Background/Purpose:

Several reports have demonstrated that Rheumatology disorders are increasingly arising. In USA, for example, three of the top eight primary diagnosis groups presenting to ambulatory care visits in 2007 were for musculoskeletal disorders.

In the meanwhile, medical student’s surveys have consistently demonstrated their lack of confidence in diagnosing and managing musculoskeletal problems.

Until 2005 the rheumatology teaching in our School of Medicine was predominantly based in lecture classes, some seminars and a written multiple choice test. Since then, in order to improve the rheumatology teaching, we introduced new learning objectives in this field with three domains of learning: knowledge, attitudes, and skills.

To achieve these domains, we added a program consisting of small group tutorials, the use of one-way-mirror offices to direct observation, personalized feedback, formative evaluations and objective structured clinical examinations (OSCEs).

The aim of this study was to describe this novel assessment method, and evaluate the acquisitions of rheumatology teaching domains in undergraduate students with this program.

Methods:

We implemented seven consultation offices with one-way mirror, with special audio and video systems.

The students are organized in small groups of six, with a rheumatology professor, and during two weeks they review the most common rheumatology problems: musculoskeletal diseases, osteoarthritis, rheumatoid arthritis, systemic lupus erytemathosus, laboratory test and radiology.

Each day starts with a session discussion about the different diseases, then one student performed a real rheumatology patient evaluation being observed for the group, who is also filling a summary sheet of the interview with special emphasis in the attitudes and the skills observed. After a complete evaluation, the entire group discussed relevant aspects of the interview and of the patient’s disease, and gives feedback.

To determine the acquisitions of the contents and competences, we introduce a formative test at the beginning and the end of the program, and an OSCE. Also, each student completes a survey about the program and the methodology.

Results:

In the last five years, over 500 students have completed this new curriculum program.

The student’s surveys about this methodology showed a high level of satisfaction. They estimated the objectives achievement in more than 90%, and evaluate the overall program with a mean score of 6.8 over 7 (range 6.6-7).

Three hundred and seventy one students filled the formative test at the beginning of the program, and 361 at the end. At the beginning, the percentage of correct answers was 62% vs 92% at the end of the program (p < 0.01). In the first formative test, there were 10% of non-respond answers, vs 0.5% at the second test (p < 0.01).

In the final OSCE, all the students had a good performance being all approved with over 60% of achievement in the three different domains evaluated.

Conclusion:

This new assessment in rheumatology teaching is highly appreciated for the students, and it seems to be a good methodology to the acquisition of knowledge and trainee in competences in rheumatology patient’s evaluation.

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« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-competence-based-model-for-teaching-rheumatology-in-undergraduate-medical-students-in-pontificia-universidad-catolica-de-chile-a-five-years-experience/