It's probably more in the how. However, sometimes being an eager ortho student, you'll answer a general question that is asked to you and the residents.
Like, imagine in a conference an attending asks a question to the general group, and you always answer.. that's awesome that you know the answer.. and even though you weren't like 'na na na poo poo, I got it before you'.. residents, hell, people in general, will look down at you thinking that you're a show off.
This is a lesson I've learned in life, screw just ortho...