RESEARCH - Benefits of a programme of patient-instructors to teach and assess musculoskeletal skills in medical students

[Guest guest]

******** JUNE DIXON - this is you! *********

ls of the Rheumatic Diseases 2006;65:1626-1630

© 2006 by BMJ Publishing Group Ltd & European League Against Rheumatism

--------------------------------------------------------------------------

EXTENDED REPORT

Benefits of a programme taking advantage of patient-instructors to teach and

assess musculoskeletal skills in medical students

M Bideau1,*, P-A Guerne2,*, M-P Bianchi1 and P Huber1

1 Unit of Development and Research in Medical Education, Faculty of

Medicine, University of Geneva, Geneva, Switzerland

2 Division of Rheumatology, Department of Internal Medicine, University

Hospital, Geneva, Switzerland

Correspondence to:

P-A Guerne

Division of Rheumatology, University Hospital, 26 Avenue Beau-Séjour, 1211

Geneva 14, Switzerland; pierre-andre.guerne@...

Aim: To evaluate a rheumatoid arthritis patient-instructor-based

formation-assessment programme for its ability to improve and assess

musculoskeletal knowledge and skills in third-year medical students.

Methods: (1) The quality of our musculoskeletal teaching was assessed before

patient-instructor intervention through an open-questions test (pre-test)

and performance record forms (PRFs) filled in by the patient-instructors.

(2) The improvement afforded by patient-instructors was evaluated through a

second (identical) open-questions test (post-test). (3) The resulting skills

in the students were further assessed by an individual patient-instructors

physical status record form (PSRF), filled in by the students.

Results: Pre-tests and post-tests showed an improvement in correct answers

from a mean score of 39% to 47%. The history-taking questions that obtained

<50% scores in the pre-test mostly dealt with the consequences of a chronic

illness. Intervention of patient-instructors especially improved knowledge

of the psychosocial aspects and side effects of drugs. With regard to

physical examination, patient-instructors makedly improved the

identification of assessment of signs of active and chronic inflammation.

PRF analysis showed that 10 of 28 questions answered by <50% of the students

were related to disease characteristics of rheumatoid arthritis,

extra-articular signs, side effects of drugs and psychosocial aspects.

Analysis of the PSRF indicated that the weakness of our students' physical

examination abilities in particular is related to recognising the types of

swelling and differentiating tenderness from pain on motion.

Conclusion: This study proves the considerable benefits of the involvement

of patient-instructors in the teaching and assessment of clinical skills in

students.

http://ard.bmj.com/cgi/content/abstract/65/12/1626

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org