Musculoskeletal Medicine in Undergraduate Medical Education

Abstract

Musculoskeletal (MSK) instruction has been identified as being inadequate in undergraduate medical education around the world. Just over two decades ago, there began to be recognition by medical education institutions that learners were emerging from their training lacking in both sufficient confidence and knowledge to manage MSK conditions. This was reflected in low passing rates on validated MSK knowledge assessments and in various evaluations that reported that primary care physicians, residents, and medical students generally had low confidence in their ability to accurately diagnose and treat MSK-related complaints. These gaps were linked back to problems at the undergraduate level of training, and barriers to implementing comprehensive MSK instruction were identified as a lack of time and resources dedicated to this subject area. Despite this recognized issue, little work has been done to reform Canadian medical school’s MSK curricula and identify sustainable solutions. Thus, we used the Context, Input, Process, and Product program evaluation framework situated within a sequential exploratory mixed methods approach to develop, implement, and evaluate a novel self-directed learning tool for MSK medicine at the DeGroote School of Medicine. First, a qualitative interpretive description study was used to assess student and faculty perceptions of the strengths and weaknesses of the MSK curriculum and inform the development of the learning tool. Next, a two-groups pre-test post-test design and a cross-sectional survey were used to evaluate the implementation and efficacy of the learning tool in helping medical students learn MSK medicine. Ultimately, this thesis outlines methods for evaluating MSK curricula and provides a promising learner-informed tool for assisting students in learning about MSK medicine in clinical settings.