One week with the experts: A short course improves musculoskeletal undergraduate medical education

Kelly, M. and Bennett, D. and Bruce-Brand, R. and O'Flynn, S. and Fleming, P. (2014) One week with the experts: A short course improves musculoskeletal undergraduate medical education. Journal of Bone and Joint Surgery - Series A, 96 (5). e391-e397. ISSN 00219355 (ISSN)

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Background: Musculoskeletal problems constitute a considerable workload across all medical and surgical disciplines. There is a mismatch between the burden of musculoskeletal medicine seen by non-orthopaedists clinically and the amount of time afforded it in undergraduate training. Recent initiatives to address this include the United States Bone and Joint Decade and curricular innovations that demonstrate a benefit from improved instruction. Such curricular interventions are usually situated within a wider program reform and last a short time. Gaining institutional support and securing curricular time are challenging. This article shows the positive evaluation of a brief, intense course on musculoskeletal medicine. Methods: A one-week course was offered to 154 medical students. The study took place in Ireland, where the student body comprises a mix of graduate students and undergraduate students, who enter medical school directly from second-level education. This course comprised brief didactic talks, case-based small group work, and physical examination skills demonstration. Attitudes toward musculoskeletal medicine prior to the course were elicited. The course was evaluated using pre-course and post-course standardized cognitive tests. Long-term retention was evaluated by end-of-year extended matching questions and an objective standardized clinical examination station. The test results between undergraduate and graduate students and student rating of musculoskeletal medicine as important or less important were compared. Results: Complete data were available for 125 students (81%). Seventy-four percent of students rated musculoskeletal medicine to be of major or critical importance to their career. There was a significant difference (p < 0.001, r = 0.678) in the mean score of the standardized cognitive test between the pre-course test and the post-course test; the mean performance score (and standard deviation) was 48.2% ± 14.2% (range, 17% to 79%), with a pass rate of 3.3%, for the pre-course test and 75.3% ± 15.02% (range, 32% to 100%), with a pass rate of 61%, for the post-course test. At the end of the year, 69.9% of students passed the extended matching questions and 96.7% passed an objective standardized clinical examination station. Graduate students performed better on the post-course standardized cognitive test score (p < 0.001) and objective standardized clinical examination (p < 0.05). Students who rated musculoskeletal medicine as important did not perform better than those who rated it as less important (p = 0.334). Conclusions: We report a favorable evaluation of a short, intense course on musculoskeletal medicine and suggest that the introduction of basic concepts of musculoskeletal medicine is feasible within established curricula. Copyright © 2014 By The Journal of Bone and Joint Surgery, Incorporated.

