University of California, Irvine, CA, USA.
Department of Orthopaedics, Rhode Island Hospital, Brown University, 593 Eddy Street, Providence, RI, 02903, USA.
Perspect Med Educ. 2014 Jun;3(3):238-244. doi: 10.1007/s40037-014-0124-1.
Musculoskeletal (MSK) conditions account for nearly 15-30 % of encounters in a primary care practice. Yet, studies demonstrate that medical students and residents lack the knowledge and confidence to care for many MSK conditions. This study addresses the design of focused MSK educational practices towards improving students' knowledge, interest, and confidence for conducting MSK examinations. Students attending a voluntary educational symposium on sports medicine were recruited to participate. The symposium was directed toward teaching elements of the MSK exam. Participants completed validated pre- and post-workshop surveys that assessed confidence in performing MSK examinations as well as satisfaction and perceived importance of MSK education. Additionally, mean survey responses from a convenience group of students who did not participate in the symposium were compared against the intervention group. Thirteen students participated in the educational symposium. Hundred and nine students completed the general survey. In the non-intervention group, students demonstrated knowledge and confidence improvements through the second year of medical school but did not show similar improvement in subsequent years. No difference in MSK confidence scores between fourth-year students going into high versus low MSK focused specialities was observed. In the intervention group students demonstrated improvements in confidence with respect to the knee, shoulder and ankle exams (p < 0.01). Areas not covered such as concussions and neuromuscular impairments failed to show significant change. Current core clinical training, at least at our school, does not achieve satisfactory levels of knowledge and confidence with respect to caring for MSK conditions. However, a focused didactic and skill development intervention does produce significant improvements. Follow-up is needed to determine whether these improvements are sustained.
肌肉骨骼（MSK）疾病占初级保健实践中就诊的 15-30%。然而，研究表明，医学生和住院医师缺乏照顾许多 MSK 疾病的知识和信心。本研究旨在设计针对 MSK 教育实践的重点教育方法，以提高学生进行 MSK 检查的知识、兴趣和信心。招募参加运动医学自愿教育研讨会的学生参加。该研讨会旨在教授 MSK 检查的要素。参与者完成了预先和课后的问卷调查，评估他们进行 MSK 检查的信心以及对 MSK 教育的满意度和重要性。此外，与干预组相比，对未参加研讨会的便利组学生的平均调查答复进行了比较。13 名学生参加了教育研讨会。共有 109 名学生完成了一般调查。在非干预组中，学生在医学生的第二年表现出知识和信心的提高，但在随后的几年中没有表现出类似的提高。在进入高与低 MSK 重点专业的第四年学生之间，MSK 信心评分没有差异。在干预组中，学生在膝关节、肩关节和踝关节检查方面的信心得到了提高（p<0.01）。没有涵盖的领域，如脑震荡和神经肌肉障碍，没有显示出显著的变化。目前的核心临床培训，至少在我们的学校，没有达到令人满意的知识和信心水平，以照顾 MSK 疾病。然而，集中的教学和技能发展干预确实产生了显著的改善。需要进行后续研究以确定这些改善是否持续。
