title: Musculoskeletal medicine: an assessment of the attitudes and knowledge of medical students at Harvard Medical School.
abstract: OBJECTIVE
  To assess medical students' knowledge and clinical confidence in musculoskeletal medicine as well as their attitudes toward the education they receive in this specialty.
  
  
  METHODS
  A cross-sectional survey of students in all four years of Harvard Medical School was conducted during the 2005-2006 academic year. Participants were asked to fill out a 30-question survey and a nationally validated basic competency exam in musculoskeletal medicine.
  
  
  RESULTS
  The response rate was 74% (449/608). Medical students rated musculoskeletal education to be of major importance (3.8/5) but rated the amount of curriculum time spent on musculoskeletal medicine as poor (2.1/5). Third-year students felt a low to adequate level of confidence in performing a musculoskeletal physical examination (2.7/5) and failed to demonstrate cognitive mastery in musculoskeletal medicine (passing rate on competency exam: 7%), whereas fourth-year students reported a similar level of confidence (2.7/5) and exhibited a higher passing rate (26%). Increasing exposure to the subject by taking clinical electives resulted in greater clinical confidence and enhanced performance on the exam (P < .001). Students' feedback suggested that musculoskeletal education can be better integrated into the preclinical curriculum, more time should be spent in the field, and more focus should be placed on common clinical conditions.
  
  
  CONCLUSIONS
  These findings, which are consistent with those from other schools, suggest that medical students do not feel adequately prepared in musculoskeletal medicine and lack both clinical confidence and cognitive mastery in the field. Implementing a four-year integrated musculoskeletal curriculum is one way that medical schools can address this concern.
authors: Musculoskeletal Curriculum, Harvard Medical School, Orthopedic Hand Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. cday1@bidmc.harvard.edu
authors: Charles S
authors: CS
authors: Day
authors: Albert C
authors: AC
authors: Yeh
authors: Orrin
authors: O
authors: Franko
authors: Miguel
authors: M
authors: Ramirez
authors: Edward
authors: E
authors: Krupat
mesh_terms: D001290:Attitude; D001900:Boston; D003430:Cross-Sectional Studies; D003479:Curriculum / Q000592:standards*; D003625:Data Collection; D003937:Diagnosis, Differential; D004504:Education, Medical, Undergraduate / Q000592:standards*; D004521:Educational Measurement; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D009985:Orthopedics / Q000193:education*; D010808:Physical Examination; D015397:Program Evaluation; D012577:Schools, Medical; D012655:Self-Evaluation Programs; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires