Gv. Lawry et al., Teaching a screening musculoskeletal examination: A randomized, controlledtrial of different instructional methods, ACAD MED, 74(2), 1999, pp. 199-201
Purpose. To develop and test a program to teach a rapid screening musculosk
eletal examination.
Method. In 1995, 191 medical and physician assistant students were randomiz
ed to four intervention groups: written materials only (n = 47), written ma
terials and videotape (n = 46), written materials and small-group sessions
facilitated by fourth-year medical students (n = 55), and all three methods
(n = 43). Assessments, in the form of a written test and standardized pati
ent examinations, were conducted before the interventions (n = 40 randomly
selected students), seven to ten days and again three months after the inte
rventions (n = all 191 students), and 16 months after the interventions (n
= 103 students).
Results. While the four intervention groups' written test scores were appro
ximately equal, their scores on the standardized patient examination differ
ed significantly. The students taught in small groups demonstrated signific
antly superior examination skills compared with the students taught with wr
itten material or videotape at seven to ten days and retained this relative
superiority after three and 16 months (p < .0001).
Conclusion. Small-group instruction with hands-on supervised practice is su
perior to more passive instructional methods for teaching musculoskeletal e
xamination skills and can be successfully delivered by trained senior medic
al student facilitators with minimal direct expenditure of faculty time.