Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Ottawa, ON

Poster Presentation:


Evaluation of the impact of an innovative pediatric Gait, Arms, Legs and Spine (pGALS) physical examination workshop on third-year medical students

Authors:
Mercedes O. Chan,University of Alberta,Edmonton,AB,Rebecca . Clark,University of Alberta,Edmonton,AB,Yan . Yuan,University of Alberta,Edmonton,AB,Karen . Forbes,University of Alberta,Edmonton,AB


Background:

Musculoskeletal (MSK) disorders account for up to 10% of pediatric visits in primary care.1,2 However, physicians who most often see children with MSK complaints are not confident performing a pediatric MSK examination (PME).3,4 PME is under taught in medical school,1,2 and examination of the joints is uncommonly documented by trainees.5



Objectives:

To examine the short- and long-term impact of a novel PME workshop on medical students’ confidence in performing PME.



Results:

Six cohorts (127 students) completed the initial questionnaire. Mean aggregate confidence at baseline was 1.87 (CI 1.71, 2.01) on a 4-point Likert scale (1=not at all, 2=confident in some aspects, 3=confident in most aspects, 4=very confident). Following the rotation, mean confidence increased to 2.86 (CI 2.75, 2.96) representing a 53% increase in mean confidence ratings (p=0.00); 58% of students reported integrating PME into their clerkship experience. Six-month follow-up data for the first three cohorts of students demonstrates a mean confidence of 2.45 (CI 2.13, 2.77), a 31% increase in mean confidence (p=0.031) from baseline.

 

Discussion:

Students report low levels of confidence in performing PME. While we cannot control for the learning of skills throughout the rotation, the workshop significantly increased confidence. Initial increases in confidence waned after 6 months, but still remained above baseline confidence. Future directions include providing recurrent opportunities for practice and assessment, i.e., through OSCEs and observations in clinical practice. This would likely be beneficial to sustain learners’ confidence so that they may integrate PME into clinical care.