Item Type: Article
Additional Information: Export Date: 23 February 2015; CODEN: JBJSA; References: (2005) Report VII Contemporary Issues in Medicine: Musculoskeletal Medicine Education Medical School Objectives Project, , Contemporary%20Issues%20in%20Med%20Musculoskeletal%20Med%20Report%20VII%20.pdf, Association of American Medical Colleges (AAMC) Accessed 2013 Feb 7; Pinney, S.J., Regan, W.D., Educating medical students about musculoskeletal problems. Are community needs reflected in the curricula of Canadian medical schools? (2001) J Bone Joint Surg Am, 83 (9), pp. 1317-1320. , Sep; Punnett, L., Wegman, D.H., Work-related musculoskeletal disorders: The epidemiologic evidence and the debate (2004) J Electromyogr Kinesiol, 14 (1), pp. 13-23. , Feb; (2008) The Burden of Musculoskeletal Diseases in the United States. Prevalence, Societal and Economic Cost, , American Academy of Orthopaedic Surgeons. Rosemont, IL: American Academy of Orthopaedic Surgeons;; Badley, E.M., Wang, P.P., Arthritis and the aging population: Projections of arthritis prevalence in Canada 1991 to 2031 (1998) J Rheumatol, 25 (1), pp. 138-144. , Jan; Day, C.S., Yeh, A.C., Franko, O., Ramirez, M., Krupat, E., Musculoskeletal medicine: An assessment of the attitudes and knowledge of medical students at Harvard Medical School (2007) Acad Med, 82 (5), pp. 452-457. , May; Queally, J.M., Cummins, F., Brennan, S.A., Shelly, M.J., O'Byrne, J.M., Assessment of a new undergraduate module in musculoskeletal medicine (2011) J Bone Joint Surg Am, 93 (3), pp. e9. , Feb 2; Al-Nammari, S.S., James, B.K., Ramachandran, M., The inadequacy of musculoskeletal knowledge after foundation training in the United Kingdom (2009) J Bone Joint Surg Br, 91 (11), pp. 1413-1418. , Nov; Skelley, N.W., Tanaka, M.J., Skelley, L.M., Laporte, D.M., Medical student musculoskeletal education: An institutional survey (2012) J Bone Joint Surg Am, 94 (19), pp. e146. , Oct 3; Dicaprio, M.R., Covey, A., Bernstein, J., Curricular requirements for musculoskeletal medicine in American medical schools (2003) J Bone Joint Surg Am, 85 (3), pp. 565-567. , Mar; Pinney, S.J., Regan, W.D., Educating medical students about musculoskeletal problems. Are community needs reflected in the curricula of Canadian medical schools? (2001) J Bone Joint Surg Am., 83 (9), pp. 1317-1320. , Sep;; Williams, J.R., The teaching of trauma and orthopaedic surgery to the undergraduate in the United Kingdom (2000) J Bone Joint Surg Br., 82 (5), pp. 627-628. , Jul;; Bilderback, K., Eggerstedt, J., Sadasivan, K.K., Seelig, L., Wolf, R., Barton, S., McCall, R., Marino, A.A., Design and implementation of a system-based course in musculoskeletal medicine for medical students (2008) J Bone Joint Surg Am., 90 (10), pp. 2292-2300. , Oct;; Clark, M.L., Hutchison, C.R., Lockyer, J.M., Musculoskeletal education: A curriculum evaluation at one university (2010) BMC Med Educ., 10 (1), p. 93. , Epub 2010 Dec 12; Wilson, F.C., Esther, R.J., Development and use of a second-year musculoskeletal organ-system curriculum: A forty-year experience (2010) J Bone Joint Surg Am., 92 (11), pp. e14. , Sep 1;; O'Dunn-Orto, A., Hartling, L., Campbell, S., Oswald, A.E., Teaching musculoskeletal clinical skills to medical trainees and physicians: A Best Evidence in Medical Education systematic review of strategies and their effectiveness: BEME Guide No. 18 (2012) Med Teach, 34 (2), pp. 93-102; Woolf, A.D., Walsh, N.E., Akesson, K., Global core recommendations for a musculoskeletal undergraduate curriculum (2004) Ann Rheum Dis., 63 (5), pp. 517-524. , May;; Freedman, K.B., Bernstein, J., The adequacy of medical school education in musculoskeletal medicine (1998) J Bone Joint Surg Am., 80 (10), pp. 1421-1427. , Oct;; Angoff, W., Scales norms equivalent scores (1971) Educational Measurement. 2nd Ed, , Thorndike RL, editor. Washington, DC: American Council on Education;; Dunlap, W.P., Cortina, J.M., Vaslow, J.B., Burke, M.J., Meta-analysis of experiments with matched groups or repeated measures designs (1996) Psychol Methods, 1 (2), pp. 170-177; Cohen, L., Manion, L., Morrison, K., (2007) Approaches to Qualitative Data Analysis. Research Methods in Education, , New York, Routledge;; Beran, M.C., Awan, H., Rowley, D., Samora, J.B., Griesser, M.J., Bishop, J.Y., Assessment of musculoskeletal physical examination skills and attitudes of orthopaedic residents (2012) J Bone Joint Surg Am., 94 (6), pp. e36. , Mar 21;; Carley, S., Driscoll, P., Trauma education (2001) Resuscitation., 48 (1), pp. 47-56. , Jan;; Issenberg, S.B., McGaghie, W.C., Gordon, D.L., Symes, S., Petrusa, E.R., Hart, I.R., Harden, R.M., Effectiveness of a cardiology review course for internal medicine residents using simulation technology and deliberate practice (2002) Teach Learn Med., 14 (4), pp. 223-228. , Fall;; Johnson, A.L., Sharma, J., Chinchilli, V.M., Emery, S.E., McCollister Evarts, C., Floyd, M.W., Kaeding, C.C., Black, K.P., Why do medical students choose orthopaedics as a career? (2012) J Bone Joint Surg Am., 94 (11), pp. e78. , Jun 6;; Mayo, E., (1933) The Human Problems of An Industrial Civilization. 2nd Ed, 3, pp. 53-73. , New York: MacMillan;
Uncontrolled Keywords: article; attitude; career; clinical examination; cognition; evaluation study; graduate student; human; Ireland; medical education; medical expert; medical school; medical student; medicine; musculoskeletal system; physical examination; priority journal; psychologic test; rating scale; scoring system; skill; undergraduate student
Depositing User: Colin Lowry
Last Modified: 27 Nov 2015 09:51

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