An Evaluation of the Effectiveness of a Medical School Musculoskeletal Curriculum at an Academic Medical Center

Abstract

Background: Musculoskeletal disorders are common medical problems encountered by physicians and affected 126.6 million Americans in 2012. Musculoskeletal education has inadequate in United States medical schools.
 Objective: To determine the musculoskeletal competency of third year medical students.
 Methods: A cross-sectional 25-question nationally validated musculoskeletal competency exam was given to the third year medical students. A survey was given to second and third year medical students to assess students’ level of interest in musculoskeletal medicine and their feedback regarding the curriculum.
 Results: The mean score of the competency exam was 69.0%. There was 48/107 (44.9%) students’ who reached the minimum passing score of 70%. Free-response feedback from both classes featured themes of more hands-on learning, a longer clinical block, and more small-group learning sessions.
 Conclusions: Third year medical students scored relatively well on the exam. Student feedback suggests the 2-week musculoskeletal block is useful and relevant to their future careers.

Musculoskeletal education in undergraduate medical curricula–A systematic review

“…Furthermore, despite being the only assessment tools to populate the literature and undergo validation in musculoskeletal education, they both fail to assess musculoskeletal clinical skills, or psychometric factors, both core components of ultimate competency in the discipline. Moreover, the perceived confidence and attitude of medical students for musculoskeletal disease is concerningly low 28,30,33,34,36 . Despite variability in the tool assessing clinical confidence between studies, and marginal increments observed with advancing years of medical education, 28,30,33 no student reported above average confidence in musculoskeletal medicine in our analysis, regardless of stage of study 28,30,33,34,36 .…”

“…Moreover, the perceived confidence and attitude of medical students for musculoskeletal disease is concerningly low 28,30,33,34,36 . Despite variability in the tool assessing clinical confidence between studies, and marginal increments observed with advancing years of medical education, 28,30,33 no student reported above average confidence in musculoskeletal medicine in our analysis, regardless of stage of study 28,30,33,34,36 . Furthermore, student‐reported adequacy of their musculoskeletal education was consistently suboptimal 37,38 …”

“…Concerning musculoskeletal education quality, the 2 key domains assessed in the included studies were knowledge and attitudes or perceptions of musculoskeletal disease, corresponding to levels 1 and 2 of Kirkpatrick levels of curriculum evaluation. Eight of the included studies assessed medical students’ knowledge in musculoskeletal science, health and disease 27–34 . Two of the 8 studies 28,29 used the standardized National Board of Medical Examiners (NBME) musculoskeletal subject examination to assess students’ knowledge of musculoskeletal conditions, and the other 6 studies 27,30–34 used the validated Freedman and Bernstein basic musculoskeletal competency examination 35 .…”

“…19.3%, 30 21%, 6 44.9% 33 and 47.8%. 31 Studies comparing test scores of students in different years of a medical program did demonstrate improvements in scores with increasing year, albeit to varying degrees.…”

“…29 Nine studies reported on medical students' attitudes or perceptions of musculoskeletal education in medical training. 28,30,[32][33][34][36][37][38] Five of the 9 studies assessed clinical confidence on musculoskeletal topics using quantitative surveys. 28,30,33,34,36 Three studies 28,33,36 used a 5-point Likert scale for perceived confidence assessment, with a mean score of 2.5 across all medical years reported in 1 study, 36 a mean score of 2.8 ± 0.8 in 2nd year medical students vs 2.86 ± 0.86 in 4th year students reported in another, 28 and a statement of scores being higher in 3rd year vs 2nd year students reported in a 3rd study.…”