Introduction As the Bone and Joint Decade 2000–2010 draws to a close, it is timely to review its impact on musculoskeletal medical education, which was clearly identified by the World Health Organization as a key factor contributing to less than optimal musculoskeletal care (1). The increasing burden of musculoskeletal disorders (including chronic bone and arthritic conditions) and the uncertain quality of care provided (2,3) has meant that there is a growing imperative to ensure that optimal, evidence-based, and cost-effective treatment is being provided to people with musculoskeletal disorders by medical practitioners (4). In 2004, the Bone and Joint Decade established the International Education Task Force and Undergraduate Curriculum Development Group to develop strategies to address the issue of insufficient and/or inadequate medical education, particularly in the areas of basic and clinical science (5,6). They released global core recommendations for a musculoskeletal undergraduate medical curriculum, which were designed to enable the development of a locally applicable musculoskeletal curriculum that was able to meet national guidelines and be reflective of local needs, priorities, and opportunities (5). Despite the release of the global core recommendations for a musculoskeletal undergraduate medical curriculum, in 2007 Woolfe and Akesson identified that the poor quality of medical education and a lack of coordination between the different disciplines and professional specialties working in musculoskeletal health care have meant that people do not receive the best practice treatment (6). Furthermore, in 2007 Day et al demonstrated significant deficiencies in the knowledge of chronic arthritic conditions in graduating medical students (2). Deficiencies in undergraduate education in musculoskeletal science have also been identified by medical students and graduates in studies conducted in a number of countries (2,7–10), and there is an obvious requirement for clinically relevant, evidence-based curriculum design that integrates traditional scientific and clinical disciplines. The Australian Musculoskeletal Education Collaboration (AMSEC) project began in Australia in 2005, with the aim of developing nationally agreed musculoskeletal core competencies (based on the Bone and Joint Decade curriculum recommendations) for implementation in all Australian medical schools. Initiated by the Australian Orthopaedic Association and funded by the Australian government, this project has succeeded in bringing together all key musculoskeletal specialist and representative organizations in a national, multidisciplinary education collaboration (including orthopedics, rheumatology, general practice, rehabilitation medicine, sports medicine, endocrinology, neurology, geriatrics, radiology, pediatrics, nursing, and interested allied health professions). While the Bone and Joint Decade recommendations formed the base from which the Australian competencies were developed, it was also vital that specific Australian standards and requirements were considered. The AMSEC competencies were therefore also related directly to the Australian Medical Council standards and principles and The National Patient Safety Framework (11,12). The purpose of this article is to outline the relevance of a competency-based approach to musculoskeletal education and to describe the development of theAMSECmusculoskeletal core competencies. Furthermore, we demonstrate the significance of the AMSEC competencies and the competency education process for optimal education in musculoskeletal medicine relative to chronic rheumatic disease.
Read full abstract