as an innovative educator in its field, it is imperative to provide the community with courses tailored to their changing needs. The recently launched diploma project, which involves creating curricula for lifelong learning, aims to meet these needs.

AO Spine Advanced Simulation Course, Minimally Invasive Cockpit Surgery, Degenerative Spine and Spondylolisthesis, Regional Course, Dubai, United Arab Emirates, 2018
In 2018 AO Trauma held
392 educational events involving 35,225 participants,
14,716 faculty days and
4,939 faculty.

To retain and enhance its position as a knowledge leader in its field, AO Trauma continued its move from certifying attendance to certifying proficiency in 2018, which means certifying that course participants demonstrate the required level of knowledge, skills, and attitudes.

The AO Strategy Fund supported the Pro-C: AO Trauma's Proficiency Curriculum project, which takes an evidence-based approach to teaching surgical skills and allows the AO to extend its leadership in orthopedic education to become the standard reference for skills teaching.

Everything AO Trauma does in education is based on the backward planning process of curriculum development to positively impact patient outcomes by addressing particular clinical needs: from applied to clinical research, quality control and education—as can be seen in the ongoing Clinical Priority Program.

Crucially, AO Trauma offers course participants the same high standard all over the world. In 2018, it improved these templates, introduced new exercises, changed modules and updated the formats offered. The curricula for both basic and advanced courses was updated, and a blended learning component was added to the basic principles course. As a measure to help maximize impact, AO Trauma increased the minimum duration of its fellowship programs from 4–12 to 6–12 weeks.

In 2018, AO Trauma continued the backward planning process for curriculum development, established education key performance indicators (KPIs), and assessed the technological landscape in search of new educational formats. This digital transformation will continue to be a major part of the AO's future in the coming years.

In 2018 AO Spine held
213 educational events involving 11,053 participants
2,516 faculty days and
1,644 faculties.

Many channels, one message

In the spirit of the AO's founders, the AO is constantly looking for new ways to reach its audience, improve patient outcomes, and enhance value for its community. This process of continual assessment and reassessment led in 2018 to several new approaches to traditional educational offerings.

In 2018, AO Spine expanded its use of webinars and e-learning to provide knowledge and adapted its face-to-face courses to more clearly focus on skills. This combination allows for an optimum learning experience for participants, ensuring everyone who attends the face-to-face courses has first had the opportunity to develop their theoretical knowledge, before they expand their skills. Feedback shows that this has been a success.

With the AO's dedication to digital transformation, the integration of virtual reality and simulation further into education will provide more opportunities to deliver and reinforce knowledge remotely, in conjunction with face-to-face course provision.

AO Foundation President Robert McGuire on AO's education highlights

In 2018, AO CMF prepared to relaunch the updated Management of Facial Trauma (MFT) educational concept. First launched in 2017, the MFT course has been a global success, with more than 2,000 participants receiving training in 60 courses across 32 countries. In 2018 the AO CMF Global Education Task Force comprehensively reviewed all MFT content in line with course feedback. The result is an updated and enriched MFT 2.0 that more closely responds to participant needs that will be made available to participants in 2019.

Faculty Education Program leading the way

The AO's Faculty Education Program (FEP) is a comprehensive and widely applicable professional education program designed to improve teaching skills. It is based on adult learning principles with an emphasis on practical implementation.

FEPs consist of a five-week online learning part, a one-and-a-half-day, face-to-face event, and an online follow-up. This promotes excellence in teaching and learning in a lecture setting, small group discussions, and practical exercises. In 2018, 30 programs were conducted in Chinese, English, German, Italian, Russian, and Spanish, by the Regional Education Teams (RETs) comprising two surgeon faculty and one AO-certified professional educator.

In addition, 128 experienced faculty members, who had an upcoming chairperson assignment and already completed the FEP, joined the Chairperson Education Program which introduces the principles of instructional design and faculty management, as well as assessment and evaluation.

New formats 2018-2019

At the AO Davos Courses 2018, AO CMF held the first-ever live "On Air"event: Condylar fractures—to treat or not to treat. This involves a disarmingly simple concept: CMF surgeons from around the world are invited to join a live-stream discussion involving the world's leading experts in their field, and a select studio audience—broadcast from the heart of the AO Davos Courses 2018.

Developed in response to an identified need in the AO CMF community for new approaches to involving people in the AO Davos Courses and greater flexibility in terms of means of access, this winning formula will be made available to the rest of the AO at the AO Davos Courses 2019. AO CMF is working to ensure it reaches ever more people in its community around the world in coming years.

