Can training in musculoskeletal examination skills be effectively delivered by undergraduate students as part of the standard curriculum?
OBJECTIVE
There is a need to improve competence of musculoskeletal system (MSS) examination in medical students and junior doctors. Peer-assisted learning (PAL) is a technique whereby students learn from and with each other. This study aimed to determine whether PAL can be integrated into standard undergraduate medical curricula to improve MSS examination using the gait, arms, legs, spine (GALS) screening tool.


METHODS
Fifty final-year students (trainers) were trained using GALS for MSS examination while attending a standard clinical medical attachment at Glasgow Royal Infirmary. These students delivered GALS training to a further 159 students (trainees). Pre/post-confidence questionnaire (100-mm visual analogue scale) and written feedback were obtained. Final Objective Structured Clinical Examination (OSCE) scores from an MSS station were compared with a control group of 229 students randomized to other hospitals for the standard MSS training.


RESULTS
Analysis of completed trainer questionnaires (30/50) showed increased confidence in all parts of GALS after training [<47 (19) cf. >88 (12); P < 0.005]. Similarly, confidence in trainees (136/159) who answered the questionnaire increased [<43 (19) cf. >85 (15); P < 0.005]. Written comments highlighted that students would recommend PAL. OSCE results showed 84% (192/229) of students in the control group passed the MSS station, with 87% (139/159) of trainees (P = 0.3) and 100% (50/50) of trainers (P < 0.01).


CONCLUSIONS
MSS examination skills are improved by integrating PAL into the undergraduate medical curriculum, with student confidence being increased, and higher OSCE scores.
Centre for Rheumatic Disease, Department of Immunology, Infection and Inflammation, Glasgow Royal Infirmary, Alexandra Parade, Glasgow G31 2ER, UK. martinperry@doctors.net.uk
Martin E
ME
Perry
Joanne M
JM
Burke
Lorraine
L
Friel
Max
M
Field
D000704:Analysis of Variance; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum / Q000592:standards*; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis*; D009141:Musculoskeletal System; D010379:Peer Group; D010808:Physical Examination / Q000379:methods / Q000592:standards; D012219:Rheumatology / Q000193:education*; D012606:Scotland; D013337:Students, Medical; D011795:Surveys and Questionnaires