Multicenter Case Study: Can JBJS Clinical Classroom Boost Resident OITE Scores?

This post comes from the JBJS Clinical Classroom team. JBJS Clinical Classroom is an adaptive learning platform designed specifically to meet the needs of orthopaedic surgeons and residency programs.

Orthopaedic residents and program leaders alike continue to ask the same question: Does structured, question-based learning translate into improved performance on the Orthopaedic In-Training Examination (OITE)?

Building on our single-program case study at the University of Nebraska Medical Center (UNMC), we expanded our analysis to include 282 orthopaedic residents across 13 residency programs, examining the relationship between JBJS Clinical Classroom engagement and OITE score.

This multicenter analysis evaluated resident performance across a diverse group of orthopaedic training environments in the U.S. and Canada. Resident engagement was measured using Clinical Classroom Progress, while performance was assessed using OITE score.

The participating programs included:

• Atrium Health Carolinas Medical Center and OrthoCarolina
• Case Western Reserve University
• Georgetown University Hospital
• HCA Florida JFK Hospital
• Henry Ford Hospital
• McLaren Flint
• McMaster University
• Oklahoma State University
• Prisma Health/University of South Carolina
• University of Nebraska
• University of Texas Southwestern
• University of Washington
• Yale University

Key Findings

Across all 282 residents, greater engagement with JBJS Clinical Classroom was associated with higher OITE scores.

Specifically, we observed a positive correlation between Clinical Classroom progress and OITE score:

• Correlation coefficient (r): 0.176
• Sample size (n): 282
• P value: 0.0047

While the magnitude of this correlation is modest, it is statistically significant and consistent with the idea that answering more questions and increasing Clinical Classroom progress is associated with improved exam performance.

What Does This Mean?

These findings suggest that JBJS Clinical Classroom may help improve resident OITE scores, particularly when residents actively engage with the question bank over time. Importantly, this relationship was observed across multiple institutions, training models, and geographic regions, supporting the generalizability of the results.

This mirrors findings from our earlier study of 25 residents at the University of Nebraska Medical Center, reinforcing a consistent signal:

Residents who engage more with Clinical Classroom tend to perform better on the OITE.

As with most educational interventions, Clinical Classroom is unlikely to be a standalone solution. However, it appears to function effectively as part of a broader study strategy, offering residents repeated exposure to board-style questions, explanations, and clinical reasoning.

Limitations and Future Directions

This analysis demonstrates an association, not causation. Residents who are more motivated or who study more consistently may naturally engage more with Clinical Classroom.

Takeaway

Across 13 orthopaedic residency programs, increased engagement with JBJS Clinical Classroom was associated with higher OITE scores. These results support Clinical Classroom as a valuable educational tool for residents preparing for in-training examinations and board-style assessments.

The JBJS Clinical Classroom team is currently developing a white paper that delves deeper into this study.

Offers

Subscription information for JBJS Clinical Classroom can be found below:

Residents: $79/year (limited-time discount applied during checkout, only available for residents until February 28, 2026)

Residency Programs: $180/year/resident

For more information on JBJS Clinical Classroom, including how it works and how to subscribe your residency program, please visit the Clinical Classroom site at JBJS.org. Data analysis like this is free for programs who subscribe to the yearly program subscription.