AO CMF On Air at the AO Davos Courses 2018
In 2018 AO CMF held
121 educational events involving 6,947 participants
2,120 faculty days and
1,119 faculty.

Last year also saw over 2,000 surgeons complete the AO CMF Global Needs Analysis for Education, designed to ensure AO CMF educational events are relevant, the highest quality, and respond to the needs of today's aspiring surgeons.

As a result, AO CMF identified a consistent need for education in reconstruction, across all regions; significant interest in new technologies; and continued demand for fellowships; as well as significant interest in online and in-person courses with practical elements, surgical simulation, and case-based courses.

AO Recon 2018 Educational Events
24 educational events 
16 countries, (5 new countries) 
3,500 participants, involving 
391 faculty days, and
231 faculty;

In 2018 AO Trauma and AO Recon developed the periprosthetic curriculum which is designed to address changing clinical needs and improve patient outcomes. Education is a primary focus for AO Recon, and since it was founded in 2014, it has gained global recognition as a leader in the field.

Entering into partnerships with orthopedic societies helps AO Recon amplify its reach and grow as a network of surgeons led by world leaders in their field. AO Recon's educational events consistently attract a high proportion of self-payers, which speaks to real need for what AO Recon offers.

Over 1,600 surgeons registered for the AO Recon webinars and webcasts in 2018, enabling participants from all over the world to further educate themselves online and ask questions to the experts in real time.

In 2018, the AO VET Education Commission developed new guidelines that apply to both course chairs and faculty. This initiative responds to a very real need. As AO VET continues to expand internationally, it is most important that the processes and procedures governing course chairs and faculty are both aligned with best practice and fully consistent. These changes are underpinned by an essential principle of global transparency and succession planning.

Reaching out into the community

In-hospital education is another element of AO Spine's updated approach. Going out into the community, providing outstanding and innovative education in the workplace, enables increased attendance rates and offers the AO greater, more nuanced insights into environmental factors that impact decisions around the approach to treatment. This is something that AO Spine is proud to have rolled out to all regions in 2018—a process in which the AO Spine centers globally are integral.

In 2018 AO Trauma introduced an online organizational tool that makes it easier to meet expanding demand for clinical training modules (CTMs), which are in-hospital training programs for operating room personnel (ORP) to help make AO Trauma more accessible to this key audience. The program includes different CTMs, and ORP can sign up for the courses online in a new streamlined procedure. These changes have led to a significant increase in uptake.

ORP in 2018
53 ORP courses were provided
2,407 participants,
1,835 faculty days, and
723 faculty.

In 2018, AO Trauma continued to explore its pioneering in-hospital educational consultancy on orthogeriatrics. This entails a team of orthogeriatric experts going to a hospital to evaluate treatment and giving recommendations about how to establish comprehensive orthogeriatric treatment systems. These events have taken place in Colombia, Norway, and Singapore.

Interactive learning opportunities

Every year, the AO Technical Commission (AOTK) System hosts Meet the Experts sessions at the AO's flagship educational event, the AO Davos Courses. These engaging live sessions offer participants the opportunity to experience firsthand presentations and hands-on demonstrations of new surgical techniques based on solutions that have recently received AO Technical Commission approval. At the AO Davos Courses 2018, the AO Technical Commission Meet the Experts roster included six sessions; four were focused on latest AO Technical Commission product approvals, one on the Evolution of Craniofacial Distraction, and one on Patient Specific Implants.

In 2018 AO VET held
53 educational events involving
2,486 participants,
1,125 faculty days, and
373 faculty.

Partnerships for growth

AO VET has been working to expand its relationships with other educational providers, as this is an essential element in ensuring that access to its outstanding educational offerings is maximized. The growing partnerships with the American College of Veterinary Surgeons and with the European College of Veterinary Surgeons are significant areas on which AO VET has made progress in 2018.

By partnering with these colleges and veterinary societies, AO VET seeks to build an ever-greater reputation as the go-to provider of education in veterinary orthopedics.

AO VET, Masters Course, Feline Orthopedics and Traumatology, AO Davos Courses 2018

In 2018 AO CMF took part in two major congresses: the International Federation of Head and Neck Oncological Societies (IFHNOS) in Buenos Aires, Argentina, where AO CMF organized two well-attended intra-congress panels; and the European Association for Cranio Maxillofacial Surgery (EACMFS) conference in Munich, Germany, where AO CMF held symposia on drug-induced osteonecrosis of the mandible and on Pediatric CMF Surgery.

