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Lesley Kay - One of the best experts on this subject based on the ideXlab platform.
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regional Examination of the Musculoskeletal system rems a core set of clinical skills for medical students
Rheumatology, 2004Co-Authors: David Coady, David Walker, Lesley KayAbstract:Objectives. The aim of this study was to determine an agreed set of core regional Musculoskeletal Examination skills for medical students to learn. Methods. Initially focus groups were undertaken amongst Rheumatologists, Orthopaedic Surgeons, Geriatricians and General Practitioners. These findings were used to inform the production of a questionnaire survey. The findings from both the questionnaire survey and focus groups were assessed using a group nominative technique with national representation from each of the four specialities involved. Results. This process has led to the identification of 50 items, considered to be core regional Musculoskeletal Examination skills for medical students. Conclusions. This core set of Musculoskeletal clinical skills may now be used to inform the production of teaching materials aimed at medical students.
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teaching medical students Musculoskeletal Examination skills identifying barriers to learning and ways of overcoming them
Scandinavian Journal of Rheumatology, 2004Co-Authors: David Coady, David Walker, Lesley KayAbstract:Objectives: To elicit the barriers to the effective teaching of Musculoskeletal Examination skills amongst medical students.Methods: This was a qualitative study including six focus groups with specialities most often involved in delivering Musculoskeletal clinical teaching: rheumatology, orthopaedics, general practice, and geriatrics.Results: The main barriers to the delivery of effective clinical teaching included the lack of agreement on what to teach, lack of confidence in teaching amongst non‐Musculoskeletal specialities, and poor communication between specialities.Conclusions: There is a need to overcome the identified barriers if Musculoskeletal clinical teaching to medical students is to be improved. In particular, there is a need to agree which Examination skills medical students should learn.
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regional Musculoskeletal Examination what the students say
Jcr-journal of Clinical Rheumatology, 2003Co-Authors: David Coady, Lesley Kay, David M WalkerAbstract:Abstract Confusion exists over which Musculoskeletal Examination skills medical students should learn. This study aimed to explore the views of third-year medical students. This was a qualitative study to allow in-depth exploration of beliefs and attitudes. Twenty students were randomly assigned to 1 of 2 focus groups. Their attitudes towards Musculoskeletal Examination were explored and discussed. The groups’ discussions were recorded, transcribed, and framework analysis was undertaken with the aid of NUD*IST computer software. The following themes were identified: students dislike eponymous names for clinical tests; students felt there is a need for a more structured approach to Musculoskeletal Examination; students appeared unaware that many clinical tests were not based on evidence; students complained of a lack of confidence in the use of Musculoskeletal clinical tests. Student's confidence in their Musculoskeletal Examination skills may be improved by the development of an agreed set of so-called core Examination skills.
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The attitudes and beliefs of clinicians involved in teaching undergraduate Musculoskeletal clinical Examination skills.
Medical teacher, 2003Co-Authors: David Coady, David Walker, Lesley KayAbstract:The aim of this study was to explore which regional Musculoskeletal Examination skills medical students should learn and be examined on. A qualitative research study was undertaken, and six focus groups were formed involving 36 consultants from four chosen specialties. The feeling was that greater emphasis should be placed on the functional assessment of a patient. Students should be able to discern through Examination what the patient can and cannot do with his/her affected limb/joint. It was felt that many of the traditional eponymously named special tests (e.g.Thomas’ test, Trendelenburg’s test) should be dispensed with along with traditional descriptions such as varus, valgus, swan neck and Boutonniere deformities. It was felt these were often a cause of confusion for medical undergraduates. A broad view and diversity in opinions was detected with differences between specialties. The strongest theme to emerge by far was the desire to simplify and standardize the regional Examination as much as possible.
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joints if relevant do available textbooks contain adequate information about Musculoskeletal Examination skills for medical students
Medical Teacher, 2001Co-Authors: Lesley Kay, David Coady, David WalkerAbstract:The objective was to determine whether routinely available textbooks describe the core Musculoskeletal Examination skills for medical students. Textbooks were evaluated for content against a list of 27 core Examination skills as perceived by rheumatologists, orthopaedic surgeons and general practitioners. The study took place in Newcastle upon Tyne, libraries of the rheumatology department, teaching hospital and medical school. The main outcome was the inclusion of a description of Examination skills by available textbooks. Median score for each textbook was only 19 (range 1–24) of a possible 27 core skills. Screening Examination was not included in general texts. General principles were well covered but detail was insufficient, particularly in texts aimed at students taking final Examinations. It is not easy for students to access adequate information about core items of Musculoskeletal Examination from textbooks readily available to them. This may reflect a general view of the lack of importance of musc...
