Enhancing musculoskeletal examination skills through near-peer teaching: student outcomes and perspectives.

backgroundMusculoskeletal (MSK) conditions are highly prevalent and represent a major burden in Australia and worldwide, yet undergraduate musculoskeletal education remains underrepresented in medical curricula. Near-peer teaching (NPT) has emerged as an effective adjunct to standard teaching, particularly in developing clinical examination skills.

objectiveTo examine the effect of a near-peer-led, OSCE-style tutorial on medical student performance of the upper limb musculoskeletal examination, and to explore students’ perceptions of its clarity, relevance, and educational value.

methodsA quasi-experimental pre–post study was conducted with 23 second year-year medical students in a problem-based learning program. Participants completed a pre-test OSCE, attended a near-peer-led tutorial, and undertook a post-test OSCE three days later. Assessments were scored using a 15-item rubric with percentage conversion. A post-hoc survey comprising Likert-scale and open-ended questions explored student perceptions. Quantitative data were analysed using paired statistical tests, while qualitative responses underwent content analysis.

resultsImprovements were observed in 14 of 15 OSCE items, with statistically significant gains in shoulder and elbow palpation, shoulder active and passive range of motion, patient comfort, and examination organisation (p < 0.05). The overall average performance improved from 63.8 ± 15.8% pre-test to 76.3 ± 10.5% post-test (p = 0.01). Survey responses (n = 17) indicated that all students perceived the tutorial as superior to lectures, textbooks, or videos, with 59% rating it extremely useful for clinical practice. Thematic analysis revealed strengths in logical organisation, integration of anatomy and pathology, demonstration, and opportunities for hands-on practice. Most students reported substantial gains in confidence and understanding. Findings support the utility of NPT in musculoskeletal education, with improvements potentially explained by cognitive and social congruence, experiential learning, and self-efficacy. While a single session significantly enhanced competence and confidence in many components of the physical examination, skills such as special testing requires repeated practice and longer-term follow up to observe similar gains.

conclusionA single near-peer-led, OSCE-style tutorial supports improvement in medical students’ objective performance and self-reported confidence in conducting the upper limb musculoskeletal examination. It is a beneficial adjunct to traditional musculoskeletal curricula for both learners and tutors. Broader, longitudinal research is needed to evaluate long-term knowledge retention and generalisability.