Taking part in these events provided AO CMF with valuable opportunities to further establish relationships with members, and to raise awareness among congress participants. In addition to the traditional booth opportunities, in Buenos Aires, AO CMF initiated meet-and-greet sessions to expand community engagement through formal and informal networking opportunities.

There is no other organization in the world that does as much for orthopedic surgeons as AO.
Danny P Goel MD, CEO, Precision OS Technology

In 2018, inspired by the AO's achievements over the first 60 years, AO Invest invested in Precision OS Technology, a company that combines orthopedic surgeons and high-end game developers, to deliver solutions that help orthopedic surgeons improve their performance.

The aim is to develop tailor-made AO content that meets the fast-changing needs of the AO's global network of surgeons and health care professionals. This collaboration is part of the AO's broader efforts to ensure it retains its leading position as the international provider of surgeon-led educational solutions in the fields of trauma and musculoskeletal disorders.

"The difference between AO Invest and other investors is that the AO is uniquely positioned given its global stance on education, specifically for orthopedic surgeons. There is no other organization in the world that does as much for orthopedic surgeons as AO," said Danny P Goel, MD, CEO, Precision OS Technology.

This was one of two agreements AO Invest signed in 2018, the second was with Finnish medical device firm Synoste that creates smart solutions for bone-lengthening and bone-deformation correction. Inspired by the AO's tradition as an innovation leader, AO Invest's goal is to invest in cutting-edge technologies around the world. It hopes these will bring benefits to the health care professionals in the AO's network—and ultimately to patients—and will help it gain recognition as a respected player in the start-up landscape.

"Our collaboration with AO is relatively new. We provide an innovative approach to education, and we are there to enhance the current model of education that the AO provides," said Danny P Goel, MD, CEO, Precision OS Technology. 

These two new agreements bring AO Invest's portfolio up to four, with Synoste and Precision OS now sitting alongside Augmedics, which develops an augmented-reality surgical navigation system for spine surgery, and Digital Surgery, which is building an ecosystem of software tools for surgery and surgical teams.

AO showcases latest research findings at AMEE 2018

The Association for Medical Education in Europe's annual conference (AMEE) was attended by 3,800 participants from around the world. The AO was significantly involved in the Surgery Track and is proud to be a member of the Swiss Organizing Committee. Surgeon faculty and staff from the AO's clinical divisions and the AO Education Institute presented their work in the new Surgery Track, shared best practices and the latest research findings in surgical education and skills training, and the development of teachers and trainers.

Miriam Uhlmann and Wa'el Taha running a workshop on building a global faculty development program.

The AO ran three workshops on backward planning of curricula, the development of proficiency metrics, and the development of the education program covering limb surgery in disaster situations. AO surgeons and staff also gave presentations in six peer-reviewed poster sessions. The key symposium, titled Acquisition, Maintenance, and Verification of Surgical Skills, featured Wa'el Taha, Chair of the AO Trauma Education Commission (AOTEC) along with Ajit K Sachdeva (American College of Surgeons), Stephen Tobin (Royal Australasian College of Surgeons), and Craig McIlhenny (Royal College of Surgeons of Edinburgh, Scotland).

To mark the AO's 60th anniversary and in recognition of its Swiss heritage, the AO presented four awards at AMEE 2018 for the best posters and short communications in surgeon education and simulation in surgical education.

Looking to the future

AO CMF is building momentum toward its first-ever global summit: FACE AHEAD. This innovative, unique experience is focused on next-generation CMF, plastic, and ear, nose and throat (ENT) surgeons, and will be held March 26–28, 2020 in Barcelona, Spain. Planning and preparations are well underway.

The first pilot of AO Trauma's new event, the AO Trauma World Meeting, took place in Madrid, Spain in 2018. About 250 people attended the five courses offered during the three-day event, and the second pilot event will be held in 2019.

Surgery Reference

In 2018, the AO Surgery Reference published new content on the pediatric forearm shaft, dog mandible, and dog or cat distal femur, and also revised existing older content on the adult proximal forearm, femoral shaft, distal tibia, and humeral shaft. On average, the AO Surgery Reference has 12,828 visits each day, 60% of which are in order to prepare for surgery. This means that AO Surgery Reference touches 7,700 patients per day.

More on education at AO in 2018

AO Davos Courses 2018 highlights

AO research excellence aims to improve care worldwide

Excellence on display at the AO Technical Commission Meet the Experts sessions