David Coady - One of the best experts on this subject based on the ideXlab platform.
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validation of msat an instrument to measure medical students self assessed confidence in Musculoskeletal Examination skills
Medical Education, 2007Co-Authors: Pirashanthie Vivekanandaschmidt, David Coady, David Walker, Martyn Lewis, Andrew Hassell, Monica Mclean, Anisur RahmanAbstract:Context Self-assessment promotes reflective practice, helps students identify gaps in their learning and is used in curricular evaluations. Currently, there is a dearth of validated self-assessment tools in rheumatology. We present a new Musculoskeletal self-assessment tool (MSAT) that allows students to assess their confidence in their skills in and knowledge of knee and shoulder Examination. Objectives We aimed to validate the 15-item MSAT, addressing its construct validity, internal consistency, responsiveness, repeatability and relationship with competence. Methods Participants were 241 Year 3 students in Newcastle upon Tyne and 113 Year 3 students at University College London, who were starting their Musculoskeletal skills placement. Factor analysis explored the construct validity of the MSAT; Cronbach's α assessed its internal consistency; standardised response mean (SRM) evaluated its responsiveness, and test-retest, before and after a pathology lecture, assessed its repeatability. Its relationship with competence was explored by evaluating its correlation with shoulder and knee objective structured clinical Examinations (OSCEs). Results The MSAT was valid in distinguishing the 5 domains it intended to measure: clinical Examination of the knee; clinical Examination of the shoulder; clinical anatomy of the knee and shoulder; history taking, and generic Musculoskeletal anatomical and clinical terms. It was internally consistent (α = 0.93), responsive (SRM 0.6 in Newcastle and 2.2 in London) and repeatable (intraclass correlation coefficient 0.97). Correlations between MSAT scores and OSCE scores were weak (r < 0.2). Conclusions The MSAT has strong psychometric properties, thereby offering a valid approach to evaluating the self-assessment of confidence in Examination skills by students. Confidence does not necessarily reflect competence; future research should clarify what underpins confidence.
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regional Examination of the Musculoskeletal system rems a core set of clinical skills for medical students
Rheumatology, 2004Co-Authors: David Coady, David Walker, Lesley KayAbstract:Objectives. The aim of this study was to determine an agreed set of core regional Musculoskeletal Examination skills for medical students to learn. Methods. Initially focus groups were undertaken amongst Rheumatologists, Orthopaedic Surgeons, Geriatricians and General Practitioners. These findings were used to inform the production of a questionnaire survey. The findings from both the questionnaire survey and focus groups were assessed using a group nominative technique with national representation from each of the four specialities involved. Results. This process has led to the identification of 50 items, considered to be core regional Musculoskeletal Examination skills for medical students. Conclusions. This core set of Musculoskeletal clinical skills may now be used to inform the production of teaching materials aimed at medical students.
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teaching medical students Musculoskeletal Examination skills identifying barriers to learning and ways of overcoming them
Scandinavian Journal of Rheumatology, 2004Co-Authors: David Coady, David Walker, Lesley KayAbstract:Objectives: To elicit the barriers to the effective teaching of Musculoskeletal Examination skills amongst medical students.Methods: This was a qualitative study including six focus groups with specialities most often involved in delivering Musculoskeletal clinical teaching: rheumatology, orthopaedics, general practice, and geriatrics.Results: The main barriers to the delivery of effective clinical teaching included the lack of agreement on what to teach, lack of confidence in teaching amongst non‐Musculoskeletal specialities, and poor communication between specialities.Conclusions: There is a need to overcome the identified barriers if Musculoskeletal clinical teaching to medical students is to be improved. In particular, there is a need to agree which Examination skills medical students should learn.
