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What do they need to know: achieving consensus on paediatric musculoskeletal content for medical students
Sharmila Jandial1, Jane Stewart2, Helen E Foster3
1Department of Paediatric Rheumatology, Great North Children's Hospital, Newcastle, UK. Sharmila.jandial@ncl.ac.uk.
Insights
This study established consensus on 45 essential learning outcomes for a pediatric musculoskeletal (pMSK) curriculum for medical students. This aims to improve doctors' confidence and skills in assessing children with MSK issues.
Area of Science:
- Medical Education
- Pediatric Musculoskeletal Medicine
- Curriculum Development
Background:
- Children frequently present with musculoskeletal (MSK) issues, ranging from minor to life-threatening conditions.
- Healthcare providers often lack confidence and adequate training in pediatric musculoskeletal (pMSK) clinical skills.
- There is a need for standardized learning outcomes for medical students in pMSK medicine.
Purpose of the Study:
- To achieve expert consensus on essential learning outcomes for a pediatric musculoskeletal (pMSK) curriculum for medical students.
- To address the gap in current guidance for pMSK education in medical training.
Main Methods:
- A two-phase study involving focus groups, interviews, and a Delphi process with medical students and experts.
- Identification of key pMSK educational topics and categories in Phase 1.
- Consensus-building on learning outcomes through a two-iteration Delphi process in Phase 2.
Main Results:
- Phase 1 identified relevant pMSK skills, knowledge, and attitudes for medical students.
- A total of 45 learning outcomes were agreed upon by experts.
- Outcomes cover history taking, examination, normal development, clinical presentations, investigations, and referral pathways for pMSK conditions.
Conclusions:
- Developed evidence- and consensus-based content for a pMSK curriculum for medical students.
- Implementation aims to equip future doctors with necessary skills for assessing pediatric MSK presentations.
- Facilitates earlier diagnosis and referral to specialist care for children with MSK conditions.
Background:
Children present commonly with musculoskeletal (MSK) problems, due to a spectrum of causes including potentially life threatening disease, to doctors in varied health care settings. However, doctors involved in the care of children report a lack of confidence in their paediatric musculoskeletal (pMSK) clinical skills and many have little exposure to pMSK teaching. There is no current guidance on the pMSK clinical skills and knowledge required for medical students. The objective of this study was to achieve consensus amongst experts on the learning outcomes for a pMSK curriculum for medical students.
Methods:
This was a two-phase study. In Phase one, pMSK educational topics and categories were identified from UK medical students and experts (recruited from pMSK medicine, child health, education and primary care) utilising focus groups and interviews. These themes and concepts informed the structure of learning outcomes that were presented to a Delphi panel in Phase two, with the aim of achieving consensus on the final content of the curriculum.
Results:
In Phase 1 participants identified pMSK skills, knowledge and attitudes relevant for medical students. This content was translated into learning outcomes. In Phase 2, the proposed outcomes were submitted to scrutiny by a two-iteration Delphi process with experts in the field. The agreed learning outcomes (n = 45) were either generic to child health or specific to pMSK medicine, and related to history taking and examination, knowledge about normal development, key clinical presentation and conditions, approaches to investigation and referral pathways.
Discussion:
This study has identified evidence and consensu based content for a pMSK curriculum for medical students, derived from key stakeholders and to be integrated into medical student pMSK teaching.
Conclusion:
It is envisaged that implementation of this content will equip graduating doctors with relevant and important skills and knowledge to assess children with MSK presentations, and facilitate early diagnosis and referral to specialist care.
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