Evaluating Medical Students' Confidence in Musculoskeletal Examination: Implications for Improving Musculoskeletal Medicine Education.

In response to feedback from previous medical students, the office of medical education at a state-funded medical school (University of Hawaii) conducted an IRB-approved survey study to formally evaluate the experience of current medical students regarding their confidence with MSK examination skills, and solicited suggestions for improvement. We collected data from students who were transitioning from second to third year regarding the following: (1) confidence in various physical exams, (2) perceived preparedness for clerkships, (3) usefulness of existing MSK clinical activities, and (4) suggestions for improvement. A majority of students expressed lack of confidence in the MSK physical exam, which was notably lower than other organ system exams. Recommendations for curriculum improvement included early integration of MSK examination teaching with corresponding anatomy laboratory sessions, inclusion of physiatry teaching, and increased small-group learning sessions. This study revealed the need for (1) synchronizing MSK clinical skills training with anatomy curriculum during the first year, and (2) inclusion of physiatry teaching in the MSK curriculum. Ideally, this study will serve as a starting point for further innovations and improvements in MSK medical education.