Using Peer Role-playing to Improve Student Skills for Musculoskeletal Physical Examinations

Abstract

<jats:title>Abstract</jats:title> <jats:p>The traditional curriculum for medical students in Japan does not include sufficient opportunity for the students to develop their skills for musculoskeletal examination and clinical reasoning and diagnosis. So, many residents report a lack of confidence in performing these tasks. Our aim was to assess the effectiveness of peer role-playing to improving these skills among 90 women medical students who were completing their first orthopaedic clinical clerkship. Participants were allocated into two groups. One group participated in role-play (the simulation group) and the other did not participate in role-play because of the clerkship schedule or almanac circumstance (the no-simulation group). This program consisted of two modules: the simulation-based module and the outpatient encounter module. Each module included two sessions. The simulation-based module had two parts: a structured encounter with role-play for musculoskeletal cases, and a structured debriefing with the course supervisor including self-reflection. The students’ performance was observed and assessed using the mini clinical evaluation exercise (mini-CEX) for musculoskeletal cases in the simulation-based module (Day1) and the outpatient encounter module (Day2). The simulation-based module increased the physical examination score on the mini-CEX because of the encounters with real-life patients with musculoskeletal symptoms. This result suggests that role-play as a peer enhancing simulation may help to improve the competency of medical students in performing a musculoskeletal physical examination in a clinical setting.</jats:p>