Rheumatology training in the UK: the trainees' perspective

Foster, Helen; Everett, Samuel; Myers, Andrea

doi:10.1093/rheumatology/keh454

Cited by 11 publications

(5 citation statements)

References 8 publications

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“…Delay in access to care for children with JIA is a major problem, likely a global issue with multifactorial aetiology [1][2][3][4] including poor self-rated confidence in musculoskeletal (MSK) clinical assessment in doctors to whom children may present [5,6] as a result of inadequate paediatric MSK clinical skills teaching at undergraduate and postgraduate level [7][8][9][10][11][12][13][14]. The GALS (Gait, Arms, Legs, Spine) adult MSK screening examination has been taught to medical students throughout the UK and has been shown to improve the assessment of the MSK system in adults with rheumatic disease [15,16].…”

Section: Introductionmentioning

confidence: 99%

Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children

et al. 2011

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The pGALS (paediatric Gait, Arms, Legs, Spine) Musculoskeletal (MSK) screen is validated in English-speaking school-aged children and has been shown to be useful in acute paediatric practice in the UK. The aim of this study is to evaluate the practicality and acceptability of pGALS in children in an acute hospital setting in Malawi. School-aged inpatients and children presenting to the Queen Elizabeth Hospital Blantyre, Malawi, participated. Practicality (time taken, degree of completion) and patient/parent assessed acceptability (time take, discomfort) were assessed using a 'smiley face' visual analogue scale. Fifty-one children (median age 8 years) were assessed; 23 out of 51 (45%) in the emergency department and the remainder were inpatients. Most presentations were infection or trauma related (n = 35, 69%). Practicality of pGALS was good [median time to complete pGALS--4 min (range 1.8-7.4)] and completed in 48 out of 51 children (94%). Acceptability was high; 98% of parents considered the time taken to be acceptable, 84% of children deemed little/no additional discomfort. Abnormalities using pGALS were found in 21 out of 51 (41%), mostly in the lower limbs. The pGALS MSK screen was practical and acceptable in this acute setting. Abnormal findings were common.

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Section: Introductionmentioning

confidence: 99%

Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children

et al. 2011

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“…Musculoskeletal symptoms in children and adolescents are very common, occurring in 4 -30% of young persons (1-3) and accounting for 3% of day case attendances (4).…”

Section: Introductionmentioning

confidence: 99%

“…Poor clinical skills are a significant barrier to care, with trainees in pediatrics and primary care reporting poor self-confidence in their ability to assess a child's musculoskeletal system (4,16 -19), poor documentation of musculoskeletal assessment (16), and inadequate training in pediatric rheumatology (4,20,21). These observations may be explained by the fact that teaching of musculoskeletal clinical skills involving children is not part of core training in UK medical schools (22), few standard pediatric textbooks describe musculoskeletal clinical examination techniques in children (23), and clinical skills are not reinforced in clinical practice because pediatricians themselves may not have received appropriate training.…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal screening examination (pGALS) for school‐age children based on the adult GALS screen

Foster

Kay

Friswell

et al. 2006

Arthritis & Rheumatism

Self Cite

129

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Objective. To develop and validate a musculoskeletal screening examination applicable to school-age children based on the adult Gait, Arms, Legs, Spine (GALS) screen.Methods. Adult GALS was tested in consecutive school-age children attending pediatric rheumatology clinics and was compared with an examination conducted, on the same day, by a pediatric rheumatologist who classified children as having abnormal or normal joints. Adult GALS was tested for validity compared with the pediatric rheumatologist's assessment and deficiencies in adult GALS were identified. Experts proposed amendments to adult GALS, achieving consensus by modified Delphi techniques. The resultant pediatric screening tool (pGALS) was tested (methodology identical to the testing of adult GALS) in an additional group of children.Results. Adult GALS was tested in 50 children (median age 11 years, range 4 -16), of whom 37 (74%) had juvenile idiopathic arthritis. Adult GALS missed important abnormalities in 18% of children, mostly at the ankle, foot, and temporomandibular joints. The pGALS was tested in 65 children (median age 13 years, range 5-17 years) and demonstrated excellent sensitivity (97-100%) and specificity (98 -100%) at all joints, with high acceptability scored by child and parent/guardian. The median time to perform pGALS was 2 minutes (range 1.5-3 minutes). Conclusion. The pGALS musculoskeletal screening tool has excellent validity, is quick to perform, and is acceptable to school-age children and parents/guardians. We propose that pGALS be incorporated into undergraduate and postgraduate medical training to improve pediatric musculoskeletal clinical skills and facilitate diagnosis and referral to specialists.

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“…Depending on their seniority and the departmental rules, the trainee may perform the consultations independently and then report to their consultant, or attend together with their senior colleague [6]. The consultant might then review the patient him/herself or may simply give advice.…”

Section: Training Curriculum: Competencies and Assessmentsmentioning

confidence: 99%

Rheumatology training in Poland vs. United Kingdom

Lazarewicz

Chinoy²

2017

Reumatologia

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When evaluating the quality of Rheumatology specialty training, it can be useful to explore similarities and differences between countries. In this article we compare the training in the UK and Poland. The two training programmes are similar in length and in the competencies that must be achieved, although they do have significant differences in the way the training is structured. The UK-based system is more out-patient based, which can be advantageous, as after completion of training the doctor is more confident in treating common rheumatological problems.On the other hand, having exposure to paediatric rheumatology and orthopaedics like one has in Polish-based training, despite a short placement time, is definitely beneficial for the trainee in gaining all-round knowledge.In conclusion, each system has its merits and can be further enhanced by observing how junior doctors are sub-speciality trained in different countries.

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Rheumatology training in the UK: the trainees' perspective

Cited by 11 publications

References 8 publications

Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children

Acceptability and practicality of pGALS in screening for rheumatic disease in Malawian children

Musculoskeletal screening examination (pGALS) for school‐age children based on the adult GALS screen

Rheumatology training in Poland vs. United Kingdom

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