Real patient learning integrated in a preclinical block musculoskeletal disorders. Does it make a difference?

Abstract

Although musculoskeletal disorders are the most common reason for general practitioner visits, training did not keep pace. Implementation of learning from patients with rheumatologic disorders linked together with the teaching of theoretical knowledge in the preclinical medical education might be an important step forward in the improvement of quality of care for these patients. The Leiden Medical School curriculum has implemented two non-obligatory real patient learning (RPL) practicals integrated within the preclinical block musculoskeletal disorders. This study investigates the educational effectiveness of the practicals, the expectations students have of RPL, and students' satisfaction. Participants' grades on the end-of-block test served as the test results of the educational effectiveness of the practicals and were compared with those of the non-participants. Qualitative data was collected by means of questionnaires generated by focus groups. The participants in practicals scored significantly higher at the end-of-block test. The expected effects of the contact with real patients concerned positive effects on cognition and skills. 'Contextualizing of the theory', 'better memorizing of clinical pictures', and 'understanding of the impact of the disease' were the most frequently mentioned effects of the practicals. Overall, the participants were (very) enthusiastic about this educational format. The RPL practicals integrated within a preclinical block musculoskeletal disorders are a valuable addition to the Leiden medical curriculum. This relatively limited intervention exhibits a strong effect on students' performance in tests. Future research should be directed towards the long-term effects of this intervention.

Fig. 1

Potential participants, cohort of students followed the MSD block. Participants, students who enrolled in real patient learning practicals. Non-participants, students who did not enrol in RPL practicals. Q1, questionnaire introduced to students before the start of RPL practicals. Q2, questionnaire introduced to students after the participation in RPL practicals. End-of-block test+, number of students who sat the end-of-block test. End-of-block test−, number of students who did not sit the end-of-block test