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regional Musculoskeletal Examination what the students say
Jcr-journal of Clinical Rheumatology, 2003Co-Authors: David Coady, Lesley Kay, David M WalkerAbstract:Abstract Confusion exists over which Musculoskeletal Examination skills medical students should learn. This study aimed to explore the views of third-year medical students. This was a qualitative study to allow in-depth exploration of beliefs and attitudes. Twenty students were randomly assigned to 1 of 2 focus groups. Their attitudes towards Musculoskeletal Examination were explored and discussed. The groups’ discussions were recorded, transcribed, and framework analysis was undertaken with the aid of NUD*IST computer software. The following themes were identified: students dislike eponymous names for clinical tests; students felt there is a need for a more structured approach to Musculoskeletal Examination; students appeared unaware that many clinical tests were not based on evidence; students complained of a lack of confidence in the use of Musculoskeletal clinical tests. Student's confidence in their Musculoskeletal Examination skills may be improved by the development of an agreed set of so-called core Examination skills.
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The attitudes and beliefs of clinicians involved in teaching undergraduate Musculoskeletal clinical Examination skills.
Medical teacher, 2003Co-Authors: David Coady, David Walker, Lesley KayAbstract:The aim of this study was to explore which regional Musculoskeletal Examination skills medical students should learn and be examined on. A qualitative research study was undertaken, and six focus groups were formed involving 36 consultants from four chosen specialties. The feeling was that greater emphasis should be placed on the functional assessment of a patient. Students should be able to discern through Examination what the patient can and cannot do with his/her affected limb/joint. It was felt that many of the traditional eponymously named special tests (e.g.Thomas’ test, Trendelenburg’s test) should be dispensed with along with traditional descriptions such as varus, valgus, swan neck and Boutonniere deformities. It was felt these were often a cause of confusion for medical undergraduates. A broad view and diversity in opinions was detected with differences between specialties. The strongest theme to emerge by far was the desire to simplify and standardize the regional Examination as much as possible.
David Walker - One of the best experts on this subject based on the ideXlab platform.
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use of structured Musculoskeletal Examination routines in undergraduate medical education and postgraduate clinical practice a uk survey
BMC Medical Education, 2016Co-Authors: Kenneth F Baker, David Walker, Sharmila Jandial, Ben Thompson, K Taylor, Helen E FosterAbstract:Structured Examination routines have been developed as educational resources for Musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these Examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. Electronic questionnaires were distributed to adult and paediatric Musculoskeletal teaching leads at UK medical schools and current UK doctors in training. Responses were received from 67 tutors representing teaching at 22/33 [67 %] of all UK medical schools, and 70 trainee doctors across a range of postgraduate training specialities. There was widespread adoption, at responding medical schools, of the adult Examination routines within Musculoskeletal teaching (GALS: 14/16 [88 %]; REMS: 12/16 [75 %]) and assessment (GALS: 13/16 [81 %]; REMS: 12/16 [75 %]). More trainees were aware of GALS (64/70 [91 %]) than REMS (14/67 [21 %]). Of the 39 trainees who used GALS in their clinical practice, 35/39 [90 %] reported that it had improved their confidence in Musculoskeletal Examination. Of the 17/22 responding medical schools that included paediatric Musculoskeletal Examination within their curricula, 15/17 [88 %] used the pGALS approach and this was included within student assessment at 4 medical schools. We demonstrate the widespread adoption of these Examination routines in undergraduate education and significant uptake in postgraduate clinical practice. Further study is required to understand their impact upon clinical performance.
