Pharmacologic Management and Treatment of Osteoporosis: A Small Group Case‐Based Learning Activity

Abstract

Background: An estimated 50% of women and 20% of men over age 50 will suffer an osteoporosis-related fracture. Because osteoporosis is the most common bone disease in the world, osteoporosis-related pharmacology should be prioritized in medical education. Nevertheless, the AAMC has voiced concerns that medical schools may not provide adequate instruction on musculoskeletal medicine, particularly osteoporosis. We enhanced osteoporosis education in the preclinical curriculum through an interactive case-based learning session. Methods: To supplement in-class didactics during the second year Musculoskeletal Medicine course, all students (CO 2018, n=121) participated in a small group case-based session designed to address osteoporosis management and treatment. Groups of ten students worked with a single faculty facilitator. The 120-minute session integrated knowledge of osteoporosis pharmacology including indications for pharmacologic treatment, mechanisms of action, major adverse effects, and safe prescribing practices. Pharmacology knowledge acquisition was assessed by student performance on five session-related pharmacology multiple choice questions (MCQs) included on the internally developed final course exam. Student satisfaction was assessed by voluntary response to an anonymous post-session survey. This study was reviewed and deemed exempt by the FIU IRB. Results: Average student performance on the five session-relevant final exam MCQs was 94% (SD 0.04). 88.4% of students (n=107) responded to the anonymous post-session survey. On a 5-point Likert scale (Strongly Disagree – Strongly Agree), 101 of 107 students (94%) agreed or strongly agreed with the statement, “The basic science-clinical combination lecture on osteoporosis followed by the small group case discussion on osteoporosis prepared me adequately to understand the topic” (mean 4.56, SD 0.63). Conclusion: The implemented case session provided a framework for the application of pharmacologic concepts related to the treatment and management of osteoporosis. Students performed well on session-relevant pharmacologic exam questions, demonstrating competency in the objectives. Student satisfaction with the session was found to be high, with most students feeling well prepared. Case-based learning is a valuable and favorably regarded strategy to teach the pharmacologic management and treatment of osteoporosis.