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Abstract Number: 2881

The Center of Excellence in Musculoskeletal Care and Education: A Sustainable Interprofessional, Multidisciplinary Programmatic Innovation Developed with the Department of Veterans Affairs

Michael J. Battistone1, Andrea M. Barker2, Marissa Grotzke3, Peter Beck4, Jeffery Berdan5, Caroline Milne6, JoAnn Rolando7 and Grant W. Cannon1, 1Division of Rheumatology, Salt Lake City VA and University of Utah, Salt Lake City, UT, 2General Internal Medicine, Salt Lake City VA and University of Utah, Salt Lake City, UT, 3Division of Endocrinology, Salt Lake City VA and University of Utah, Salt Lake City, UT, 4Orthopaedics, Salt Lake City VA and University of Utah, Salt Lake City, UT, 5Physical Medicine and Rehabilitation, Salt Lake City VA and University of Utah, Salt Lake City, UT, 6Medicine, Salt Lake City VA and University of Utah, Salt Lake City, UT, 7Salt Lake City VA and University of Utah, Salt Lake City, UT

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Education, educational innovation, interdisplinary and medical education, medical

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Session Information

Session Title: Education

Session Type: Abstract Submissions (ACR)

Background/Purpose

While musculoskeletal (MSK) problems are common in primary care, the current formal education in the evaluation and management of these conditions is inadequate.  Through funding from the Veterans Affairs (VA) Office of Academic Affiliations, we developed an interprofessional, interdisciplinary, mixed-method program to enhance the clinical education of medical students, residents, fellows, and trainees of other health professions.

Methods

The week-long course begins with didactics, is reinforced through technology-enhanced simulation and peer-teaching in small-group settings, and culminates in supervised ambulatory clinical experiences and reflective practice.

Table 1

Monday

Tuesday

Wednesday

Thursday

Friday

Introduction

Back Pain

-Didactic-

Gout

-Didactic-

Orthopaedic Injection Clinic

 

-or-

PM&R Clinic

Center of Excellence Multidisciplinary Musculoskeletal Clinic

Introduction to the Evaluation of Rheumatic Disease

-Didactic-

Physical Exam of the Knee

-Didactic-

Rheumatology 101:

Serologies and RA

-Didactic-

Physical Exam of the Shoulder

-Didactic-

Physical Exam of the Knee

-Group Practice-

Arthrocentesis

-Didactic and Group Practice-

Physical Exam of the Shoulder

-Group Practice-

Approach to

Knee Pain

-Didactic-

Approach to Shoulder Pain

-Didactic-

Lunch

Lunch

Lunch

Lunch

Lunch

Bone Health I:

Osteoporosis Risk Factors and Evaluation

-Didactic-

Bone Health II:

Osteoporosis Treatment and Hypogonadism

-Didactic-

Rheumatology Clinic

Primary Care Musculoskeletal Clinic

Rheumatoid Arthritis Clinic

Shoulder Cases

-Group Practice-

OSCE

Participants learn to perform, describe, and document a systematic physical exam of the shoulder and knee, interpret these findings, and develop patient-centered management options in a framework of high value care. Faculty represent Internal Medicine (IM) (Primary Care, Rheumatology, Endocrinology), Orthopaedics, and Physical Medicine and Rehabilitation (PM&R) disciplines. Course assessments include written surveys, 2-station Objective Structured Clinical Examination, and individual exit interviews.

Results

Student and trainee participants in the 2013-14 academic year are summarized below. Survey response rate was 89%. Post-course competency in examining the shoulder and knee, and in reporting, interpreting, and managing the case using a framework of high-value care, was confirmed with 2-station OSCE.

Table 2

 

Post-Graduate Trainees

Students

Discipline/Profession

IM

Rheum

Geri

Neuro

Ortho

PM&R

Occ Med

Med

APRN

PA

Number of Trainees

34

1

2

1

4

5

1

4

9

10

Percentage of Cohort

48%

1%

3%

1%

6%

7%

1%

6%

13%

14%

 

 

Pre-MSK COE Week

Post-MSK COE Week

Able to evaluate and manage shoulder complaints

16%

98%

Able to evaluate and manage knee complaints

35%

94%

Competent to aspirate/inject knee or subacromial space

18%

76%

Conclusion

The MSK Intensive Education Week provides an interdisciplinary and interprofessional environment to teach trainees from multiple backgrounds in the evaluation and management of patients with complex MSK diseases through a cooperative practice model and evaluates their competency to practice in this system.


Disclosure:

M. J. Battistone,
None;

A. M. Barker,
None;

M. Grotzke,
None;

P. Beck,
None;

J. Berdan,
None;

C. Milne,
None;

J. Rolando,
None;

G. W. Cannon,
None.

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