Musculoskeletal examination teaching by patients versus physicians: how are they different? Neither better nor worse, but complementary

Med Teach. 2011;33(5):e227-35. doi: 10.3109/0142159X.2011.557412.

Abstract

Background: Musculoskeletal (MSK) complaints comprise 12-20% of primary healthcare; however, practicing physicians' MSK physical examination (PE) skills are weak. Further, there is a shortage of specialists able to effectively teach this subject. Previous evaluations of patient educators have yielded mixed results.

Aims: The aim of this study is to document how teaching by patient educators and physician tutors in MSK PE skills differs.

Methods: A qualitative researcher observed, video-recorded, and took notes during preclerkship MSK PE teaching sessions given by patient educators or physician tutors. The researcher identified themes which were evaluated by collective case study methods.

Results: Two patient educator and four physician groups were evaluated. The patient educators were more consistent regarding content and style than the physicians. There appeared to be a continuum in teaching organization from patient educator to novice physician tutors to experienced physician tutors. The patient educators consistently covered all major joints (physicians did not); physicians were more likely to request verbalization of actions, relate findings to history, receive questions, and use opportunistic teaching moments.

Conclusions: Understanding preclerkship MSK teaching by patient educators compared to physician tutors is necessary for appropriate targeting of the existing Patient Partners® in Arthritis patient educator program and to guide the development of future MSK teaching initiatives.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Competence
  • Cohort Studies
  • Communication
  • Education, Medical, Undergraduate / methods*
  • Faculty, Medical / organization & administration*
  • Humans
  • Musculoskeletal Diseases / diagnosis*
  • Physical Examination*
  • Teaching / methods*