Assessment of clinical competence of medical students by using standardized patients with musculoskeletal problems

Connell, Karen J.; Sinacore, James; Schmid, Frank R.; Chang, Rowland W.; Perlman, Susan G.

doi:10.1002/art.1780360316

Cited by 25 publications

(10 citation statements)

References 17 publications

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“…Standardized patients (SPs) are frequently employed in the teaching and assessment of physical exam or diagnostic skills [45]. While SPs are well trained and allow for the replication of real clinical interactions, they lack the actual clinical findings.…”

Section: Educational Strategies and Implementationmentioning

confidence: 99%

Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future

Monrad

Zeller

Craig

et al. 2011

Curr Rev Musculoskelet Med

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Despite the prevalence of musculoskeletal disorders in the United States, physicians have received inadequate training during medical school on how to examine, diagnose, and manage these conditions. This article provides an overview of the existing literature on undergraduate medical musculoskeletal education, including learning objectives, researched methodology, and currently utilized assessment tools. A discussion of challenges to and suggested approaches for the implementation of medical school musculoskeletal curricula is presented.

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Section: Educational Strategies and Implementationmentioning

confidence: 99%

Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future

Monrad

Zeller

Craig

et al. 2011

Curr Rev Musculoskelet Med

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show abstract

“…Musculoskeletal problems among patients presenting to a typical primary-care physician have been estimated to range from 15 to 30% (Rosenblatt et al, 1982;Pinney and Regan, 2001). These findings suggest that GPs may inappropriately manage patients who have common musculoskeletal problems (Rigby and Oswald, 1986;Ahern et al, 1991;Connell et al, 1993;Glazier et al, 1996). The teaching of musculoskeletal examination at medical schools has frequently been regarded as poor (McCredie and Brooks, 1985;Freedman and Bernstein, 1998;Steiner et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Survey of general practitioners' attitudes toward physical medicine and rehabilitation

Raissi

Mansoori

Madani

et al. 2006

International Journal of Rehabilitation Research

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This study reports the attitudes of general practitioners towards physical medicine and rehabilitation after participating in a continued medical education course in this field. Given the high prevalence of musculoskeletal disorders and number of disabled persons in the country, along with the role of general practitioners in the primary and long-term management of such patients, basic competency in rehabilitation medicine must be considered in the educational curriculum of medical students. Nevertheless, rehabilitation medicine is not taught in most universities. This study was performed to evaluate the attitude of general practitioners towards physical medicine and rehabilitation as a baseline for developing educational programs in this field. In a simple descriptive study, at the end of a continued medical education program in low back pain management, 217 questionnaires, focusing on the field of physical medicine and rehabilitation, were distributed between participants. One-hundred-and-forty-three questionnaires were analyzed. Statistical analyses were performed with descriptive and Student's t-test. The results showed that of the participants, 69 (48.3%) were female and that they graduated from 24 medical schools. Most respondents (92.2%) believed that musculoskeletal education had not been sufficient in general practitioner training courses. Of the respondents, 56.8% had visited at least one disabled patient during the previous month, while 11% had visited more than 10 in the same period, but 84.3% had not studied disabilities. Musculoskeletal physical examination was the most needed educational field cited by general practitioners. In conclusion, this study clearly documents the inadequacy of basic rehabilitation training in medical schools. The findings reveal the most needed and preferred rehabilitation areas for general practitioners, and these should be considered in the establishment of rehabilitation training programs for Iranian medical students.

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“…Additionally, medical students had difficulties selecting and justifying laboratory tests that would further narrow diagnostic possibilities and link the final diagnosis to the specific aspects of the history, physical examination and results of laboratory tests [12]. It has been assumed that making a diagnosis has shifted from the history and the physical examination to results of laboratory tests because faculty members are more often away from the bedside [13].…”

Section: Introductionmentioning

confidence: 99%

Ordering patterns for laboratory and radiology tests by students from different undergraduate medical curricula

et al. 2013

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BackgroundThe overuse of laboratory tests and radiology imaging and their possible hazards to patients and the health care system is observed with growing concern in the medical community. With this study the authors wished to determine whether ordering patterns for laboratory and radiology tests by medical students close to their graduation are related to undergraduate training.MethodsWe developed an assessment for near graduates in the setting of a resident’s daily routine including a consultation hour with five simulated patients, three hours for patient work up with simulated distracting tasks, and thirty minutes for reporting of patient management to a supervisor. In 2011, 60 students participated in this assessment: 30 from a vertically integrated (VI) curriculum (Utrecht, The Netherlands) and 30 from a traditional, non-VI curriculum (Hamburg, Germany). We assessed and compared the number of laboratory and radiology requests and correlated the results with the scores participants received from their supervisors for the facet of competence “scientifically and empirically grounded method of working”.ResultsStudents from a VI curriculum used significantly (p < .01) less total laboratory requests (N = 283 versus N = 466) which correlated with their scores for a “scientifically and empirically grounded method of working” (Pearson’s r = .572). A significantly (p < .01) higher number of radiology imaging was ordered with a large effect size (V = .618) by near graduates from a non-VI curriculum (N = 156 versus N = 97) even when this was not supporting the diagnostic process.ConclusionThe focused ordering patterns from VI students might be a result of their early exposure to the clinical environment and a different approach to clinical decision making during their undergraduate education which further studies should address in greater detail.

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Assessment of clinical competence of medical students by using standardized patients with musculoskeletal problems

Abstract: Standardized patient-based tests can be structured to provide enlightening information about medical students' clinical competence with regard to musculoskeletal problems.

Cited by 25 publications

References 17 publications

Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future

Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future

Survey of general practitioners' attitudes toward physical medicine and rehabilitation

Ordering patterns for laboratory and radiology tests by students from different undergraduate medical curricula

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