Can Medical Students Learn the Pediatric Musculoskeletal Examination Independently?

The objective was to investigate whether medical students can learn a pediatric musculoskeletal examination independently by studying the pediatric Gait, Arms, Legs, and Spine (pGALS) assessment.

Fourth-year medical students were surveyed in 2018 regarding confidence and experience with the pediatric musculoskeletal training. Students performed an initial scored musculoskeletal examination on a standardized pediatric patient reporting chronic joint concerns. The total score had a theoretic range from 0 to 42, and scoring was based on the pGALS examination for children presenting with joint pain. Subsequently, students watched training pGALS videos. After this intervention, students completed follow-up physical examinations and surveys.

Fourteen graduating medical students participated. Of these students, 12 students planned to enter a pediatric residency. On the initial survey, participants were the least confident in their pediatric musculoskeletal examination skills compared with all other pediatric physical examinations. Before the pGALS training, 21.4% of participants reported being confident or very confident in their pediatric musculoskeletal examination skills, compared with 100% of participants after training (P < 0.0001). The pre- and post-musculoskeletal examination scores were also statistically different (P = 0.0001). There were no participants who believed that they received extensive education in the pediatric musculoskeletal examination as part of their medical education. All of the participants desired further musculoskeletal training. All of the participants believed that the pGALS tool was beneficial.

Graduating medical students may not be confident nor proficient at the pediatric musculoskeletal examination. Instruction in the pGALS assessment may be a low-cost and efficient way to improve confidence and proficiency in the pediatric musculoskeletal examination.