Melo Luciano, Schrieber Leslie, Eyles Jillian, Deveza Leticia A, Meneses Sarah R F, Hunter David J
Rheumatology Department, Royal North Shore Hospital, Sydney, New South Wales, Australia.
School of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Int J Rheum Dis. 2017 Apr;20(4):451-459. doi: 10.1111/1756-185X.13080. Epub 2017 May 2.
To compare the musculoskeletal (MSK) physical examination skills, knowledge acquisition and performance of first-year medical students trained by MSK specialist tutors to students trained by non-MSK specialist tutors, after a 6-week MSK physical examination tutorial program.
Twenty-first year medical students took part in the study. They were recruited into two groups, according to their exposure to either an MSK specialist or a non-MSK specialist tutor during their 6-week MSK training block. Knowledge acquisition was measured via a pre- and post-training objective structured clinical examination (OSCE). We assessed students' self-belief and confidence levels regarding their newly acquired skills via a questionnaire. Independent t tests were used to examine mean group differences of OSCE scores and perceived level of confidence.
Both groups demonstrated a significant improvement (3.9 and 3.8 points, respectively, on an eight-point scale for shoulder assessment, P < 0.01, 3.3 and 3.5, respectively, on a five-point scale for spine assessment, P < 0.01) in OSCE scores compared to baseline after completing the 6-week MSK physical examination tutorial program. There was no between-group difference in the OSCE scores from pre- to post-training (P = 0.92 for shoulder, P = 0.66 for spine) or for perceived level of confidence in performing a basic MSK examination after training (P = 0.91).
Students exposed to MSK specialist tutors did not demonstrate increased skill levels or knowledge in the area of MSK physical examination compared to those receiving the same training under the supervision of non-MSK specialist tutors. Both student groups demonstrated improvement.
比较在接受为期6周的肌肉骨骼系统（MSK）体格检查辅导课程后，由MSK专科导师培训的一年级医学生与由非MSK专科导师培训的学生在肌肉骨骼系统体格检查技能、知识掌握及表现方面的差异。
21名一年级医学生参与了本研究。根据他们在为期6周的MSK培训阶段中接受MSK专科导师或非MSK专科导师指导的情况，将他们分为两组。通过培训前和培训后的客观结构化临床考试（OSCE）来评估知识掌握情况。我们通过问卷调查评估学生对新获得技能的自我信念和信心水平。使用独立t检验来检验OSCE分数和感知信心水平的组间平均差异。
在完成为期6周的MSK体格检查辅导课程后，与基线相比，两组学生的OSCE分数均有显著提高（肩部评估在8分制上分别提高了3.9分和3.8分，P<0.01；脊柱评估在5分制上分别提高了3.3分和3.5分，P<0.01）。从培训前到培训后，两组在OSCE分数（肩部P = 0.92，脊柱P = 0.66）或培训后进行基本MSK检查的感知信心水平（P = 0.91）方面均无组间差异。
与在非MSK专科导师监督下接受相同培训的学生相比，接受MSK专科导师指导的学生在MSK体格检查领域并未表现出更高的技能水平或知识水平。两组学生均有进步。
