Skip to main content
Erschienen in: Journal of General Internal Medicine 11/2016

27.06.2016 | Original Research

“Mini-Residency” in Musculoskeletal Care: a National Continuing Professional Development Program for Primary Care Providers

verfasst von: Michael J. Battistone, MD, Andrea M. Barker, MPAS, PA-C, Marissa P. Grotzke, MD, J. Peter Beck, MD, Phillip Lawrence, PharmD, Grant W. Cannon, MD, MACP

Erschienen in: Journal of General Internal Medicine | Ausgabe 11/2016

Einloggen, um Zugang zu erhalten

Abstract

Introduction

A cost-effective professional development program enhancing musculoskeletal (MSK) skills of physicians and allied health providers working in primary care settings has been reported at a single site. This article describes the first 2 years of the national expansion and implementation of a 3-day “MSK Mini-residency.”

Methods

Faculty from Veterans Affairs (VA) medical centers worked in partnership with national program faculty from the Salt Lake City VA to present an intensive, integrated, multidisciplinary program to strengthen the skills of primary care providers in evaluating and managing MSK conditions common in primary care. Course assessments included written surveys and a two-station observed structured clinical examination (OSCE) evaluating the physical examination of the shoulder and knee.

Results

In the first 2 years of the program, 13 VA facilities participated. Two hundred twenty-seven health care providers, including 135 physicians, were trained. Two hundred seven participants (91 %) completed all pre- and post-course written assessments and the two-station OSCE.

