NDLI: Design and implementation of a system-based course in musculoskeletal medicine for medical students.

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Design and implementation of a system-based course in musculoskeletal medicine for medical students.

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Design and implementation of a system-based course in musculoskeletal medicine for medical students.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Bilderback, Karl Eggerstedt, Jane Sadasivan, Kalia K. Seelig, Leonard Wolf, Robert Barton, Shane McCall, Richard Chesson, Andrew L. Marino, Andrew A.
Description	Country affiliation: United States Author Affiliation: Bilderback K ( Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center-Shreveport, PO Box 33932, Shreveport, LA 71130-3932, USA.)
Abstract	BACKGROUND: The amount of time devoted to musculoskeletal medicine in the typical undergraduate curriculum is disproportionately low compared with the frequency of musculoskeletal complaints that occur in a general practice. Consequently, whether because of the quantity or quality of the education, the competence level of graduating physicians regarding musculoskeletal problems is inadequate. Our purposes were to design a self-contained, system-based course in musculoskeletal medicine for medical students in the preclinical years and to measure the level of competence achieved by a class of first-year medical students who took the course. METHODS: The course was formulated by faculty from the departments of orthopaedic surgery, anatomy, and rheumatology and included elements of both objectives-based and problem-centered curricular models. The clinical lectures were preceded by pertinent anatomy lectures and dissections to provide a context for the clinical information. The lectures on basic science were designed to rationalize and explicate clinical practices. Small-group activities were incorporated to permit engagement of the students in critical thinking and problem-solving. A general musculoskeletal physical examination was taught in two two-hour-long small-group sessions with the orthopaedic residents serving as instructors. Cognitive competency was evaluated with use of comprehensive anatomy laboratory and written examinations, the latter of which included a validated basic competency examination in musculoskeletal medicine. Process-based skills were evaluated in the small-group meetings and in a timed, mock patient encounter in which each student's ability to perform the general musculoskeletal physical examination was assessed. RESULTS: The course lasted six weeks and consisted of forty-four lecture hours, seventeen hours of small-group meetings, and twenty-eight hours of anatomy laboratory. The average student score on the basic competency examination was 77.8%, compared with 59.6% for a historical comparison group (p < 0.05). Each student demonstrated the ability to adequately perform a general musculoskeletal physical examination in twenty minutes. The survey of student opinion after the course indicated a high level of student satisfaction. CONCLUSIONS: The main features of the course were: (1) an emphasis on both cognitive and process-based knowledge; (2) more contact hours and broader content than in previously described courses in musculoskeletal medicine; (3) the use of small groups to focus on problem-solving and physical examination competencies; (4) basic-science content directly related to clinical goals. These features might be used at other institutions that employ a system-based curriculum for the preclinical years to help improve competence in musculoskeletal medicine.
File Format	HTM / HTML
ISSN	00219355
Issue Number	10
Volume Number	90
e-ISSN	15351386
Journal	The Journal of Bone and Joint Surgery-American Volume
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Orthopedic surgery Anatomy Education Curriculum Education, Medical, Undergraduate Organization & Administration Orthopedics Program Development Rheumatology Clinical Competence Cognition Humans Physical Examination Program Evaluation Evaluation Studies Journal Article
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery Sports Science

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