Musculoskeletal education: an assessment of the clinical confidence of medical students

Abstract

Musculoskeletal (MSK) conditions account for nearly 15-30 % of encounters in a primary care practice. Yet, studies demonstrate that medical students and residents lack the knowledge and confidence to care for many MSK conditions. This study addresses the design of focused MSK educational practices towards improving students' knowledge, interest, and confidence for conducting MSK examinations. Students attending a voluntary educational symposium on sports medicine were recruited to participate. The symposium was directed toward teaching elements of the MSK exam. Participants completed validated pre- and post-workshop surveys that assessed confidence in performing MSK examinations as well as satisfaction and perceived importance of MSK education. Additionally, mean survey responses from a convenience group of students who did not participate in the symposium were compared against the intervention group. Thirteen students participated in the educational symposium. Hundred and nine students completed the general survey. In the non-intervention group, students demonstrated knowledge and confidence improvements through the second year of medical school but did not show similar improvement in subsequent years. No difference in MSK confidence scores between fourth-year students going into high versus low MSK focused specialities was observed. In the intervention group students demonstrated improvements in confidence with respect to the knee, shoulder and ankle exams (p < 0.01). Areas not covered such as concussions and neuromuscular impairments failed to show significant change. Current core clinical training, at least at our school, does not achieve satisfactory levels of knowledge and confidence with respect to caring for MSK conditions. However, a focused didactic and skill development intervention does produce significant improvements. Follow-up is needed to determine whether these improvements are sustained.