Discussion

The MSK Mini-residency program is an effective and well-received mixed-method educational initiative to strengthen the skills of primary care physicians and other health care providers in evaluating and managing patients with MSK complaints and to document their competence in performing physical examinations of the shoulder and knee. The 2-year experience in implementation suggests that this model of educational partnerships is a feasible approach to disseminating innovative educational programs in a way that preserves curricular consistency yet is adaptable to local needs.
Literatur
1.
Zurück zum Zitat Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum. 2008;58(1):15–25.CrossRefPubMed Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. Arthritis Rheum. 2008;58(1):15–25.CrossRefPubMed
2.
Zurück zum Zitat Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35.CrossRefPubMedPubMedCentral Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat FitzGerald JD, Battistone M, Brown CR Jr, Cannella AC, Chakravarty E, Gelber AC, et al. Regional distribution of adult rheumatologists. Arthritis Rheum. 2013;65(12):3017–25.CrossRefPubMed FitzGerald JD, Battistone M, Brown CR Jr, Cannella AC, Chakravarty E, Gelber AC, et al. Regional distribution of adult rheumatologists. Arthritis Rheum. 2013;65(12):3017–25.CrossRefPubMed
4.
Zurück zum Zitat Cherry DK, Hing E, Woodwell DA, Rechtsteiner EA. National Ambulatory Medical Care Survey: 2006 summary. Natl Health Stat Rep. 2008; (3):1–39. Cherry DK, Hing E, Woodwell DA, Rechtsteiner EA. National Ambulatory Medical Care Survey: 2006 summary. Natl Health Stat Rep. 2008; (3):1–39.
5.
Zurück zum Zitat Glazier RH, Dalby DM, Badley EM, Hawker GA, Bell MJ, Buchbinder R. Determinants of physician confidence in the primary care management of musculoskeletal disorders. J Rheumatol. 1996;23(2):351–6.PubMed Glazier RH, Dalby DM, Badley EM, Hawker GA, Bell MJ, Buchbinder R. Determinants of physician confidence in the primary care management of musculoskeletal disorders. J Rheumatol. 1996;23(2):351–6.PubMed
6.
Zurück zum Zitat Smith J, Laskowski ER, Noll SR. Development of a musculoskeletal examination skills course for a physical medicine and rehabilitation residency program. Am J Phys Med Rehabil. 2001;80(10):747–53.CrossRefPubMed Smith J, Laskowski ER, Noll SR. Development of a musculoskeletal examination skills course for a physical medicine and rehabilitation residency program. Am J Phys Med Rehabil. 2001;80(10):747–53.CrossRefPubMed
7.
Zurück zum Zitat Haywood BL, Porter SL, Grana WA. Assessment of musculoskeletal knowledge in primary care residents. Am J Orthop (Belle Mead N.J.). 2006;35(6):273–5. Haywood BL, Porter SL, Grana WA. Assessment of musculoskeletal knowledge in primary care residents. Am J Orthop (Belle Mead N.J.). 2006;35(6):273–5.
8.
Zurück zum Zitat Wilcox T, Oyler J, Harada C, Utset T. Musculoskeletal exam and joint injection training for internal medicine residents. J Gen Intern Med. 2006;21(5):521–3.CrossRefPubMedPubMedCentral Wilcox T, Oyler J, Harada C, Utset T. Musculoskeletal exam and joint injection training for internal medicine residents. J Gen Intern Med. 2006;21(5):521–3.CrossRefPubMedPubMedCentral
9.
10.
Zurück zum Zitat Monrad SU, Zeller JL, Craig CL, Diponio LA. Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future. Curr Rev Musculoskelet Med. 2011;4(3):91–8.CrossRefPubMedPubMedCentral Monrad SU, Zeller JL, Craig CL, Diponio LA. Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future. Curr Rev Musculoskelet Med. 2011;4(3):91–8.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat O’Dunn-Orto A, Hartling L, Campbell S, Oswald AE. Teaching musculoskeletal clinical skills to medical trainees and physicians: a Best Evidence in Medical Education systematic review of strategies and their effectiveness: BEME Guide No. 18. Med Teach. 2012;34(2):93–102.CrossRefPubMed O’Dunn-Orto A, Hartling L, Campbell S, Oswald AE. Teaching musculoskeletal clinical skills to medical trainees and physicians: a Best Evidence in Medical Education systematic review of strategies and their effectiveness: BEME Guide No. 18. Med Teach. 2012;34(2):93–102.CrossRefPubMed
12.
Zurück zum Zitat Gnatz SM, Pisetsky DS, Andersson GB. The value in musculoskeletal care: summary and recommendations. Semin Arthritis Rheum. 2012;41(5):741–4.CrossRefPubMed Gnatz SM, Pisetsky DS, Andersson GB. The value in musculoskeletal care: summary and recommendations. Semin Arthritis Rheum. 2012;41(5):741–4.CrossRefPubMed
13.
Zurück zum Zitat Nelson RE, Battistone MJ, Ashworth WD, Barker AM, Grotzke M, Huhtala TA, et al. Cost effectiveness of training rural providers to perform joint injections. Arthritis Care Res. 2014;66(4):559–66.CrossRef Nelson RE, Battistone MJ, Ashworth WD, Barker AM, Grotzke M, Huhtala TA, et al. Cost effectiveness of training rural providers to perform joint injections. Arthritis Care Res. 2014;66(4):559–66.CrossRef
14.
Zurück zum Zitat Nelson SD, Nelson RE, Cannon GW, Lawrence P, Battistone MJ, Grotzke M, et al. Cost-effectiveness of training rural providers to identify and treat patients at risk for fragility fractures. Osteoporos Int. 2014;25(12):2701–7.CrossRefPubMed Nelson SD, Nelson RE, Cannon GW, Lawrence P, Battistone MJ, Grotzke M, et al. Cost-effectiveness of training rural providers to identify and treat patients at risk for fragility fractures. Osteoporos Int. 2014;25(12):2701–7.CrossRefPubMed
15.
