An Assessment of Musculoskeletal Knowledge in Graduating Medical and Physician Assistant Students and Implications for Musculoskeletal Care Providers

Grunfeld, Robert; Banks, Sharon; Fox, Edward J.; Levy, Bruce A.; Craig, Clifford L.; Black, Kevin P.

doi:10.2106/jbjs.j.00417

Cited by 23 publications

(24 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The discrepancy is highlighted when comparing the representation of a topic in the medical school curriculum with its prevalence in primary care and urgent care settings. Approximately 20% of all visits to primary care clinics and emergency departments are the result of MSK complaints, second only to upper respiratory illness [7,11,13].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 20% of all visits to primary care clinics and emergency departments are the result of MSK complaints, second only to upper respiratory illness [7,11,13].…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies [1,5,9,12,13,17,21] and the American Association of Medical Colleges (AAMC) [3] have raised concern that medical schools may not give sufficient instruction on this topic. In 2003, DiCaprio et al [9] demonstrated the lack of required instruction in MSK medicine in both preclinical and clinical years of undergraduate medical education.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Musculoskeletal Medicine Is Underrepresented in the American Medical School Clinical Curriculum

DiGiovanni

Sundem

Southgate

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Musculoskeletal (MSK) conditions are common, and their burden on the healthcare system is increasing as the general population ages. It is essential that medical students be well prepared to evaluate and treat MSK disorders in a confident manner as they enter the workforce. Recent studies and the American Association of Medical Colleges have raised concern that medical schools may not give sufficient instruction on this topic. Other authors have shown that preclinical instruction has increased over the past decade; however, it is unclear if required clinical instruction also has followed that trend. Questions/purposes The purposes of this study were: (1) to assess the presence and duration of required or selective instruction in a MSK medicine specialty within the clinical years of undergraduate medical education; and (2) to assess the current state of requirements of clinical clerkships or rotations in other surgical and nonsurgical fields for comparison with the initial findings.Methods The web sites of all 141 US medical schools were assessed to determine the content of their clinical curricula for the 2014-2015 academic year; five were excluded because they had not yet had a graduating class by the conclusion of the 2014-2015 academic year. Complete information on required rotations was obtained through the schools' web sites for all 136 (100%) medical schools. For selective experience during the surgery clerkships, complete information was available for 130 of the remaining 136 (96%) web sites. Results Mean (in weeks, ± SD) duration of core clerkships were as follows: internal medicine (10 ± 2), surgery (8 ± 2), pediatrics (7 ± 1), obstetrics/gynecology (6 ± 1), and psychiatry (5 ± 1). Other common required clerkships were: family medicine (required in 96% [131 of 136] of schools, mean duration of 6 ± 2 weeks), neurology (81% [110], 4 ± 1), and emergency medicine (55% [75], 3 ± 1). Required MSK instruction, at a mean of 2 ± 1 weeks, was only present in 15% (20 of 136) of medical schools. In addition, clinical MSK instruction was offered as a selective (eg, students pick from a selection of subspecialties such as orthopaedics, plastics, or urology during a general surgery clerkship) in 34% (44 of 130) of all medical schools. This is less than other non-core specialties: geriatrics/ambulatory care (required in 40% [54 of 136] of schools, mean duration of 3 ± 1 weeks), critical care (30% [41], mean of 3 ± 1 weeks), radiology (26% [35], mean of 3 ± 1 weeks), anesthesiology (23% [31], mean of 2 ± 1 weeks), and other surgical subspecialties (19% [26

show abstract

Section: Discussionmentioning

confidence: 99%

“…Approximately 20% of all visits to primary care clinics and emergency departments are the result of MSK complaints, second only to upper respiratory illness [7,11,13].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Musculoskeletal Medicine Is Underrepresented in the American Medical School Clinical Curriculum

