Improving junior doctors' confidence in paediatric musculoskeletal assessment

Area of Science:

• Pediatric Emergency Medicine
• Medical Education
• Musculoskeletal Assessment

Background:

• Musculoskeletal symptoms are frequent reasons for pediatric healthcare visits.
• Junior doctors express low confidence in evaluating the pediatric musculoskeletal system.
• Standardized assessment tools are needed to improve junior doctor confidence.

Purpose of the Study:

• To assess the confidence of junior medical officers (JMOs) in pediatric musculoskeletal assessment within the emergency department (ED).
• To determine if a readily available teaching module can enhance JMO confidence in this area.

Main Methods:

• Junior medical officers in a pediatric ED were surveyed pre- and post-rotation on their confidence levels.
• A subgroup received formal teaching on pediatric musculoskeletal assessment using the "gait, arm, leg, and spine" (PALS) examination.
• Confidence levels were compared between the intervention and non-intervention groups.

Main Results:

• A trend towards increased confidence in pediatric musculoskeletal assessment was observed in the intervention group (41% 'some confidence' to 52% 'fairly confident').
• This trend did not reach statistical significance (P=0.068).
• 96% of JMOs found the teaching session useful, and 93% deemed it relevant for future practice.

Conclusions:

• A clinical examination teaching intervention demonstrated a trend toward improved confidence among JMOs in pediatric musculoskeletal assessment.
• The formal evaluation of a teaching module within the ED setting was feasible.
• Further research may be warranted to achieve statistical significance in confidence improvement.