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validation of msat an instrument to measure medical students self assessed confidence in Musculoskeletal Examination skills
Medical Education, 2007Co-Authors: Pirashanthie Vivekanandaschmidt, David Coady, David Walker, Martyn Lewis, Andrew Hassell, Monica Mclean, Anisur RahmanAbstract:Context Self-assessment promotes reflective practice, helps students identify gaps in their learning and is used in curricular evaluations. Currently, there is a dearth of validated self-assessment tools in rheumatology. We present a new Musculoskeletal self-assessment tool (MSAT) that allows students to assess their confidence in their skills in and knowledge of knee and shoulder Examination. Objectives We aimed to validate the 15-item MSAT, addressing its construct validity, internal consistency, responsiveness, repeatability and relationship with competence. Methods Participants were 241 Year 3 students in Newcastle upon Tyne and 113 Year 3 students at University College London, who were starting their Musculoskeletal skills placement. Factor analysis explored the construct validity of the MSAT; Cronbach's α assessed its internal consistency; standardised response mean (SRM) evaluated its responsiveness, and test-retest, before and after a pathology lecture, assessed its repeatability. Its relationship with competence was explored by evaluating its correlation with shoulder and knee objective structured clinical Examinations (OSCEs). Results The MSAT was valid in distinguishing the 5 domains it intended to measure: clinical Examination of the knee; clinical Examination of the shoulder; clinical anatomy of the knee and shoulder; history taking, and generic Musculoskeletal anatomical and clinical terms. It was internally consistent (α = 0.93), responsive (SRM 0.6 in Newcastle and 2.2 in London) and repeatable (intraclass correlation coefficient 0.97). Correlations between MSAT scores and OSCE scores were weak (r < 0.2). Conclusions The MSAT has strong psychometric properties, thereby offering a valid approach to evaluating the self-assessment of confidence in Examination skills by students. Confidence does not necessarily reflect competence; future research should clarify what underpins confidence.
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regional Examination of the Musculoskeletal system rems a core set of clinical skills for medical students
Rheumatology, 2004Co-Authors: David Coady, David Walker, Lesley KayAbstract:Objectives. The aim of this study was to determine an agreed set of core regional Musculoskeletal Examination skills for medical students to learn. Methods. Initially focus groups were undertaken amongst Rheumatologists, Orthopaedic Surgeons, Geriatricians and General Practitioners. These findings were used to inform the production of a questionnaire survey. The findings from both the questionnaire survey and focus groups were assessed using a group nominative technique with national representation from each of the four specialities involved. Results. This process has led to the identification of 50 items, considered to be core regional Musculoskeletal Examination skills for medical students. Conclusions. This core set of Musculoskeletal clinical skills may now be used to inform the production of teaching materials aimed at medical students.
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teaching medical students Musculoskeletal Examination skills identifying barriers to learning and ways of overcoming them
Scandinavian Journal of Rheumatology, 2004Co-Authors: David Coady, David Walker, Lesley KayAbstract:Objectives: To elicit the barriers to the effective teaching of Musculoskeletal Examination skills amongst medical students.Methods: This was a qualitative study including six focus groups with specialities most often involved in delivering Musculoskeletal clinical teaching: rheumatology, orthopaedics, general practice, and geriatrics.Results: The main barriers to the delivery of effective clinical teaching included the lack of agreement on what to teach, lack of confidence in teaching amongst non‐Musculoskeletal specialities, and poor communication between specialities.Conclusions: There is a need to overcome the identified barriers if Musculoskeletal clinical teaching to medical students is to be improved. In particular, there is a need to agree which Examination skills medical students should learn.
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The attitudes and beliefs of clinicians involved in teaching undergraduate Musculoskeletal clinical Examination skills.
Medical teacher, 2003Co-Authors: David Coady, David Walker, Lesley KayAbstract:The aim of this study was to explore which regional Musculoskeletal Examination skills medical students should learn and be examined on. A qualitative research study was undertaken, and six focus groups were formed involving 36 consultants from four chosen specialties. The feeling was that greater emphasis should be placed on the functional assessment of a patient. Students should be able to discern through Examination what the patient can and cannot do with his/her affected limb/joint. It was felt that many of the traditional eponymously named special tests (e.g.Thomas’ test, Trendelenburg’s test) should be dispensed with along with traditional descriptions such as varus, valgus, swan neck and Boutonniere deformities. It was felt these were often a cause of confusion for medical undergraduates. A broad view and diversity in opinions was detected with differences between specialties. The strongest theme to emerge by far was the desire to simplify and standardize the regional Examination as much as possible.
Helen E Foster - One of the best experts on this subject based on the ideXlab platform.
