ABSTRACT
OBJECTIVE: Musculoskeletal injections can alleviate pain in certain problems of the musculoskeletal system. A significant part of general practitioners (GPs) does not feel competent to administer these injections while it is also known that medical residents of several specialties lack confidence in surgical and other technical skills. However, it is not known whether GP residents feel competent in these skills at the end of their residency and which factors are associated with this self-assessed competence. METHOD: To find out how GP residents think about musculoskeletal injections, twenty Dutch GP residents were interviewed in their final year using semi-structured interview techniques. These interviews were analyzed using template analysis. RESULTS: GP residents often experience a certain reluctance in the administration of musculoskeletal injections even though they mostly find that these injections do belong in primary care. The most named barriers are a low self-assessed competence and fear of septic arthritis, while other factors relate to the resident (confidence, coping style, and views on the specialty), the supervisor (their attitude), the patient (their situation and preferences), the injection (feasibility and estimated effectiveness) and the practice organization (office hours). CONCLUSION: GP residents consider many factors in their decision to administer musculoskeletal injections, most importantly their own competence and a fear of complications. Medical departments can help their residents through education on the decision-making process and the risks of certain interventions and provide opportunities to improve specific technical skills.
