title: A comprehensive new curriculum to teach and assess resident knowledge and diagnostic evaluation of musculoskeletal complaints.
abstract: Musculoskeletal complaints are a common reason for primary care visits; however, many essential physical examination, diagnostic and treatment skills are not adequately taught. The objectives of the study were to create and implement a comprehensive clinical skills teaching model, and to evaluate its effects on residents' knowledge and diagnostic skills. A comparison of cohorts who participated and did not participate in a musculoskeletal curriculum was undertaken. Second and third year medical residents participated in comprehensive curricula to teach and evaluate musculoskeletal skills. Sixty-seven attended the first of three lectures on the painful shoulder; 61 attended all three lectures and completed pre- and post-self assessment forms and tests. Three months later 26 of these residents and 10 controls participated in an OSCE examination. Thirty-nine medical residents attended the first of three lectures on the painful knee; 32 attended all three lectures and completed pre- and post-self assessment forms and tests. Seven of these residents and eight controls participated in an OSCE examination three months later. Both the shoulder and knee curricula were associated with a significant improvement in test scores (p < 0.0001), in self-assessment of physical examination, diagnostic and procedural skills (p < 0.0001), and in OSCE results (p < 0.005). It was concluded that the skills required for the diagnosis and treatment of common musculoskeletal complaints can be effectively taught and assessed using inexpensive and simple methods.
authors.affiliation: Department of Medicine, Division of General Medicine and Primary Care, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. csmith2@bidmc.harvard.edu
authors.forename: C Christopher
authors.initials: CC
authors.lastname: Smith
authors.forename: Lori
authors.initials: L
authors.lastname: Newman
authors.forename: Roger B
authors.initials: RB
authors.lastname: Davis
authors.forename: Julius
authors.initials: J
authors.lastname: Yang
authors.forename: Radhika
authors.initials: R
authors.lastname: Ramanan
mesh_terms: D001900:Boston; D002983:Clinical Competence / Q000592:standards*; D015331:Cohort Studies; D003479:Curriculum; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D009140:Musculoskeletal Diseases / Q000175:diagnosis*