Advanced Primary Care Orthopedics: Bridging the Gap in Musculoskeletal Education.

Abstract

Musculoskeletal problems are common in primary care, yet many family physicians lack confidence and competence in this area. The Advanced Primary Care Orthopedics (APCO) course utilizes hands-on physical exam instruction, interactive cases, and intentional repetition to teach anatomy, a standardized exam, and important diagnoses. This study assesses the effectiveness of APCO in improving musculoskeletal exam knowledge and confidence. APCO is a 1.5-day course taught annually to family medicine residents. A 1-day course has also been conducted as a preconference workshop targeting faculty physicians. Participants completed pre- and postcourse assessments to evaluate their knowledge and confidence with the musculoskeletal exam. We compared results using mean differences with paired t-test statistics. In the 2018 and 2019 resident courses, 23 of 30 participants (77%) completed the knowledge assessment and 25 of 30 participants (83%) completed the confidence assessment. Knowledge assessment scores improved by 9.5 points (P<.05) after completion of the course. Confidence in the musculoskeletal exam, as assessed on a 5-point Likert scale (1-not confident at all; 5-very confident), improved from 2.2 to 3.8 after the course (P<.05). In the 2018 preconference workshop, 23 of 36 participants (64%) completed the confidence assessment. Confidence increased from 2.17 to 3.61 (P<.05) after course completion. Participation in the APCO course increased short-term musculoskeletal knowledge and confidence. APCO has many potential applications for residency curricula, faculty development, and continuing medical education.