Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Milton S. Hershey Medical Center, 30 Hope Drive, Hershey, PA 17033, USA.
J Bone Joint Surg Am. 2012 Feb 15;94(4):343-8. doi: 10.2106/JBJS.J.00417.
The purpose of the present study was to evaluate musculoskeletal knowledge among graduating medical students and physician assistant students with use of a National Board of Medical Examiners (NBME) examination. We hypothesized that there would be no difference in scores between the two groups. In addition, we looked for relationships between examination scores and both the student-reported musculoskeletal experiences and the school-reported musculoskeletal curriculum.
One hundred and forty-four students from three medical schools and ninety-one students from four physician assistant schools were included in the present study; both groups were graduating students in the final semester of education. The National Board of Medical Examiners Musculoskeletal Subject Examination (NBME MSK) was utilized to assess musculoskeletal knowledge.
The mean examination score (and standard deviation) was 73.8% ± 9.7% for medical students and 62.3% ± 11% for physician assistant students (95% confidence interval [CI], -13.8 to 0.00; p < 0.05). Medical students with an interest in orthopaedics as a career scored significantly higher than those without an expressed orthopaedic interest, and medical students without an expressed career interest in orthopaedics scored significantly higher than physician assistant students (p < 0.05). Among medical students, a longer duration of a clinical rotation in orthopaedics was associated with a higher examination score (p < 0.05). The average number of hours of preclinical musculoskeletal education in the first two years of school was significantly higher for medical schools (122.1 ± 25.1 hours) than for physician assistant schools (89.8 ± 74.8 hours) (p < 0.05).
Graduating medical students scored significantly higher than graduating physician assistant students on the NBME MSK. This may be related to multiple factors, and further studies are necessary to evaluate the overall musculoskeletal clinical competence of both groups of students.
本研究旨在通过美国医师执照考试委员会（NBME）考试评估医学生和医师助理学生的肌肉骨骼知识。我们假设两组学生的分数没有差异。此外，我们还研究了考试成绩与学生报告的肌肉骨骼经历和学校报告的肌肉骨骼课程之间的关系。
本研究纳入了来自三所医学院和四所医师助理学校的 144 名医学生和 91 名医师助理学生，两组均为教育最后一个学期的毕业生。使用 NBME 肌肉骨骼科目考试（NBME MSK）评估肌肉骨骼知识。
医学生的平均考试成绩（标准差）为 73.8%±9.7%，医师助理学生的平均考试成绩（标准差）为 62.3%±11%（95%置信区间[CI]，-13.8 至 0.00；p＜0.05）。对骨科作为职业感兴趣的医学生得分明显高于对骨科没有表达兴趣的医学生，对骨科没有表达职业兴趣的医学生得分明显高于医师助理学生（p＜0.05）。在医学生中，骨科临床轮转时间较长与考试成绩较高相关（p＜0.05）。医学院前两年的基础医学肌肉骨骼教育的平均学时数（122.1±25.1 小时）明显高于医师助理学校（89.8±74.8 小时）（p＜0.05）。
毕业医学生在 NBME MSK 上的得分明显高于毕业医师助理学生。这可能与多种因素有关，需要进一步研究来评估两组学生的整体肌肉骨骼临床能力。
