Assessing Musculoskeletal Competency in Osteopathic Medical Students

Abstract

Musculoskeletal related conditions are the second most common reason patients seek medical attention in the primary care setting and the second most costly cause of morbidity behind cardiovascular disease. Furthermore, due to the changes that occur in the musculoskeletal system during the aging process, the frequency of musculoskeletal related office visits will increase as the number of elderly patients increases in the U.S. Therefore, it is very important that physicians are thoroughly educated, competent, and confident to diagnose and treat musculoskeletal conditions. However, previous research examining a cohort of graduating osteopathic medical students and a cohort of allopathic medical residents has demonstrated that musculoskeletal knowledge retention, based on a standardized competency exam, is less than optimal. Our study evaluated first‐year osteopathic medical students before and after they had taken a Musculoskeletal System course through administration of a 25‐question examination developed by internal medicine and orthopedic residency directors utilized in previous studies. The competency examination covered a broad area of topics that were considered important by surgical and nonsurgical criteria. We administered the examination before and after the course to two separate cohorts of first year medical students, the class of 2014 and the class of 2017. We compared these two cohorts to determine if changes within our Musculoskeletal course enhanced overall performance on the competency examination. The results show that the Musculoskeletal System course significantly improved examination performance by 27.8% for the class of 2014 and 28.4% for the class of 2017. But what was more interesting was that the average post‐course score of the class of 2017 was significantly higher than the average score of students in the class of 2014 showing 23% more students demonstrated competency. Our first‐year osteopathic medical students performed similarly to graduating osteopathic medical students (32% vs. 33%) and outperformed allopathic medical residents (32% vs. 22%) in the portion of students demonstrating competence. In summary, our Musculoskeletal System course improved musculoskeletal knowledge in students, and our first‐year osteopathic medical students did as well or better compared to graduating osteopathic students and allopathic residents, respectively. This study indicates that despite first‐year students comparing favorably with more experienced students in musculoskeletal knowledge there is room for improvement within our Musculoskeletal System course. Future changes to the course may include more case study scenarios and a focus on more high impact, high frequency musculoskeletal related presentations and management.Support or Funding InformationThis work was supported by an internal grant from Lake Erie College of Osteopathic Medicine.