Musculoskeletal Basics: The Shoulder and the Knee Workshop for Primary Care Residents

Denizard-Thompson, Nancy; Feiereisel, K. B.; Pedley, Carolyn F.; Burns, Cynthia; Campos, Claudia L.

doi:10.15766/mep_2374-8265.10749

Cited by 8 publications

(9 citation statements)

References 12 publications

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“…The workshop group scored significantly higher on the post-rotation OSCE, had greater increases in comfort with examination and had higher levels of perceived helpfulness of the rotation in both enhancing MSK skills and diagnosing MSK conditions. This supports the use of interactive workshops in increasing knowledge and clinical skills 13,14 .…”

Section: Discussionsupporting

confidence: 61%

“…The residents increased their correct performance significantly and this effect was maintained at 9 months. In another study by Denizard-Thompson et al 13 , 36 residents received a half-day session on shoulder and knee complaints. This included a presentation highlighting history, examination and procedural skills and a charades game in which competitors demonstrated joint examinations.…”

Section: Discussionmentioning

confidence: 99%

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Incorporating Interactive Workshops into Bedside Teaching: Completion of a Multi- Modal Rheumatology Rotation Significantly Increases Internal Medicine Residents’ Competency and Comfort with Comprehensive Knee Examinations

Kwiatkowski¹,

Shakoor²,

Manadan³

et al. 2021

Preprint

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Background: 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.Methods: 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. Results: 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).Conclusion: 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.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Incorporating Interactive Workshops into Bedside Teaching: Completion of a Multi- Modal Rheumatology Rotation Significantly Increases Internal Medicine Residents’ Competency and Comfort with Comprehensive Knee Examinations

Kwiatkowski¹,

Shakoor²,

Manadan³

et al. 2021

Preprint

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“…Other studies have used longer or resource-intensive sessions and included additional joints. [7][8][9][10][11][12] We believe that the focus should be on the most common injections performed by primary care providers. We also believe that a brief session for clinic faculty is beneficial, since they supervise trainees performing these procedures in their outpatient clinics.…”

Section: Discussionmentioning

confidence: 99%

“…There is evidence that academic physicians (specifically IM) perform and precept few joint injections, 6 but participation in dedicated workshops and curricula can improve confidence of trainees performing these procedures. [7][8][9][10][11][12] Previous studies have focused training sessions lasting half a day or longer or using a cadaver lab. These types of programs may be difficult to implement given other training needs, supervising physician schedules, and room or other resource availability.…”

Section: Introductionmentioning

confidence: 99%

Improving Internal Medicine Resident Comfort With Shoulder and Knee Joint Injections Using an Injection Workshop

et al. 2020

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Introduction: Joint injections can be effective treatments for musculoskeletal issues. We examined whether a brief teaching session delivered to residents and faculty would significantly improve resident confidence in performing shoulder and knee joint injections. Methods: We implemented a 90-minute workshop instructed by two sports medicine providers. The objectives and content of the workshop included the topics of indications and contraindications, risks and benefits, supplies and setup, and injection techniques, all assessed on 5-point Likert scales. The workshop included a lecture, followed by residents practicing injections on simulation models and identifying key bony landmarks. Outpatient clinic faculty were given the same lecture and practiced on models. The postworkshop questionnaire was administered to the residents 4 months later. Results: Eighteen residents participated. Mean confidence for performing knee injections increased from 2.2 to 3.8 immediately postlecture (p = .006). Shoulder injection confidence increased from 1.6 to 3.8 immediately postlecture (p = .0002). Confidence in knowledge of the risks and benefits, supplies needed, and indications increased similarly. Four months postworkshop, confidence levels were sustained above pretesting levels for all areas studied. Faculty members appreciated their workshop since they had not often performed injections. Discussion: This brief workshop-style teaching session can provide meaningful, durable improvements in a trainee's confidence regarding performing shoulder or knee joint injections. The session requires few resources and fits into regular didactic sessions. Further development of this model could increase clinical performance and practice confidence and make these procedures more widely accessible to patients.

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“…The need for improved MSK training across the medical education continuum is well-established, and many educational models at the undergraduate and graduate primary care levels have been reported [5,8,[11][12][13]. To our knowledge, this project is the first to describe the experience of adapting an established MSK curriculum to fit the resources and needs of another site.…”

Section: Introductionmentioning

confidence: 99%

Implementing an established musculoskeletal educational curriculum in a new context: a study of effectiveness and feasibility

Pearson

Barker

Battistone

et al. 2020

Medical Education Online

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Background: Musculoskeletal (MSK) problems are common, yet many primary care (PC) providers feel inadequately trained to manage these conditions. Previous studies describe successful MSK educational innovations at single sites, but none have reported on subsequent attempts to replicate or adapt these innovations to new contexts. This article presents a study of a national Veterans Affairs MSK training program modified to fit an existing PC educational program. Objectives: (1) To evaluate the effectiveness and feasibility of an adapted MSK curriculum in a new context. (2) To provide a model for adaptation studies in health professions education. Design: A national MSK shoulder and knee curriculum was adapted for San Francisco VA PC trainees, which included a small-group workshop and workplace learning within a newlycreated MSK clinic. Effectiveness was evaluated by assessments of trainee confidence in exam and injection skills (via 5-point Likert scale) and faculty-observed performance of knee and shoulder exams (reported as percent of maximum possible score). Feasibility was evaluated by determining acceptability of the program to PC trainees (via 5-point Likert scale) and ability to implement the curriculum using local resources. Results: 52 trainees completed the training during a 2-year period. Trainees' confidence in MSK exam skills improved from 3.3 to 4.5 for shoulder, and from 3.5 to 4.6 for knee. Confidence performing joint injections improved from 2.6 to 4.2 (shoulder) and 2.5 to 4.5 (knee) (p < 0.001 for all). Observed performance improved markedlyfrom 50% to 92% for shoulder, and 57% to 90% for knee. Feasibility was evident in high acceptability (5.0 for MSK clinic, and 4.9 for workshops), and successful and sustained implementation. Conclusions: Adapting an established MSK curriculum to a new context was effective and feasible. This may serve as a more efficient model for improving trainee education than de novo curriculum design at individual sites.

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Musculoskeletal Basics: The Shoulder and the Knee Workshop for Primary Care Residents

Cited by 8 publications

References 12 publications

Incorporating Interactive Workshops into Bedside Teaching: Completion of a Multi- Modal Rheumatology Rotation Significantly Increases Internal Medicine Residents’ Competency and Comfort with Comprehensive Knee Examinations

Incorporating Interactive Workshops into Bedside Teaching: Completion of a Multi- Modal Rheumatology Rotation Significantly Increases Internal Medicine Residents’ Competency and Comfort with Comprehensive Knee Examinations

Improving Internal Medicine Resident Comfort With Shoulder and Knee Joint Injections Using an Injection Workshop

Implementing an established musculoskeletal educational curriculum in a new context: a study of effectiveness and feasibility

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