Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, 10700, Bangkoknoi, Bangkok, Thailand.
BMC Med Educ. 2024 Jan 23;24(1):83. doi: 10.1186/s12909-024-05043-8.
General pediatricians often initially address children's musculoskeletal (MSK) issues and play a crucial role in triaging and managing patients' rheumatologic conditions. This study assessed the effectiveness of a structured curriculum in enhancing pediatric residents' knowledge, MSK examination skills, and confidence during a 4-week pediatric rheumatology rotation.
Pediatric residents in their either second or third year who participated in the 4-week rheumatology rotation once across three academic years (July 2020-June 2023) were enrolled. Residents' knowledge, MSK examination skills, and confidence were assessed at pre- and post-rotation by using 25 multiple-choice questions, the Thai pediatric Gait Arms Legs Spine examination, and a questionnaire, respectively. The curriculum comprised instruction on MSK examinations, interactive lectures, case-based discussion, topic reviews, MSK radiology conference, clinical experience in rheumatology clinic and consultations, with self-guided learning with educational resources.
Fifty-eight pediatric residents (48 females, 10 males) with a mean age of 28.9 ± 0.8 years participated. Significant improvements were noted postrotation. Knowledge scores rose from 63.0 ± 12.2 to 79.7 ± 9.1 (mean difference 16.7 ± 10.3, p < 0.001). Similarly, MSK examination scores increased from 67.5 ± 14.4 to 93.6 ± 8.7 (mean difference 26.1 ± 14.6, p < 0.001). Residents also reported a marked increase in confidence across all evaluated areas, including history taking, MSK examination, arthrocentesis, and diagnosing and treating rheumatologic conditions (p < 0.001).
The 4-week structured curriculum in the pediatric rheumatology rotation significantly enhanced pediatric residents' knowledge, MSK examination skills, and confidence. These findings support the integration of pediatric rheumatology rotations into pediatric residency training programs.
一般儿科医生通常首先处理儿童的肌肉骨骼 (MSK) 问题，并在分诊和管理患者的风湿病方面发挥关键作用。本研究评估了一个结构化课程在增强儿科住院医师知识、MSK 检查技能和信心方面的有效性，该课程在 4 周儿科风湿病轮转期间进行。
参加过 3 个学年（2020 年 7 月至 2023 年 6 月）为期 4 周的风湿病轮转的儿科住院医师（第二年或第三年）被纳入研究。通过使用 25 个多项选择题、泰国儿科步态手臂腿部脊柱检查和问卷，分别在轮转前和轮转后评估住院医师的知识、MSK 检查技能和信心。课程包括 MSK 检查指导、互动讲座、基于案例的讨论、专题复习、MSK 放射学会议、在风湿病诊所和咨询中进行临床经验、以及使用教育资源进行自我指导学习。
58 名儿科住院医师（48 名女性，10 名男性）参与研究，平均年龄为 28.9 ± 0.8 岁。轮转后发现显著改善。知识得分从 63.0 ± 12.2 提高到 79.7 ± 9.1（平均差异 16.7 ± 10.3，p < 0.001）。同样，MSK 检查评分从 67.5 ± 14.4 提高到 93.6 ± 8.7（平均差异 26.1 ± 14.6，p < 0.001）。住院医师在所有评估领域的信心也明显提高，包括病史采集、MSK 检查、关节穿刺术以及诊断和治疗风湿病（p < 0.001）。
儿科风湿病轮转中的 4 周结构化课程显著提高了儿科住院医师的知识、MSK 检查技能和信心。这些发现支持将儿科风湿病轮转纳入儿科住院医师培训计划。
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