Background/Purpose: Knowledge of musculoskeletal anatomy is suboptimal at many levels of rheumatology training and practice. In a recent practical anatomy pre-test administered prior to a clinical anatomy workshop rheumatology fellows, practicing rheumatologists and non-rheumatologists from 7 American countries (unpublished) scored a mean of less than 50% correct on a series of anatomic questions thought important to rheumatologic practice. We now report the results of a self-assessed competence questionnaire completed after our workshop took place. 

Methods:

The workshop on clinical anatomy consisted of a regional demonstration of anatomy, physical examination and simulated injections using clinical vignettes, anatomical drawings and attendee cross examination. The post-workshop questionnaire included the same twenty questions with the practical identification or demonstration of anatomic structures replaced by a self-assessment of competence. A five point Likert scale ranging from not competent to highly competent was used yielding a maximum score of 100. A total of 144 participants from 5 of the original 7 countries were asked to participate with 2 countries not included due to anticipated communication barriers. The initial request was sent one month after the workshop and monthly thereafter to a total of 3 requests. Comparison of self-assessment scores of anatomic competence between fellows, rheumatologists and other participants, as well as comparison of participants from the different countries, was calculated by ANOVA. Efficacy of the workshop was determined by the comparison of the pre-workshop (as assessed by instructors) and the post-workshop (self-assessed) scores by the t test for paired samples.

Results: The overall response rate was 74.3% (107 respondents, inter-country range 56-100). A significantly higher overall self-assessed competence score was noted after the workshop as compared to the pre-workshop score (74.7±13.1 v.s. 48.1±13.1; p<0.0001). Interestingly, marked score differences noted between countries in the pre-workshop tests (inter-country range: 42.8±20.5 to 62.7±15.8; ) were no longer present in the post-workshop assessments (inter-country range 66.7±12.6 to 80.2±10.6). Likewise, whereas rheumatology fellows scored significantly higher in the pre-test assessment than non-rheumatologists, in the post-workshop self-assessment there were no significant differences in the scores of the three groups.

Conclusion: We found a uniformly high level of self confidence in the identification of key anatomical items following an intensive workshop in clinical anatomy despite significant differences between countries and between professional groups in the pre-workshop test. A limitation to our study is that scores from two dissimilar assessment methods, a practical clinical musculoskeletal anatomy pre-test and a self-rated competency assessment, were compared. Nonetheless based on these limited data we are optimistic that our clinical anatomy workshop can positively impact knowledge and skills in this important area for rheumatologists and that further assessment of the utility of our workshop is warranted.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/self-perceived-efficacy-of-a-workshop-on-musculoskeletal-clinical-anatomy/