Table 1

Basic competencies in clinical assessment and diagnosis

CategoryCompetencies required
HistoryTo identify abnormality from normality (pain, displacement, dislocation stiffness, swelling, and limitation of activities) by a history relevant to the musculoskeletal system
  • To be able to apply a screening history as part of a general inquiry—for example, enquiring about pain, limitation of activities, stiffness, and swelling (“PASS”)

  • To be able to take a relevant history in the knowledge of the characteristics of the major conditions of:

    • – Bone, including fracture, malignancy, infection, osteoporosis

    • – Joints, including rheumatoid arthritis, other arthritides, degenerative joint disease

    • – Connective tissue, including bursitis, tendonitis, tenosynovitis, enthesopathy

    • – Nerve tissue, including entrapment, peripheral neuropathy, radiculopathy

    • – Muscle tissue, including congenital, inflammatory, neurological

  • To be able to take an appropriate history in relation to high energy and low energy trauma and injury and its sequelae

  • To know how to assess acute and chronic pain according to its characteristics, severity, effects, and modulating factors

  • To understand the impact on the individual of a chronic musculoskeletal condition due to impairment of function, limitation of activities and restriction of participation (WHO ICF)22

ExaminationTo identify normality and abnormality by examination of the musculoskeletal system
  • To be able to perform a screening examination as part of general examination, for example by using the GALS (Gait, Arms, Legs, and Spine) screen23

  • To be able to perform an appropriate examination on musculoskeletal trauma (inspection, palpation, range of motion and status distal to the trauma) (colour, circulation, sensibility, mobility)

  • To be able to perform an appropriate examination of major joints (hip, knee, humeroscapular) and small joints such as finger joints in order to identify and characterise by examination, pain, tenderness, swelling, dislocation, displacement, deformity, muscle wasting, weakness, abnormal movement, and functional impairment

  • To be able to perform an appropriate examination of the neck, back, and sacroiliac joints

Attitude and communication skillsTo demonstrate the appropriate attitude and communication skills for the management of people with acute and chronic musculoskeletal conditions
  • To have an understanding of the problems of people with musculoskeletal conditions and the full impact on the individual and their care givers (for example, focus on chronic low back pain)

  • To have a holistic approach to the patient