Musculoskeletal Medicine Course. Dr. Jason Peeler

Transcription

1 Musculoskeletal Medicine Course Dr. Jason Peeler

2 MSK Course History Part of a very busy Block #5 (also Neuro & Optha) Historically, a very poorly rated course (17% student approval rating prior to 2010) Cited during the last accreditation review (ED-47: Use of student evaluation data in program improvement) Host of problems identified by students: Extraordinary large # of instructors Poor sequence / organization Few if any standardized notes package or reference / support materials Dominated by the specialist approach etc

3 Ongoing Renewal Since 2010 What s changed? New Course Director Reorganize, re-sequence & re-format. Established educational leaders for each section. Standardized notes package and reference materials. Establish global learning objectives for whole course, as well as each individual sessions. More small group and case-based learning sessions. Ongoing and consistent formative evaluation for students Ongoing and specific student feedback and input for educational leaders and course director. Focus became the Generalist!

4 MSK Modules & Leaders 1. Fundamental Concepts - Dr. Jason Peeler 2. Upper Extremity - Dr. Neil Craton 3. Lower Extremity - Dr. Jason Peeler 4. Spine - Dr. Hillel Sommer 5. Rheumatology - Dr. David Robinson 6. MSK as a System - Dr. David Robinson

5 Other Professionals Strategically Involved (determined by course director and/or module leader) Basic scientists (anatomy/pathology/human development) Family medicine Orthopaedics Rheumatologists Physical medicine & rehabilitation Radiology Genetics Allied health professionals (OT/PT/AT, etc) Residents / graduate students (small group learning, labs, etc)

6 Consistent Approach Organization, Sequence & Format 1. Anatomy - lecture, lab & case study 2. Pathology - lecture & case presentation 3. Medical imaging lecture, tutorial & case study 4. Common conditions of region eg. Lower extremity module - broken down by region: hip & thigh / knee / lower leg, ankle & foot. Lecture, tutorial & case study 5. Pediatrics lecture 6. Surgery lecture 7. Clinical skills lecture and hands-on tutorials 8. Instructional exam take home test and review session

7 Course Organization Lecture GL T CS Total Fund. concepts Upper extremity Lower extremity Spine Rheumatology MSK as a system Total * Plus an instructional exam for each section

8 Course Goals & Objectives Focus on Preparation for Clerkship and FM Residency Goal: To develop a clinical approach to musculoskeletal conditions which includes differential diagnosis, investigations, management options and burden of illness. Objective: Upon completion of the MSK course, the student will be able to Describe the normal structure and function of the MSK system, and define unique aspects of bone, joints and muscle structure/function. Explain how macroscopic, microscopic and metabolic aspects of bone, joint (including connective tissues), and muscle structure relate to function/dysfunction of the MSK system. Describe normal patterns of growth / development and regeneration of the MSK system. Describe the principles and practices of injury prevention as they relate to common MSK conditions. Describe the principles and practices used in the conservative and/or surgical management of common MSK conditions. Explain the importance of interdisciplinary and inter-professional care in the management of common MSK conditions. Describe the physical, psychological, financial and quality of life consequences associated with living with a common MSK conditions. Describe the common traumatic, inflammatory, infectious, degenerative, metabolic, and congenital diseases of the MSK system. For each describe: Prevalence and age distribution Patho-anatomical and biomechanical mechanisms, and common structures and locations involved. Clinical manifestations, differential diagnosis, and natural history Role of imaging and other tests in the diagnosis and management Various management options ranging from pharmacology, physiotherapy, alternative therapies, psychotherapies and surgery. Associated disability, morbidity and mortality. Red flags in MSK care. Describe and perform a MSK history and physical examination to determine anatomic location, differential diagnosis and management urgency.

9 Student Approval Rating now at 80%. Course is going in the right direction!

10 MSK Course Moving Forward Within CuRe

11 What we are building is not changing 1. Student successful in MSK course. 2. Student to acquire knowledge and skills required for success in clerkship. 3. Success on Medical Council of Canada MCCQE and LMCC 4. Success in FM clinical practice

12 .. How we are building it is! Course divided into M1 / M2 modules. Revised methods of delivery & evaluation. Novel methods and opportunities for delivery of clinical skills portion of course. Integration of new ideas - Expansion of steering committee Evolution / adaptation of course materials, small group and casebased learning methods. Further integration of MSK course. Longitudinal courses Complex patient OSCE & PR evaluations.

13 M1 Course 2 weeks (Jan 6 17 th ) 34 contact hrs. Content: Fundamental concepts Anatomy Pathology Human Development Medical Imaging Baseline CS Formative Evaluation Summative Evaluation M2 Course 4 weeks (Feb 16 March 13 th ) 68 contact hrs. Content: Common conditions of Upper extremity Lower extremity Spine Rheumatology Region specific CS Formative Evaluation Summative Evaluation

14 M1 Course 2 weeks (Jan 6 17 th ) 34 contact hrs. Content: Fundamental concepts Anatomy Pathology Human Development Medical Imaging Baseline CS Formative Evaluation Summative Evaluation M2 Course 4 weeks (Feb 16 March 13 th ) 68 contact hrs. Content: Common conditions of Upper extremity Lower extremity Spine Rheumatology Region specific CS Formative Evaluation Summative Evaluation Focus will continue to be the Generalist!

15 Current Challenges within CuRe 14 week course now condensed into 6 weeks Delivery of normal in 2 weeks. Availability of preceptors for small group sessions. Reliable / Valid methods of evaluation / remediation. Selection of appropriate tutorial cases Simple vs. Complex Pediatric vs. Geriatric Congenital vs. Development vs. Acquired Linking with longitudinal courses Clinical skills, problem solving, etc.

16 CuRe Course Steering Committee Jason Peeler Athletic Therapy / Anatomy Neil Craton Sports Medicine Hillel Sommer Phys Med David Robinson Rheumatology James Koenig Radiology Susan Thompson Orthopaedics / Pediatrics Jennifer Salter Phys Med Kyle Perry - Pathology James Pierce - 3 rd year student rep Sam Victos - 4th year student rep

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