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use of structured Musculoskeletal Examination routines in undergraduate medical education and postgraduate clinical practice a uk survey
BMC Medical Education, 2016Co-Authors: Kenneth F Baker, David Walker, Sharmila Jandial, Ben Thompson, K Taylor, Helen E FosterAbstract:Structured Examination routines have been developed as educational resources for Musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these Examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. Electronic questionnaires were distributed to adult and paediatric Musculoskeletal teaching leads at UK medical schools and current UK doctors in training. Responses were received from 67 tutors representing teaching at 22/33 [67 %] of all UK medical schools, and 70 trainee doctors across a range of postgraduate training specialities. There was widespread adoption, at responding medical schools, of the adult Examination routines within Musculoskeletal teaching (GALS: 14/16 [88 %]; REMS: 12/16 [75 %]) and assessment (GALS: 13/16 [81 %]; REMS: 12/16 [75 %]). More trainees were aware of GALS (64/70 [91 %]) than REMS (14/67 [21 %]). Of the 39 trainees who used GALS in their clinical practice, 35/39 [90 %] reported that it had improved their confidence in Musculoskeletal Examination. Of the 17/22 responding medical schools that included paediatric Musculoskeletal Examination within their curricula, 15/17 [88 %] used the pGALS approach and this was included within student assessment at 4 medical schools. We demonstrate the widespread adoption of these Examination routines in undergraduate education and significant uptake in postgraduate clinical practice. Further study is required to understand their impact upon clinical performance.
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a survey of knowledge attitudes and practices relating to Musculoskeletal Examination among pediatricians in maharashtra india
Indian Journal of Rheumatology, 2015Co-Authors: Nicola Smith, Helen E Foster, Anita Dhanrajani, Raju KhubchandaniAbstract:Abstract Aims To explore knowledge, attitudes, and practices relating to Musculoskeletal Examination (MSKe) in one state of India. Methods Pediatricians from the state of Maharashtra (capital – Mumbai) were invited to complete an 11-item web-based survey. Participation implied consent and the survey was based on a similar UK study. All pediatricians from the state of Maharashtra ( n = 1523) were invited to participate; 223 pediatricians responded (response rate: 14.64%) with variable training in pediatrics and experience. Results Respondents reported similar time devoted within their consultations to management plan, history, and physical Examination. Most ( n = 166, 74.44%) had been taught to examine the Musculoskeletal system in children ( n = 82, 36.77%) or in both adults and children ( n = 84, 37.67%). However, MSKe was not part of their current routine practice, despite many ( n = 115, 51.57%) deeming this an important part of assessment. The majority ( n = 207, 92.82%) were very confident ( n = 7, 3.14%), or confident in some ( n = 120, 53.81%) or most ( n = 80, 35.87%) aspects of performing a structured MSKe, but were less confident with MSKe compared to other systems. Most ( n = 158, 70.85%) were unaware of pGALS (Pediatric Gait Arms Legs Spine) prior to the survey but many ( n = 204, 91.48%) were supportive of its inclusion within the curriculum for undergraduates and/or postgraduates, and expressed a desire to receive more information. Conclusions Many pediatricians are not confident in MSKe and are less confident compared to other bodily systems. There is need for greater training and awareness about the importance of MSKe at both undergraduate and postgraduate level. As a simple validated clinical skill, there is considerable potential to increase teaching of pGALS and thereby ultimately potentially improve MSKe performance in clinical practice.
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a102 acceptability and practicality of the paediatric gait arms legs and spine Examination in detecting Musculoskeletal abnormalities in peruvian children
