Waterbrook Anna L, Pritchard T Gail, Lane Allison D, Stoneking Lisa R, Koch Bryna, McAtee Robert, Grall Kristi H, Min Alice A, Prior Jessica, Farrell Isaac, McNulty Holly G, Stolz Uwe
Department of Emergency Medicine, The University of Arizona, Tucson, AZ, USA.
Office of Medical Student Education, The University of Arizona, Tucson, AZ, USA.
Adv Med Educ Pract. 2016 Apr 21;7:249-55. doi: 10.2147/AMEP.S92428. eCollection 2016.
Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is invariably reported as a deficiency in medical education in the USA. Sports medicine clinical rotations improve both medical students' and residents' musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.
肌肉骨骼方面的不适是患者就医最常见的原因，但在美国，肌肉骨骼医学方面的能力一直被报告为医学教育中的一项不足。运动医学临床轮转可提高医学生和住院医师的肌肉骨骼知识。尽管这些知识很重要，但急诊医学（EM）中尚无标准化的运动医学课程。因此，我们为急诊医学住院医师开发了一种新颖的运动医学轮转课程，通过教授急诊部门常见的许多肌肉骨骼疾病和损伤的评估与管理，来改善他们的肌肉骨骼教育体验，并提高他们在肌肉骨骼医学方面的知识。亚利桑那大学有两个不同的急诊医学住院医师培训项目，南校区（SC）和大学校区（UC）。UC的课程包括为期4周的传统骨科轮转，住院医师对其评价一直很低。因此，随着SC新的急诊医学住院医师培训项目的启动，我们用一种新颖的运动医学轮转课程取代了标准的骨科轮转，供急诊医学实习生学习。该轮转包括参加初级保健和骨科运动医学医生的运动医学诊所，参与体育赛事报道，指定阅读材料，教学经验，以及协助急诊部门工作的值班安排。我们分析了住院医师完成的轮转后调查问卷、初级保健运动医学教员和骨科总住院医师对住院医师的轮转后评估，以及过去5年两个项目中每位毕业住院医师进行的脱位复位总数。虽然两个项目的所有住院医师都超过了毕业所需的10次脱位复位，但与传统骨科轮转相比，参加运动医学轮转的住院医师对其教育体验的满意度在统计学上显著更高。所有SC住院医师都成功完成了他们的运动医学轮转，由主治医师完成了轮转后评估，并且在参加运动医学轮转期间没有违反值班时间规定。根据我们的经验，对于急诊医学住院医师来说，运动医学轮转是传统骨科轮转的有效替代方案。
