MUSCULOSKELETAL MEDICINE EDUCATION: A SURVEY OF CANADIAN MEDICAL PROGRAMMES
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".