DiGiovanni

Sundem

Southgate

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…M usculoskeletal disorders are the most common cause of physical impairment, disability, and ongoing pain [1][2][3] . The relationship of symptoms and disability to pathophysiology is strongly mediated by psychosocial factors 4 .…”

mentioning

confidence: 99%

Computerized Adaptive Testing of Psychological Factors

Menendez

Bot

Hageman

et al. 2013

The Journal of Bone & Joint Surgery

View full text Add to dashboard Cite

BACKGROUND: Psychological factors are important mediators of the differences between impairment and disability. The most commonly used measures of disability and psychological factors are lengthy and are usually administered as paper questionnaires. The aim of this study was to assess the correlation between perceived disability and psychological factors with use of the user-friendly, web-based Patient Reported Outcomes Measurement Information System initiative, and to compare its correlation with a frequently used, paper-based, pain self-efficacy questionnaire. METHODS: A cohort of 213 patients completed a web-based version of the abbreviated version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), the pain self-efficacy questionnaire, the Patient Reported Outcomes Measurement Information System-based computerized adaptive testing Pain Interference questionnaire, and the Patient Reported Outcomes Measurement Information System-based computerized adaptive testing Depression questionnaire. Bivariate and multivariable analyses measured the correlation of these psychological measures with QuickDASH. RESULTS: There was large correlation between QuickDASH and the Pain Interference computerized adaptive testing (r = 0.74; p lt; 0.001), between the Pain Interference computerized adaptive testing and the pain self-efficacy questionnaire (r = -0.72; p lt; 0.001), and between QuickDASH and the pain self-efficacy questionnaire (r = -0.76; p lt; 0.001). The Depression computerized adaptive testing showed a medium correlation both with QuickDASH (r = 0.37; p lt; 0.001) and with the Pain Interference computerized adaptive testing (r = 0.40; p lt; 0.001). The best multivariable model for QuickDASH included the Pain Interference computerized adaptive testing, prior treatment received, and smoking, and accounted for 57% of the variability. Fifty-one percent of the variability in the QuickDASH was explained by pain interference alone. CONCLUSIONS: Maladaptive responses to upper-extremity pain are accurately measured by the relatively user-friendly Patient Reported Outcomes Measurement Information System-based computerized adaptive testing questionnaire. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

show abstract

“…The test consists of seventy-five items: fourteen basic science items and sixty-one clinical items 9 . The internal consistency of the examination, measured by the Kuder-Richardson Formula 20 (KR-20), is reported to be 0.86 8,9 ; although higher scores (closer to 1) indicate more reliable measures, 0.7 is considered an acceptable threshold 10 . The mean (and standard deviation) of the percentage correct among the first 1177 test takers at three pilot medical schools was 69.7% ± 13.2% 9 .…”

Section: Musculoskeletal Knowledgementioning

confidence: 99%

Factors Impacting Musculoskeletal Knowledge and Clinical Confidence in Graduating Medical Students

DiGiovanni¹,

Southgate²,

Mooney³

et al. 2014

The Journal of Bone and Joint Surgery-American Volume

View full text Add to dashboard Cite

This study reveals that participation in a clinical elective is the only factor that led to a significant increase in musculoskeletal knowledge in fourth-year medical students. A two-week clinical elective can be sufficient time to have an impact on musculoskeletal knowledge, but it alone does not increase clinical confidence. Further studies are needed to determine how to improve musculoskeletal clinical confidence.

show abstract

An Assessment of Musculoskeletal Knowledge in Graduating Medical and Physician Assistant Students and Implications for Musculoskeletal Care Providers

Cited by 23 publications

References 10 publications

Musculoskeletal Medicine Is Underrepresented in the American Medical School Clinical Curriculum

Musculoskeletal Medicine Is Underrepresented in the American Medical School Clinical Curriculum

Computerized Adaptive Testing of Psychological Factors

Factors Impacting Musculoskeletal Knowledge and Clinical Confidence in Graduating Medical Students

Contact Info

Product

Resources

About