Shing Elaine Z, Wally Meghan K, Seymour Rachel B, Patt Joshua C, Scannell Brian P
Department of Orthopedic Surgery, Atrium Health Musculoskeletal Institute, Charlotte, North Carolina.
OrthoCarolina, Charlotte, North Carolina.
JB JS Open Access. 2023 Jul 26;8(3). doi: 10.2106/JBJS.OA.23.00027. eCollection 2023 Jul-Sep.
Musculoskeletal health literacy (HL) is an emerging concept in orthopaedic patient care. Estimated rates of low musculoskeletal HL in patients surpass those of general HL. Studies in other specialties suggest that medical trainees are ill equipped to interact with low HL patients, often with detrimental patient outcomes. The purpose of this study was to (1) establish the current state of HL awareness among orthopaedic surgery trainees, (2) characterize the current state of HL training in orthopaedic surgery programs, and (3) evaluate the desire for formalized HL training among orthopaedic surgery trainees.
This study was endorsed by the Collaborative Orthopaedic Education Research Group board. A 17-item questionnaire was administered anonymously to orthopaedic residents through a secure online platform in the 2020 to 2021 academic year. All participation was voluntary.
One hundred ninety-two residents (42%) from 19 orthopaedic programs completed the survey. Most residents felt "somewhat comfortable" with issues related to HL. Most residents reported no specific training in HL issues during residency (77.5%). Of the 43 residents (22.3%) who did receive formal training, most of these individuals felt that the training is effective (N = 42, 97.7%). Role playing/standardized patient encounters were reported as the most effective form of HL training. Residents felt it was somewhat important to receive formal HL training in residency (median = 4.0, interquartile range = 3.0-5.0), and there was a modest desire for formalized training (39%).
This study is the first to characterize orthopaedic resident perceptions of HL issues in practice and training. Residents were somewhat confident in their understanding of HL concepts, and those who received formal training felt it was effective. However, there remains a low rate of formal orthopaedic resident training in HL issues, which may be an area for improvement in orthopaedic training paradigms.
肌肉骨骼健康素养（HL）是骨科患者护理中一个新兴的概念。患者中肌肉骨骼低健康素养的估计发生率超过了一般健康素养的发生率。其他专业的研究表明，医学实习生在与低健康素养患者互动方面准备不足，这往往会给患者带来不利后果。本研究的目的是：（1）确定骨科手术实习生对健康素养的认知现状；（2）描述骨科手术项目中健康素养培训的现状；（3）评估骨科手术实习生对正规健康素养培训的需求。
本研究得到了骨科协作教育研究小组委员会的认可。在2020至2021学年，通过一个安全的在线平台向骨科住院医师匿名发放了一份包含17个条目的问卷。所有参与均为自愿。
来自19个骨科项目的192名住院医师（42%）完成了调查。大多数住院医师对与健康素养相关的问题感觉“有些自在”。大多数住院医师报告在住院期间没有接受过关于健康素养问题的具体培训（77.5%）。在43名（22.3%）接受过正规培训的住院医师中，大多数人认为培训是有效的（N = 42，97.7%）。角色扮演/标准化患者接触被报告为健康素养培训最有效的形式。住院医师认为在住院期间接受正规健康素养培训有些重要（中位数 = 4.0，四分位间距 = 3.0 - 5.0），并且对正规培训有一定的需求（39%）。
本研究首次描述了骨科住院医师在实践和培训中对健康素养问题的看法。住院医师对健康素养概念的理解有一定信心，并且接受过正规培训的人认为培训是有效的。然而，骨科住院医师在健康素养问题上接受正规培训的比例仍然较低，这可能是骨科培训模式中有待改进的一个方面。
