Ultrasonography to improve medical professional students’ retention of musculoskeletal anatomical landmarks
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Citation
Abstract
CONTEXT: To improve medical professional students’ musculoskeletal (MSK) physical examination skills, various educators are restructuring their didactic and clinical curriculums to include musculoskeletal ultrasonography (MSUS) experiences, allowing underlying living anatomy to be viewed and appreciated.
OBJECTIVE: To determine whether adjunctive MSUS use confers a long-term advantage in locating four shoulder landmarks—the acromioclavicular joint, the long head of the biceps tendon, the subacromial bursa, and the glenohumeral joint—in students using the imaging technique as compared to students practicing with palpation alone.
REVIEW OF THE LITERATURE: Reveals that many medical professionals are not proficient in locating MSK anatomical landmarks necessary for a complete physical examination. Considering this issue, several studies have assessed MSUS as an educational supplement to increase MSK physical examination aptitude in medical professional students. However, questions remain regarding the long-term effects of MSUS—mainly, whether students exposed to the imaging technique are more likely to retain their ability to locate various MSK anatomical landmarks when repeatedly tested over time.
PROPOSED PROJECT: In a randomized, controlled study, three cohorts of first-year medical students will be equally and randomly divided into two groups: a control group receiving no adjunctive MSUS practice, and an intervention group allowed practice with the imaging modality. This project will consist of three separate training and testing sessions—each lasting one day—and at Training Session 3, the study groups will cross over to allow all participants MSUS exposure. During every session, students will receive an introduction and then will be asked to demonstrate their palpation skills on standardized patients twice—before and after 30 minutes of guided practice. Their results will be assessed by MSUS practitioners blinded to group allocation and subsequently analyzed by independent participants.
CONCLUSIONS: This project will be the first of its kind to reveal the long-term effects of repeated MSUS training versus repeated standard practice on medical professional students’ physical exam abilities. The cross-over design will also allow investigators to assess whether students previously unexposed to MSUS will have the same, better, or worse MSK physical exam abilities compared to students who had two MSUS training sessions.