Implementing an established musculoskeletal educational curriculum in a new context: a study of effectiveness and feasibility.

Background: Musculoskeletal (MSK) problems are common, yet many primary care (PC) providers feel inadequately trained to manage these conditions. Previous studies describe successful MSK educational innovations at single sites, but none have reported on subsequent attempts to replicate or adapt these innovations to new contexts. This article presents a study of a national Veterans Affairs MSK training program modified to fit an existing PC educational program.Objectives: (1) To evaluate the effectiveness and feasibility of an adapted MSK curriculum in a new context. (2) To provide a model for adaptation studies in health professions education.Design: A national MSK shoulder and knee curriculum was adapted for San Francisco VA PC trainees, which included a small-group workshop and workplace learning within a newly-created MSK clinic. Effectiveness was evaluated by assessments of trainee confidence in exam and injection skills (via 5-point Likert scale) and faculty-observed performance of knee and shoulder exams (reported as percent of maximum possible score). Feasibility was evaluated by determining acceptability of the program to PC trainees (via 5-point Likert scale) and ability to implement the curriculum using local resources.Results: 52 trainees completed the training during a 2-year period. Trainees' confidence in MSK exam skills improved from 3.3 to 4.5 for shoulder, and from 3.5 to 4.6 for knee. Confidence performing joint injections improved from 2.6 to 4.2 (shoulder) and 2.5 to 4.5 (knee) (p < 0.001 for all). Observed performance improved markedly - from 50% to 92% for shoulder, and 57% to 90% for knee. Feasibility was evident in high acceptability (5.0 for MSK clinic, and 4.9 for workshops), and successful and sustained implementation.Conclusions: Adapting an established MSK curriculum to a new context was effective and feasible. This may serve as a more efficient model for improving trainee education than de novo curriculum design at individual sites.

Twelve tips for delivering successful interprofessional case conferences.

Interprofessional case conferences (ICCs) offer an interactive, practical way to engage members of two or more health professions in discussions that involve learning and working together to improve patient care. Well-orchestrated ICCs provide opportunities to integrate interprofessional (IP) education into routine clinical practice. The authors provide 12 tips to support the conceptualization, planning, implementation, facilitation, evaluation, and sustainability of ICCs. They draw from extensive experience as IP educators and facilitators of ICCs and from literature on IP education, case-based learning, small-group facilitation, peer-assisted learning, and learner engagement - all of which offer insights into ICCs but have not been integrated and applied to this context.