Improving junior doctors' confidence in paediatric musculoskeletal assessment.

Abstract

Musculoskeletal symptoms are a common cause for presentation of children and adolescents to health-care settings. Junior doctors report lack of confidence in assessment of the paediatric musculoskeletal system. Our aim was to assess the confidence of junior medical officers (JMOs) working in the emergency department (ED) with paediatric musculoskeletal assessment and determine if a readily available teaching module would improve confidence. JMOs rostered to the paediatric ED were surveyed regarding their confidence in paediatric musculoskeletal assessment at the start and end of their ED rotation. A subgroup of these JMOs received formal teaching on paediatric musculoskeletal assessment using the paediatric gait, arm, leg and spine examination as part of their protected teaching time during their rotation. Forty-three JMOs were considered in the final analysis. Of those, 27 received teaching (intervention group), and 16 received no teaching (non-intervention group). In the intervention subgroup, there was a trend towards an increase in confidence in paediatric musculoskeletal assessment with the commonest response prior to the teaching intervention being 'some confidence' (11/27 41%) and the commonest response after teaching being 'fairly confident' (14/27 52%) without achieving statistical significance (P = 0.068). Of the JMOs in the intervention group, 26/27 (96%) found the teaching session useful, and 25/27 (93%) considered it relevant to their future practice. A clinical examination teaching intervention resulted in a trend towards an increase in confidence for JMOs in paediatric musculoskeletal assessment. Formal evaluation of a teaching module was feasible within the ED.