Division of Allergy, Immunology & Rheumatology, The State University of New York at Buffalo, Buffalo, NY, USA.
Division of Rheumatology, Rush University Medical Center, Chicago, IL, USA.
BMC Med Educ. 2022 May 10;22(1):355. doi: 10.1186/s12909-022-03425-4.
Studies have elucidated the lack of competency in musculoskeletal (MSK) examination skills amongst trainees. Various modalities have been studied, however, there remains a dearth of literature regarding the effectiveness of bedside teaching versus dedicated workshops. Our aim was to determine if incorporating a workshop into a rheumatology rotation would be effective in increasing medicine residents' competency and comfort with knee examinations when compared to the rotation alone.
Over 16 months, rotators were randomized to workshop plus rotation versus rotation alone. Participants were tested on their knee examination skills using an objective structured clinical examination (OSCE). Surveys were administered assessing to what degree the rotation was beneficial. Comfort and helpfulness were measured using a 5-point Likert scale. Paired and independent samples t-tests were used for comparisons.
Fifty-seven residents participated. For both groups, there were improvements between pre- and post-OSCE scores (workshop p < 0.001, no workshop p = 0.003), and levels of comfort with examination (workshop p < 0.001, no workshop p < 0.001). When comparing groups, there were differences favoring the workshop in post-OSCE score (p = < 0.001), mean change in OSCE score (p < 0.001) and mean change in comfort with knee examination (p = 0.025).
An elective in rheumatology augmented residents' MSK competency and comfort. Incorporation of a workshop further increased knowledge, skills and comfort with diagnosis and treatment. Current educational research focuses on alternatives to traditional methods. This study provides evidence that a multi-modal approach, combining traditional bedside and interactive models, is of benefit.
研究已经阐明，受训者在肌肉骨骼（MSK）检查技能方面缺乏能力。已经研究了各种方法，但是，关于床边教学与专门研讨会相比的有效性的文献仍然很少。我们的目的是确定在风湿病轮转中加入研讨会是否会比单独轮转更有效地提高内科住院医师进行膝关节检查的能力和舒适度。
在 16 个月的时间里，轮转医师被随机分为研讨会加轮转组和单独轮转组。参与者使用客观结构化临床考试（OSCE）测试他们的膝关节检查技能。通过问卷调查评估轮转的受益程度。使用 5 分李克特量表评估舒适度和有用性。使用配对和独立样本 t 检验进行比较。
共有 57 名住院医师参加。对于两组，OSCE 前后的分数都有所提高（参加研讨会的组 p<0.001，未参加研讨会的组 p=0.003），并且对检查的舒适度也有所提高（参加研讨会的组 p<0.001，未参加研讨会的组 p<0.001）。比较两组时，在 OSCE 后得分（p=0.001）、OSCE 得分的平均变化（p<0.001）和膝关节检查舒适度的平均变化（p=0.025）方面，参加研讨会的组更有优势。
选修风湿病学增加了住院医师的 MSK 能力和舒适度。参加研讨会进一步提高了他们在诊断和治疗方面的知识、技能和舒适度。目前的教育研究侧重于替代传统方法。本研究提供了证据，表明结合传统床边和互动模式的多模式方法是有益的。
