MUSCULOSKELETAL MEDICINE EDUCATION: A SURVEY OF CANADIAN MEDICAL PROGRAMMES
Notice bibliographique
Résumé
Despite the large burden of disease associated with musculoskeletal (MSK) injuries & disorders, a considerable body of evidence suggests that physician training in the area of MSK medicine has historically been either absent or insufficient. In fact, North American data suggests that only a very small amount of curricular time (~3%) within medical schools is actually spent educating students on topics related to MSK medicine3–6. Not surprisingly, post-graduate investigations indicate that many physicians lack adequate confidence, knowledge, and clinical skills when practicing MSK medicine. The purpose of this investigation was to document the current state of musculoskeletal medicine education in Canadian undergraduate medical programs in order to identify variations in programming and potential shortcomings. All 14 English-speaking AFMC-accredited Canadian medical schools were surveyed using a questionnaire adopted from the work of Wang et al5, and Pinney & Reagan10. The questionnaire included 34 questions that were divided into three themes: 1). MSK anatomy teaching (twelve questions); 2). Preclinical MSK curriculum (sixteen questions); and 3). Clinical MSK education (six questions). The survey had a 100% response rate. Results indicated that the mean time spent educating medical students about MSK anatomy was 30.2 hours (SD ±14.2, range 12 – 60), with all but one program using some form of cadaveric-based instruction to support their anatomy curriculum. Thirteen programs reported teaching radiological correlates (x-ray, CT, MRI), and 11 programs included MSK surface land marking and/or palpation as part of program delivery. Preclinical students spent an average of 58.0 hours (SD ±53.4, range 6 – 204) learning about topics related to MSK medicine. Preclinical curricula were most commonly delivered by orthopaedic surgeons, rheumatologists, or physiatrists using case-based and small group learning sessions, didactic lectures and self-study activities. MSK courses included a diverse range of topics, but the extent to which each curriculum focused on “core” or “must know” MSK pathologies (eg. osteoarthritis) or injuries (eg. ankle sprain) varied widely across the 14 programs. The mean time spent teaching MSK clinical assessment skills during preclinical training was 12.6 hours (SD ±9.7, range: 3 – 40). Only 50% of medical programs required a clinical rotation in orthopaedic surgery as part of clerkship education, and this rotation was most commonly two weeks in duration. No schools required clinical rotations in either rheumatology or physical medicine & rehabilitation. This investigation quantifies the large variation in structure and content of MSK instruction among Canadian undergraduate medical programs, and highlights the need for expanded MSK learning opportunities during the clerkship portion of medical student training. Our results also highlight the need for enhanced interdisciplinary collaboration between MSK-focused physician groups when delivering the MSK curricula, as well as the identification and adoption of a standardized set of MSK course learning objectives or core topics that would be taught by all AFMC-accredited Canadian medical programs.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 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 tête enseignante, 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 ».