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Clinical Orthopaedics and Related Research

, Volume 466, Issue 10, pp 2542–2547 | Cite as

Evidence of Educational Inadequacies in Region-specific Musculoskeletal Medicine

  • Charles S. Day
  • Albert C. Yeh
Original Article

Abstract

Recent studies suggest US medical schools are not effectively addressing musculoskeletal medicine in their curricula. We examined if there were specific areas of weakness by analyzing students’ knowledge of and confidence in examining specific anatomic regions. A cross-sectional survey study of third- and fourth-year students at Harvard Medical School was conducted during the 2005 to 2006 academic year. One hundred sixty-two third-year students (88% response) and 87 fourth-year students (57% response) completed the Freedman and Bernstein cognitive mastery examination in musculoskeletal medicine and a survey eliciting their clinical confidence in examining the shoulder, elbow, hand, back, hip, knee, and foot on a one to five Likert scale. We specifically analyzed examination questions dealing with the upper extremity, lower extremity, back, and others, which included more systemic conditions such as arthritis, metabolic bone diseases, and cancer. Students failed to meet the established passing benchmark of 70% in all subgroups except for the others category. Confidence scores in performing a physical examination and in generating a differential diagnosis indicated students felt below adequate confidence (3.0 of 5) in five of the seven anatomic regions. Our study provides evidence that region-specific musculoskeletal medicine is a potential learning gap that may need to be addressed in the undergraduate musculoskeletal curriculum.

Keywords

Anatomic Region Examination Score National Ambulatory Medical Care Survey Pulmonary System Passing Criterion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Association of American Medical Colleges. Contemporary Issues in Medicine: Musculoskeletal Medicine Education. AAMC Medical School Objectives Project, Report VII; 2005. Available at: https://services.aamc.org/Publications/index.cfm?fuseaction=Product.displayForm&prd_id=204&prv_id=245. Accessed November 13, 2007.
  2. 2.
    Clawson DK, Jackson DW, Ostergaard DJ. It’s past time to reform the musculoskeletal curriculum. Acad Med. 2001;76:709–710.PubMedCrossRefGoogle Scholar
  3. 3.
    Day CS, Yeh AC, Franko O, Ramirez M, Krupat E. Musculoskeletal medicine: an assessment of the attitudes and knowledge of medical students at Harvard Medical School. Acad Med. 2007;82:452–457.PubMedCrossRefGoogle Scholar
  4. 4.
    De Innocencio J. Epidemiology of musculoskeletal pain in primary care. Arch Dis Child. 2004;89:431–434.CrossRefGoogle Scholar
  5. 5.
    De Lorenzo RA, Mayer D, Geehr EC. Analyzing clinical case distributions to improve an emergency medicine clerkship. Ann Emerg Med. 1990;19:746–751.PubMedCrossRefGoogle Scholar
  6. 6.
    DiCaprio MR, Covey A, Bernstein J. Curricular requirements for musculoskeletal medicine in American medical schools. J Bone Joint Surg Am. 2003;85:565–567.PubMedCrossRefGoogle Scholar
  7. 7.
    Freedman KB, Bernstein J. Educational deficiencies in musculoskeletal medicine. J Bone Joint Surg Am. 2002;84:604–608.PubMedGoogle Scholar
  8. 8.
    Hing E, Cherry DK, Woodwell DA. National Ambulatory Medical Care Survey: 2004 summary. Adv Data. 2006;374:1–33.PubMedGoogle Scholar
  9. 9.
    Matzkin E, Smith EL, Freccero D, Richardson AB. Adequacy of education of musculoskeletal medicine. J Bone Joint Surg Am. 2005;87:310–314.PubMedCrossRefGoogle Scholar
  10. 10.
    Pinney SJ, Regan WD. Educating medical students about musculoskeletal problems: are community needs reflected in the curricula of Canadian medical schools? J Bone Joint Surg Am. 2001;83:1317–1320.PubMedGoogle Scholar
  11. 11.
    Schmale GA. More evidence of educational inadequacies in musculoskeletal medicine. Clin Orthop Relat Res. 2005;437:251–259.PubMedCrossRefGoogle Scholar
  12. 12.
    Yeh AC, Franko O, Day CS. Impact of clinical electives and residency interest on medical students’ education in musculoskeletal medicine. J Bone Joint Surg Am. 2008;90:307–315.PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryBeth Israel Deaconess Medical CenterBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA

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