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A Medical Student Curriculum on Functional Medical Disorders
Mohsin F Butt1,2, Daniele Scotto1, Christopher G S Gilmartin1
1NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK.
Background:
Functional medical disorders (FMDs) refer to persistent physical symptoms that cause impairment or disability, but which cannot be explained by routine medical testing. Negative perceptions towards FMDs exist amongst a variety of healthcare professionals, including medical students. The aim of this study was to develop and evaluate a course addressing FMDs for medical students in their first year of clinical training, which was integrated within the formal medical school curriculum.
Approach:
A multidisciplinary team of eight healthcare professionals delivered seven teaching sessions, each two hours in length, over six weeks. The curriculum was delivered via a combination of didactic teaching, small group tutorials and sessions with simulated patients. Pre- and post-course validated questionnaires assessed knowledge of, attitudes towards and confidence around irritable bowel syndrome (IBS). Students undertook a two-station objective structured clinical examination (OSCE), which assessed their ability to take a clinical history from and communicate a diagnosis to simulated patients with IBS and fibromyalgia.
Evaluation:
Twenty-seven students completed the pre- and post-course surveys, which demonstrated an increase in knowledge of FMDs at course conclusion (88.89% vs. 57.50%, p < 0.001). Students' confidence ratings increased in all (100%) domains relating to FMDs: pathophysiology, symptoms, investigations for diagnosis and communicating a diagnosis (p < 0.001, all analyses). There was a statistically significant improvement in attitude ratings towards FMDs in 11 of 12 (91.7%) questions. All (100%) students passed the OSCE.
Implications:
A course integrated within the formal medical school curriculum may be a helpful way to improve knowledge and reduce stigma around FMDs.
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