Development of a paediatric musculoskeletal curriclum for medical students

Abstract

Despite the frequency of musculoskeletal (MSK) complaints in childhood, doctors involved in the care of children report low self-confidence in their paediatric musculoskeletal (pMSK) clinical skills and show poor performance. This is hardly surprising considering the little pMSK teaching delivered within UK medical schools and the perception that this is poorly done compared with other clinical skills within child health. This lack of pMSK education is likely to be significant when considering the delayed diagnosis and access to specialist care that affects many children with pMSK disease. As any doctor could be involved in the care of children from the point of graduation, clinical skills and knowledge needs to be introduced at undergraduate level. Although efforts have been made to improve adult MSK education, this does not take into account the principles of child health and differences between adults and children. There is therefore a need to identify and agree on core pMSK educational content to be taught within the UK undergraduate curriculum. This should follow the principles of outcome-based education as practised in UK medical schools. This study has identified the content for a pMSK undergraduate curriculum. Focus groups and interviews were held with medical students, and key stakeholders within pMSK medicine and child health. Participants proposed content for pMSK teaching and identified the barriers within the current teaching environment. Expert consensus was then achieved on curriculum content using a Delphi process followed by a Nominal Group Technique. The final pMSK curriculum comprised learning outcomes (n=47), core presentations (n=8) and core conditions (n=14). These should inform the rest of the curriculum content and could be included in undergraduate child health teaching at all UK medical schools. It is hoped that by delivering this curriculum, all graduating doctors will then be equipped with the appropriate clinical skills and knowledge to assess all children with pMSK presentations, and will ultimately improve patient care. Further work is need on implementation and evaluation of this curriculum.