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Original article
MSK30: a validated tool to assess clinical musculoskeletal knowledge
  1. Danielle L Cummings1,
  2. Matthew Smith2,
  3. Brian Merrigan3,
  4. Jeffrey Leggit4
  1. 1 Department of Orthopaedic Surgery, Madigan Army Medical Center, Tacoma, Washington, USA
  2. 2 Department of Anesthesiology, San Antonio Military Medical Center, San Antonio, Texas, USA
  3. 3 Department of Family Medicine, Fort Belvoir Community Hospital, Belvoir, Virginia, USA
  4. 4 Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  1. Correspondence to Dr Danielle L Cummings; danielle.cummings14{at}gmail.com

Abstract

Background Musculoskeletal (MSK) complaints comprise a large proportion of outpatient visits. However, multiple studies show that medical school curriculum often fails to adequately prepare graduates to diagnose and manage common MSK problems. Current standardised exams inadequately assess trainees’ MSK knowledge and other MSK-specific exams such as Freedman and Bernstein’s (1998) exam have limitations in implementation. We propose a new 30-question multiple choice exam for graduating medical students and primary care residents. Results highlight individual deficiencies and identify areas for curriculum improvement.

Methods/Results We developed a bank of multiple choice questions based on 10 critical topics in MSK medicine. The questions were validated with subject-matter experts (SMEs) using a modified Delphi method to obtain consensus on the importance of each question. Based on the SME input, we compiled 30 questions in the assessment. Results of the large-scale pilot test (167 post-clerkship medical students) were an average score of 74 % (range 53% – 90 %, SD 7.8%). In addition, the tool contains detailed explanations and references were created for each question to allow an individual or group to review and enhance learning.

Summary The proposed MSK30 exam evaluates clinically important topics and offers an assessment tool for clinical MSK knowledge of medical students and residents. It fills a gap in current curriculum and improves on previous MSK-specific assessments through better clinical relevance and consistent grading. Educators can use the results of the exam to guide curriculum development and individual education.

  • musculoskeletal medicine
  • education
  • assessment

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjsem-2018-000495

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    Footnotes

    • Contributors All authors contributed to conception/design of the work and have read and approved this manuscript. DC, BM and MS were responsible for data collection and analysis. DC drafted the manuscript and JL provided critical revision of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was designated 'IRB-exempt' by the Uniformed Services University Institutional Review Board.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data sharing statement Raw data will be made available upon request, please contact the corresponding author.