A145: Faculty and Resident Perceptions About Teaching and Learning the Pediatric Musculoskeletal Examination: An Exploratory Study
Notice bibliographique
Résumé
Background/Purpose: he purpose of this research project is to explore how we currently teach the musculoskeletal exam to Pediatric residents and how they experience the acquisition of this set of skills. All second year General Pediatric residents at the Hospital for Sick Children in Toronto, Canada, spend four weeks on the Pediatric Rheumatology service. For the majority of them this will be their only post‐graduate education in musculoskeletal medicine. Many diseases in Pediatric Rheumatology are diagnosed based on the clinical exam, and we rely on these future Pediatricians to identify children who require the assessment of a subspecialist. Unfortunately, despite our efforts in teaching the musculoskeletal exam, many Pediatric patients will have significant functional limitations identified on their first visit to a Pediatric Rheumatologist due to delays in recognition of their inflammatory joint disease. The manner in which the Pediatric musculoskeletal is taught and learned may be at the root of the problem. Methods: A qualitative study designed to investigate and describe the experiences of teachers and learners of the Pediatric musculoskeletal exam in a single tertiary care centre was conducted. The study population consisted of a purposeful sample of Pediatric Rheumatology teaching faculty and General Pediatric residents who have completed their Pediatric Rheumatology rotation. Semi‐structured individual interviews of approximately one‐hour duration were conducted in‐person with each participant. Sample size was determined as the study progressed; interviews were continued until saturation of themes was reached. Interviews were transcribed verbatim, and were analyzed on a rolling basis, using a constant comparative method of analysis associated with grounded theory. The primary investigator identified themes and a coding system was developed, with a sample of the interviews coded by a second investigator for assessment of inter‐coder agreement. Results: Twenty‐two (22) interviews were conducted, with 7 General Pediatric junior residents, 7 senior residents, and 8 Pediatric Rheumatology faculty. Themes identified included: 1) characteristics of the Pediatric musculoskeletal exam (accuracy and reliability of the exam, utility of a screening exam vs. specific maneuvers); 2) factors that support learning the exam (direct observation with immediate feedback and repetition, learning multiple examination techniques from different teachers); 3) barriers to learning the exam (multiple examiners become an inconvenience to families, passive learning as a missed teaching opportunity); and 4) issues of professionalism (residents' desire to appear professional and competent in front of patients, taking ownership of their learning). Conclusion: Themes identified illustrate multiple perceived strengths and weaknesses in how the musculoskeletal examination is taught to General Pediatric residents. The factors that facilitate learning the musculoskeletal examination may be used to inform future curriculum development.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,007 | 0,004 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».