Arthritis & Rheumatism, 2014Co-Authors: Katrina Abernethy, Sharmila Jandial, Lucy Hill, Ernesto Salazar Sanchez, Helen E FosterAbstract:Background/Purpose: The paediatric Gait, Arms, Legs and Spine (pGALS) Musculoskeletal Examination tool (Foster & Jandial 2013) has been validated for use in school-aged English Speaking children. pGALS detects significant joint abnormalities when performed by non specialists in paediatric rheumatology and has been shown to be practical and effective in acute paediatric practice in the UK (Goff 2010) and Malawi (Smith 2012). The aim of this study was to assess the acceptability and practicality of a Spanish translation of pGALS in an acute paediatric setting in Peru. Methods: pGALS was translated into Spanish in collaboration with the School of Modern Languages, Newcastle University. Over a two week period in summer 2013, 53 school-aged children presenting to a teaching hospital in a large city in Peru were recruited following informed consent from parents/carers. The pGALS assessment was conducted in Spanish by a medical student (KA), a native English speaker with Spanish as a second language, who has completed standard training in pGALS at Newcastle medical school. Data collected included patient demographics, presenting complaint, final diagnosis (from case notes), and findings of the pGALS assessment. Acceptability, with regards to time taken and discomfort, was assessed using visual analogue scales (smiley faces). This study had full ethical approval. Results: Fifty-three children were recruited (21 female, 32 male), median age 9 years old (range 4-15 years). Many (54.3%, 33/53) were assessed in the emergency department with the remainder as inpatients. The presenting complaint and final diagnosis most commonly related to infections (73.9%, 39/53). The pGALS Examination was completed in 92.5% (49/53) of children, reasons for non-completion were limb fracture (n = 2), snakebite related pain (n = 1) and vomiting due to dengue fever (n = 1). The time taken (median 4.42 minutes, range 2.47–6.50) was acceptable to most parents (98.1%, 52/53). Most children (88.7%, 47/53) found the pGALS Examination caused little or no additional discomfort. Significant findings using pGALS were found in 18/53 (34%); these related to limited limb movement due to fracture (4/18), hypermobility (4/18), plus infectious causes (5/18) and soft tissue trauma (5/18) causing pain and joint restriction in limbs, cervical spine or temporomandibular joints. The commonest findings of pGALS were abnormal gait (limp) (n = 5) and loss of foot arches (n = 4). Conclusion: The pGALS assessment was acceptable to patients and their parents, practical and detected significant Musculoskeletal changes in many children. As in previous studies of pGALS in acute paediatrics, it is important to interpret the findings in the clinical context as abnormal findings may be caused by non rheumatic disease. The Spanish translation of pGALS was effective and further work is in progress to assess validity and use in similar health care settings.
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pres final 2271 assessment of Musculoskeletal abnormalities in children with mucopolysaccharidoses using a simple Musculoskeletal Examination paediatric gait arms legs and spine
Pediatric Rheumatology, 2013Co-Authors: Mo Chan, Ethan S Sen, E Hardy, Tim Rapley, P Hensman, E Wraith, Helen E FosterAbstract:Mucopolysaccharidoses (MPS) are rare inherited disorders with a spectrum of phenotypes resulting from glycosaminoglycans (GAGs) accumulation in cells. Children with MPS often have Musculoskeletal (MSK) abnormalities ranging from joint contractures to deforming abnormalities of the extremities and spine. pGALS (paediatric Gait, Arms, Legs, and Spine), is a simple MSK assessment which has been previously validated in school-age children to detect abnormal joints.
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acceptability and practicality of Musculoskeletal Examination in acute general pediatric assessment
The Journal of Pediatrics, 2010Co-Authors: Iain Goff, Belinda Bateman, A Myers, Helen E FosterAbstract:Objective To evaluate the practicality and the acceptability of pGALS (pediatric Gait, Arms, Legs and Spine) screening, a simple pediatric Musculoskeletal screening Examination, when performed as part of an acute pediatric assessment. Study design Consecutive school-aged children attending an acute pediatric assessment unit were assessed with the addition of pGALS to the routine clinical Examination. Practicality (ie, time taken, degree of completion) and patients/parent-assessed acceptability (ie, time taken, discomfort caused) were recorded. Results Fifty consecutive school-aged children (median age 8 years) were evaluated by pGALS. Median time taken was 3 minutes (range 1.2-5.3), and Examination was completed in 47/50 (96%) children. Acceptability of pGALS was deemed high: time taken was "about right" (98% children, 94% parents) and caused no or little discomfort (72% of children, 92% of parents). Abnormalities on pGALS Examination were common, with most (17/50, 34%) explained by confirmed Musculoskeletal disease, and 6 of 50 (12%) had non- Musculoskeletal disease. Conclusions PGALS is practical and acceptable to perform in acute pediatric assessment performed by a non expert in Musculoskeletal medicine. Abnormal Musculoskeletal findings are common as part of the pGALS Examination but need to be interpreted in the global clinical context and assessment.
Andrew Hassell - One of the best experts on this subject based on the ideXlab platform.
