Department of Family Medicine, School of Medicine, University of California, San Diego, CA.
Department of Family Medicine, School of Medicine, University of California, Irvine, CA.
Fam Med. 2024 Oct;56(9):579-583. doi: 10.22454/FamMed.2024.687020. Epub 2024 Aug 19.
Musculoskeletal (MSK) complaints comprise more than 20% of all visits to health care providers each year. Despite required experiences in MSK care, family physicians report low confidence in diagnosing and treating MSK conditions. The purpose of this study was to analyze the effects of early and longitudinal exposure to MSK education on residents' confidence in and likelihood of performing MSK physical exams and injections in future practice.
From 2017 to 2019, residents completed an annual survey assessing confidence in, frequency of, and future intentions to perform exams and injections for MSK conditions. We compared responses between family medicine residents who completed a 176-hour longitudinal sports medicine (LSM) curriculum distributed over all 3 years of residency and a comparable cohort of family medicine residents who completed a 188-hour concentrated MSK curriculum primarily in the final year of residency. We made comparisons using the Fisher exact test for categorical variables and an independent samples t test for numeric variables.
We analyzed the 98 total responses from 50 residents. The proportion of residents reporting high ratings of their residency MSK education (26% to 60%), performing >5 injections (38% to 73%), reporting confidence in performing injections (12% to 40%), and indicating likelihood to perform MSK injections in the future (52% to 65%) were all greater in the LSM versus concentrated MSK curriculum cohorts (P<.05 for all).
Early and longitudinal exposure to MSK care and sports medicine in family medicine residency led to both an increase in MSK injections during residency training and a greater desire to perform these injections in postresidency practice.
肌肉骨骼（MSK）疾病占每年医疗保健提供者就诊的 20%以上。尽管家庭医生在 MSK 护理方面有规定的经验，但他们对诊断和治疗 MSK 疾病的信心较低。本研究的目的是分析早期和纵向接触 MSK 教育对居民在未来实践中对 MSK 体格检查和注射的信心和可能性的影响。
在 2017 年至 2019 年期间，居民完成了一项年度调查，评估了对 MSK 疾病进行检查和注射的信心、频率和未来意向。我们比较了完成 176 小时纵向运动医学（LSM）课程（分布在住院医师培训的所有 3 年）的家庭医学住院医师和完成主要在住院医师培训最后一年完成的 188 小时集中 MSK 课程的可比队列的家庭医学住院医师的反应。我们使用 Fisher 精确检验比较分类变量，使用独立样本 t 检验比较数值变量。
我们分析了来自 50 名居民的 98 份总回复。报告对住院医师 MSK 教育（26%至 60%）、进行>5 次注射（38%至 73%）、对进行注射的信心（12%至 40%）和表示未来进行 MSK 注射的可能性（52%至 65%）的高评价的居民比例在 LSM 与集中 MSK 课程队列中均更高（所有 P<.05）。
家庭医学住院医师培训中早期和纵向接触 MSK 护理和运动医学既增加了住院期间的 MSK 注射次数，也增加了在住院后实践中进行这些注射的愿望。
