From the Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY.
J Am Acad Orthop Surg. 2020 Dec 1;28(23):945-952. doi: 10.5435/JAAOS-D-20-00485.
Musculoskeletal (MSK) disease comprises over 20% of all visits to healthcare providers each year, yet a disproportionately small percentage of medical school education focuses on MSK disease. Even among students applying into orthopaedic surgery, less than 50% demonstrate prerequisite anatomic knowledge before beginning their residency. Medical school curriculum reform is needed, given that only 15% have a required MSK curriculum. Inadequate education ultimately leads to poor patient care and forces clinicians to learn MSK medicine later in practice. Although this inadequacy in medical school MSK education has been recognized for decades, little has changed to address this critical deficiency. A successful curriculum development requires defining critical MSK topics, evaluative methods to assess knowledge acquisition, and ultimately assessment of applying that knowledge to the care of patients. Newer strategies for MSK education include "near-peer" learning from senior classmates and residents, clinical immersion within MSK care teams, peer interest groups, and standardize learning platforms and assessment tools. Technologies such as virtual reality simulation, adaptive video learning, and other technologies will inform the development of affordable, succinct, evidence-informed curriculums that can enhance medical student MSK education with universal implementation. As clinical practice evolves to optimize patient care, so should the education of physicians who deliver that care.
肌肉骨骼 (MSK) 疾病占每年医疗保健提供者就诊的 20%以上，但医学院的医学教育中只有很小一部分侧重于 MSK 疾病。即使在申请骨科手术的学生中，也只有不到 50%的人在开始住院医师培训之前具备必要的解剖学知识。鉴于只有 15%的医学院有必修的 MSK 课程，因此需要进行医学课程改革。教育不足最终导致患者护理不佳，并迫使临床医生在实践中学习 MSK 医学。尽管几十年来一直认识到医学院 MSK 教育的不足，但几乎没有采取任何措施来解决这一关键缺陷。成功的课程开发需要定义关键的 MSK 主题、评估知识获取的评估方法，最终评估将该知识应用于患者护理的能力。MSK 教育的新策略包括向高年级同学和住院医师学习“近邻”、在 MSK 护理团队中进行临床实习、同伴兴趣小组以及标准化的学习平台和评估工具。虚拟现实模拟、自适应视频学习和其他技术等技术将为开发经济实惠、简洁、基于证据的课程提供信息，这些课程可以通过普遍实施来增强医学生的 MSK 教育。随着临床实践的发展以优化患者护理，提供这种护理的医生的教育也应该如此。
