The ABOS Knowledge, Skills, and Behavior Program: How Valuable Are the Assessments?

In this episode of the AAOS Now Podcast, host Doug Lundy, MD, MBA, FAAOS, sits down with two guests who offer differing perspectives about the American Board of Orthopaedic Surgery (ABOS) Knowledge, Skills, and Behavior (KSB) Program.

David F. Martin, MD, Executive Director of the ABOS, offers the board's perspective on why the Knowledge, Skills, and Behavior (KSB) Program exists, why it is now required, and where it's headed; Ellen Lutnick, MD, a PGY5 at the University of Buffalo and chair of the AAOS Resident Assembly Executive Committee, shares her experience of living with the program day to day.

Together, they trace the KSB Program from its 2018 launch through its 2025 requirement for residents entering the ABOS Part I exam pathway.

Dr. Martin explains that the program grew out of decades of interest in competency-based medical education and a recognition that time alone doesn't guarantee a resident has developed adequate orthopaedic knowledge, surgical skill, and professional behavior. He walks through why the ABOS made participation mandatory, how the program integrates with ACGME case logging, and the distinction between formative feedback – meant to help residents improve – and summative feedback, like board exams, that produces a pass or fail outcome.

Dr. Lutnick describes how the program was rolled out at Buffalo, what it's actually like to request feedback after or before a case, and how she's learned to be strategic about which cases to submit for evaluation. She also speaks candidly about receiving feedback she disagreed with, how professional behavior assessments surface blind spots, and what other residents have told her they would like to see change about the KSB Program.

The conversation closes with a look at where the program might go next, including whether the ABOS will eventually tie participation to specific performance scores rather than just completion numbers. Dr. Martin encourages residents to reach out with feedback so ABOS can continue to make the assessments even more helpful and easier to incorporate into a resident’s busy schedule.

Key topics covered in this episode:

• The origins of the KSB Program and its roots in competency-based medical education

• Why the ABOS chose to make KSB participation a requirement for the Part I exam

• Integration between the ABOS case entry system and the ACGME

• The difference between formative and summative assessment in residency training

• Strategies to help residents decide which cases to submit for surgical skills evaluation

• How professional behavior assessments are designed to identify outliers rather than track linear growth

• The role of verbal vs. written feedback in resident education

• Resident perspectives on receiving and processing critical feedback

• Survey fatigue and efforts to streamline the evaluation process

• What residents want to see improved, including access to individual professional behavior results

• Where the program may be headed, including the possibility of performance-based scoring requirements

Residents starting to navigate the KSB Program will find real value in hearing how a peer has learned to use the tool strategically, not just to meet a requirement, but to actively shape the feedback they receive.

Host: Doug Lundy, MD, MBA, FAAOS, Deputy Editor, AAOS Now; Chair, AAOS Now Podcast Workgroup

Guests: David F. Martin, MD, Executive Director, American Board of Orthopaedic Surgery; Professor, Orthopaedic Surgery and Rehabilitation (Winston-Salem), Wake Forest University School of Medicine

Ellen Lutnick, MD, Chair, AAOS Resident Assembly Executive Committee; PGY5 and Resident Research Coordinator, University of Buffalo Department of Orthopaedics and Sports Medicine