Background Musculoskeletal (MSK) complaints are very common in primary and specialty care. Through funding from the Office of Academic Affiliations (OAA) of the Department of Veterans Affairs (VA), we developed a Center of Excellence (COE) for patient-centered MSK care to train residents, associated health trainees, and medical students.
Objectives To report the participants' experience and self-assessed competencies during the MSK COE education week and determine the principal diagnoses encountered in the COE interdisciplinary and interprofessional clinics.
Methods The COE program had two major components. 1) A week of intensive training in MSK care combining didactics, simulations, and clinical experiences (see figure). 2) Two interdisciplinary and interprofessional clinics for evaluating patients with complex MSK disorders and training in joint injections. Trainee competence was assessed by faculty by direct observation in clinical experiences and two-station Objective Structured Clinical exam (OSCE). Trainees report self-assessment of clinical competency before and after COE training.
Results Since inception three years ago, the COE program has trained 157 trainees: 101 physician trainees from six disciplines and 56 associated health trainees from five disciplines. A review of the first 140 patients seen in the COE MSK interdisciplinary clinic documents a rich clinical training opportunity with an average of 2.4±1.5 complaints per visit, and patients being seen by 2.8±1.2 disciplines. The chief MSK complaint by patients was classified according to the following areas (orthopedics (OrS), rheumatology (RHE), endocrinology (END), and primary care (PC); however, as noted, the vast majority of patients had multiple MSK diagnoses.
Trainees reported high satisfaction with the intensive training and COE MSK clinics. Self-assessment of knowledge and skills for several of the key elements evaluated for physician trainees are listed below.
Marked increase in self-assessed MSK knowledge and skills were reported in all areas of training and improvement in clinical competence was confirmed on OSCE.
Conclusions The COE is an interdisciplinary and interprofessional training model that gives trainees a unique experience for learning to manage patients with MSK disease in a rich collaborative setting.
Acknowledgements This material is based upon work supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Academic Affiliations and Office of Specialty Care Services.
Disclosure of Interest None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.