Advanced Primary Care Orthopedics: Bridging the Gap in Musculoskeletal Education

Abstract

Background and Objectives: Musculoskeletal problems are common in primary care, yet many family physicians lack confidence and competence in this area. The Advanced Primary Care Orthopedics (APCO) course utilizes hands-on physical exam instruction, interactive cases, and intentional repetition to teach anatomy, a standardized exam, and important diagnoses. This study assesses the effectiveness of APCO in improving musculoskeletal exam knowledge and confidence. Methods: APCO is a 1.5-day course taught annually to family medicine residents. A 1-day course has also been conducted as a preconference workshop targeting faculty physicians. Participants completed pre- and postcourse assessments to evaluate their knowledge and confidence with the musculoskeletal exam. We compared results using mean differences with paired t-test statistics. Results: In the 2018 and 2019 resident courses, 23 of 30 participants (77%) completed the knowledge assessment and 25 of 30 participants (83%) completed the confidence assessment. Knowledge assessment scores improved by 9.5 points (P<.05) after completion of the course. Confidence in the musculoskeletal exam, as assessed on a 5-point Likert scale (1–not confident at all; 5–very confident), improved from 2.2 to 3.8 after the course (P<.05). In the 2018 preconference workshop, 23 of 36 participants (64%) completed the confidence assessment. Confidence increased from 2.17 to 3.61 (P<.05) after course completion. Conclusions: Participation in the APCO course increased short-term musculoskeletal knowledge and confidence. APCO has many potential applications for residency curriculums, faculty development, and continuing medical education.