The “Mini-Residency” In Musculoskeletal Care: An Efficient and Effective Mixed Method Model For Continuing Professional Education

Michael J. Battistone¹, Andrea M. Barker², Marissa Grotzke³, J Peter Beck⁴, Robert Z. Tashjian⁵, Timothy A. Huhtala⁶, Grant W. Cannon¹ and Patrice Kennedy⁷, 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, ⁴Salt Lake City VA and University of Utah, Salt Lake City, UT, ⁵Division of Orthopaedics, Salt Lake City VA and University of Utah, Salt Lake City, UT, ⁶Division of General Internal Medicine, Salt Lake City VA and University of Utah, Salt Lake City, UT, ⁷500 Foothill Boulevard, Salt Lake City VA, Salt Lake City, UT

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Arthrocentesis, Education, educational innovation and interdisplinary, medical, Workforce

Session Information

Title: Medical Education

Session Type: Abstract Submissions (ACR)

Background/Purpose:

The societal burden of musculoskeletal (MSK) disease is amplified by the limited number of subspecialists. Developing knowledge and skills of primary providers is projected to be cost-effective in addressing this. The George E. Wahlen VA Salt Lake City Health Care System (VASLCHCS) has established an interprofessional “mini-residency” in MSK care to serve this purpose.

Methods:

The mini-residency, held on the campus of VASLCHCS, is a one-week immersive experience. Content is introduced in didactics, reinforced in hands-on sessions with peer teaching and technologically enhanced simulations, and applied in the clinic in supervised patient encounters. Course evaluation was informed by Kirkpatrick’s model of assessing educational effectiveness, and Phillip’s concept of return on investment. Outcome measures included a post-course survey (5-point scale; 1 = “not at all satisfied”; 5 = “extremely satisfied”), qualitative comments in telephone interviews, and the number of joint injections performed after training.

Results:

Thirteen of the first fourteen participants completed course evaluations (93% response rate).

Participant Satisfaction

(Kirkpatrick Level 1)

97% agreed or strongly agreed across all satisfaction items (mean =4.67); all respondents (100%) strongly agreed they would recommend the MSK Mini-residency to others (mean=5.00).

Learning/Skill Acquisition

(Kirkpatrick Level 2)

100% agreed or strongly agreed across all learning items.

Application/Job Impact

(Kirkpatrick Level 3)

100% indicated the training was able to affect practice outcomes.
100% felt trained and more comfortable performing a full shoulder and knee examination.
100% are more comfortable performing MSK procedures.
Respondents indicated they conducted more thorough exams and had had fewer referrals

Credentials of Participants

States Represented

Number of Injections Performed

In 6 Months Following Training

MD (11), NP (9), PA (3)

CO, GA, ID, MN, MT UT, VA, WA, WI, WY

385 total

Average per provider = 30

Range 0-120; s.d. = 42

Conclusion:

An interprofessional “mini-residency” in musculoskeletal care is an effective model of continuing medical education. This program is highly rated, results in an expanded scope of practice for most participants, and providers who participated in this course report an increase in the numbers of joint injections they perform in their primary care settings.

Disclosure:

M. J. Battistone,
None;

A. M. Barker,
None;

M. Grotzke,
None;

J. P. Beck,
None;

R. Z. Tashjian,
None;

T. A. Huhtala,
None;

G. W. Cannon,
None;

P. Kennedy,
None.

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