Zurück zum Zitat Battistone MJ, Barker AM, Lawrence P, Grotzke MP, Cannon GW. Mini-residency in musculoskeletal care: An interprofessional, mixed-method educational initiative for primary care providers. Arthritis Care Res. 2015. Battistone MJ, Barker AM, Lawrence P, Grotzke MP, Cannon GW. Mini-residency in musculoskeletal care: An interprofessional, mixed-method educational initiative for primary care providers. Arthritis Care Res. 2015.
16.
Zurück zum Zitat Colthart I, Bagnall G, Evans A, Allbutt H, Haig A, Illing J, et al. The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME Guide no. 10. Med Teach. 2008;30(2):124–45.CrossRefPubMed Colthart I, Bagnall G, Evans A, Allbutt H, Haig A, Illing J, et al. The effectiveness of self-assessment on the identification of learner needs, learner activity, and impact on clinical practice: BEME Guide no. 10. Med Teach. 2008;30(2):124–45.CrossRefPubMed
17.
Zurück zum Zitat Eva KW, Regehr G. Self-assessment in the health professions: a reformulation and research agenda. Acad Med. 2005;80(10 Suppl):S46–54.CrossRefPubMed Eva KW, Regehr G. Self-assessment in the health professions: a reformulation and research agenda. Acad Med. 2005;80(10 Suppl):S46–54.CrossRefPubMed
18.
Zurück zum Zitat Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77(6):1121–34.CrossRefPubMed Kruger J, Dunning D. Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments. J Pers Soc Psychol. 1999;77(6):1121–34.CrossRefPubMed
19.
Zurück zum Zitat Nagler M, Feller S, Beyeler C. Retrospective adjustment of self-assessed medical competencies—noteworthy in the evaluation of postgraduate practical training courses. GMS Z Med Ausbild. 2012;29(3):Doc45.PubMedPubMedCentral Nagler M, Feller S, Beyeler C. Retrospective adjustment of self-assessed medical competencies—noteworthy in the evaluation of postgraduate practical training courses. GMS Z Med Ausbild. 2012;29(3):Doc45.PubMedPubMedCentral
20.
Zurück zum Zitat Battistone MJ, Barker AM, Beck JP, Tashjian RZ, Cannon GW. Validity evidence for two Objective Structured Clinical Examination stations to assess core examination skills of the shoulder and knee. Arthritis Rheum. 2015;67(suppl 10). Battistone MJ, Barker AM, Beck JP, Tashjian RZ, Cannon GW. Validity evidence for two Objective Structured Clinical Examination stations to assess core examination skills of the shoulder and knee. Arthritis Rheum. 2015;67(suppl 10).
21.
Zurück zum Zitat Battistone MJ, Barker AM, Okuda Y, Gaught W, Maida G, Cannon GW. Teaching the teachers: report of an effective mixed-methods course training clinical educators to provide instruction in musculoskeletal care to other providers and learners in primary care. Arthritis Rheum. 2015;67(suppl 10). Battistone MJ, Barker AM, Okuda Y, Gaught W, Maida G, Cannon GW. Teaching the teachers: report of an effective mixed-methods course training clinical educators to provide instruction in musculoskeletal care to other providers and learners in primary care. Arthritis Rheum. 2015;67(suppl 10).
22.
Zurück zum Zitat Hergenroeder AC, Chorley JN, Laufman L, Fetterhoff A. Two educational interventions to improve pediatricians’ knowledge and skills in performing ankle and knee physical examinations. Arch Pediatr Adolesc Med. 2002;156(3):225–9.CrossRefPubMed Hergenroeder AC, Chorley JN, Laufman L, Fetterhoff A. Two educational interventions to improve pediatricians’ knowledge and skills in performing ankle and knee physical examinations. Arch Pediatr Adolesc Med. 2002;156(3):225–9.CrossRefPubMed
23.
Zurück zum Zitat Bellamy N, Goldstein LD, Tekanoff RA, Support N-USGt. Continuing medical education-driven skills acquisition and impact on improved patient outcomes in family practice setting. J Contin Educ Health Prof. 2000;20(1):52–61.CrossRefPubMed Bellamy N, Goldstein LD, Tekanoff RA, Support N-USGt. Continuing medical education-driven skills acquisition and impact on improved patient outcomes in family practice setting. J Contin Educ Health Prof. 2000;20(1):52–61.CrossRefPubMed
24.
Zurück zum Zitat Petrella RJ, Davis P. Improving management of musculoskeletal disorders in primary care: the Joint Adventures Program. Clin Rheumatol. 2007;26(7):1061–6.CrossRefPubMed Petrella RJ, Davis P. Improving management of musculoskeletal disorders in primary care: the Joint Adventures Program. Clin Rheumatol. 2007;26(7):1061–6.CrossRefPubMed
25.
Zurück zum Zitat Cross KP. Adults as learners: [increasing participation and facilitating learning]. 1st ed. San Francisco: Jossey-Bass; 1981. Cross KP. Adults as learners: [increasing participation and facilitating learning]. 1st ed. San Francisco: Jossey-Bass; 1981.
26.
Zurück zum Zitat Taylor DC, Hamdy H. Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83. Med Teach. 2013;35(11):e1561–72.CrossRefPubMed Taylor DC, Hamdy H. Adult learning theories: implications for learning and teaching in medical education: AMEE Guide No. 83. Med Teach. 2013;35(11):e1561–72.CrossRefPubMed
27.
Zurück zum Zitat Moore DE Jr, Green JS, Gallis HA. Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities. J Contin Educ Health Prof. 2009;29(1):1–15.CrossRefPubMed Moore DE Jr, Green JS, Gallis HA. Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities. J Contin Educ Health Prof. 2009;29(1):1–15.CrossRefPubMed
Metadaten
Titel
“Mini-Residency” in Musculoskeletal Care: a National Continuing Professional Development Program for Primary Care Providers
verfasst von
Michael J. Battistone, MD
Andrea M. Barker, MPAS, PA-C
Marissa P. Grotzke, MD
J. Peter Beck, MD
Phillip Lawrence, PharmD
Grant W. Cannon, MD, MACP
Publikationsdatum
27.06.2016
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 11/2016
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-016-3773-4

Weitere Artikel der Ausgabe 11/2016

Journal of General Internal Medicine 11/2016 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.