16. Knowledge is Power – Designing a Pilot Plastic Surgery Residency “Curated Wiki” to Improve Efficiency and Spread Institutional Knowledge

Background: While the literature has examined plastic surgery formal curricula, institutional knowledge and the informal curriculum are less explored. The “curated wiki” concept, an end user-driven comprehensive resource for institutional knowledge and informal expectations, is heavily used in industry and scientific fields, and is proven to improve employee efficiency and reduce person-hours per unit production. However, this concept has only recently been adopted by residency programs. Studies from internal medicine, pathology, and radiology residencies show that curated wikis significantly improve education, efficiency, overall experience, and exam scores. We present a framework for program-specific curated wikis, based on 3 current practices. Methods: Plastic surgery residents and academic faculty, who previously expressed interest in curated resources for plastic surgery education, were informally interviewed. Questions targeted plastic surgery-specific resources used to curate and disseminate medical and institutional knowledge, and informal curriculum components. Follow-up questions were asked to explore participant needs/suggestions, to determine specific components a curated wiki should contain, and to develop a formal questionnaire for future research. Results: Thirteen residents and faculty at 8 programs participated. No programs had a comprehensive curated resource. Two programs had limited resources produced by a single attending, and 1 program had a comprehensive guide to surgical cases, maintained by one resident without institutional support. Five programs had no curated plastic surgery resource. Programs sometimes offered a physical “general intern’s guide” produced by general surgery departments. Residents and faculty both believed curated wikis would speed the learning curve for new residents, could streamline “instrument card” issues, and would reduce burnout. Residents cited reduction in personal stress and a smoother return from off-service rotations as benefits, while faculty cited reduction in resident errors and clearer expectations of residents/more explicit resident duties as benefits. Participant recommendations for content are presented. Conclusion: The curated wiki concept has significant, proven value in industry, scientific fields, and other residency specialties. Given this value, implementing a curated wiki in a plastic surgery residency program has high potential value. We present content guidelines for an internal curated wiki, which can easily be adopted by residency programs.