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validation of msat an instrument to measure medical students self assessed confidence in Musculoskeletal Examination skills
Medical Education, 2007Co-Authors: Pirashanthie Vivekanandaschmidt, David Coady, David Walker, Martyn Lewis, Andrew Hassell, Monica Mclean, Anisur RahmanAbstract:Context Self-assessment promotes reflective practice, helps students identify gaps in their learning and is used in curricular evaluations. Currently, there is a dearth of validated self-assessment tools in rheumatology. We present a new Musculoskeletal self-assessment tool (MSAT) that allows students to assess their confidence in their skills in and knowledge of knee and shoulder Examination. Objectives We aimed to validate the 15-item MSAT, addressing its construct validity, internal consistency, responsiveness, repeatability and relationship with competence. Methods Participants were 241 Year 3 students in Newcastle upon Tyne and 113 Year 3 students at University College London, who were starting their Musculoskeletal skills placement. Factor analysis explored the construct validity of the MSAT; Cronbach's α assessed its internal consistency; standardised response mean (SRM) evaluated its responsiveness, and test-retest, before and after a pathology lecture, assessed its repeatability. Its relationship with competence was explored by evaluating its correlation with shoulder and knee objective structured clinical Examinations (OSCEs). Results The MSAT was valid in distinguishing the 5 domains it intended to measure: clinical Examination of the knee; clinical Examination of the shoulder; clinical anatomy of the knee and shoulder; history taking, and generic Musculoskeletal anatomical and clinical terms. It was internally consistent (α = 0.93), responsive (SRM 0.6 in Newcastle and 2.2 in London) and repeatable (intraclass correlation coefficient 0.97). Correlations between MSAT scores and OSCE scores were weak (r < 0.2). Conclusions The MSAT has strong psychometric properties, thereby offering a valid approach to evaluating the self-assessment of confidence in Examination skills by students. Confidence does not necessarily reflect competence; future research should clarify what underpins confidence.
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cluster randomized controlled trial of the impact of a computer assisted learning package on the learning of Musculoskeletal Examination skills by undergraduate medical students
Arthritis Care and Research, 2005Co-Authors: Pirashanthie Vivekanandaschmidt, Martyn Lewis, Andrew HassellAbstract:Objective To identify whether there was measurable impact of a specific computer-assisted learning (CAL) package, “Virtual Rheumatology,” on the learning of Musculoskeletal Examination skills by medical students. Methods We conducted 2 parallel, cluster-randomized controlled trials using undergraduate curricula at 2 locations: Newcastle and London, UK. Medical students attending a Musculoskeletal rotation were allocated to the intervention (Virtual Rheumatology CD) or the control arm of the study by placement group. A formative 14-item objective structured clinical Examination (OSCE) assessment on the Examination of shoulder and/or knee joints was the main outcome measure at Newcastle. At London, a 17-item knee station formed part of the summative OSCE. We also used a questionnaire including a 15-item confidence log (C-Log) for self assessment of Musculoskeletal Examination skills and knowledge. Analysis was by intention to teach. Results At Newcastle, there were 112 students in the CD allocated group and 129 in the non-CD group. The CD allocated group performed significantly better on the OSCE (P = 0.002) and C-Log (P = 0.005) than the non-CD group. At London, there were 48 students in the CD allocated group and 65 in the non-CD group. The CD allocated group performed better on the knee OSCE than the non-CD group (adjusted P = 0.040), but there was little difference in the change in C-Log scores from baseline to followup between the 2 groups (P = 0.582). Conclusion The Virtual Rheumatology CD has a positive impact on the acquisition of Musculoskeletal Examination skills in medical students. Further study is needed to see if similar advantages could be gained in other clinical specialities and how CAL resources could be effectively integrated into the medical curriculum.
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the evaluation of multimedia learning packages in the education of health professionals experience of a Musculoskeletal Examination package
Nurse Researcher, 2004Co-Authors: Pirashanthie Vivekanandaschmidt, Andrew Hassell, Monica McleanAbstract:The last 20 years have seen rapid technological developments within the field of information technology. The internet, sophisticated software packages and increased accessibility to computers have all opened opportunities for educators. Against this background, increasing numbers of multimedia learning packages are available to the health professional. In this paper, Pirashanthie Vivekananda-Schmidt, Andrew Hassell and Monica McLean discuss the methodological issues relating to the evaluation of such multimedia based learning tools, using the example of a specific package, Virtual Rheumatology. They discuss the reasons for the increasing interest in the area of computer-based learning, the available evidence supporting the use of such tools in education, and issues about the design and production of this CD. They then discuss the evaluation of the package to illustrate the considerable methodological difficulties in the research and evaluation of Computer Assisted Learning (CAL) packages generally.
