OUTCOMES OF THE CANADIAN ORTHOPAEDIC SURGERY MEDICAL EDUCATION COURSE (COSMEC): A NOVEL CURRICULUM TO ENHANCE MEDICAL STUDENT LEARNING

Medical students in Canada have limited exposure to applied musculoskeletal education and orthopaedic surgery in their mandatory medical school curricula, with recent studies highlighting this knowledge gap. The Canadian Orthopaedic Surgery Medical Education Course (COSMEC) is designed to enhance the education of medical students around orthopaedic surgery and common musculoskeletal presentations encountered in primary care. This study aims to evaluate the utility of participation in COSMEC amongst Canadian medical students. Canadian medical students were invited to participate in COSMEC, which consists of six live, virtual teaching sessions and one in-person skills session lead by orthopaedic faculty and senior residents over a 12-week period. Teaching objectives were guided by musculoskeletal objectives of the Medical Council of Canada Qualifying Examination I and expert opinion. Voluntary pre- and post-course surveys were administered to assess outcomes related to (a) participant knowledge, (b) participant-reported confidence, (c) participant interest in orthopaedic surgery. Qualitative feedback was also collected from participants following each session. A total of 432 medical students enrolled in COSMEC. A total of 136 pre-course and 84 paired post-course surveys (61.7%) were received. Of the medical student respondents, 42 (50%), 22 (26.1%), 17 (20.2%) and 4 (4.8%) were in their pre-clerkship, clerkship (i.e., core clinical rotations), elective (i.e., final years/applicants) and post-graduate (i.e., medical school graduates) stages, respectively. A total of 18 respondents (21.4%) had completed a rotation in orthopaedic surgery prior to completion of the course. Knowledge quiz scores out of 14 improved from 7.92±2.6 prior to participation in COSMEC, to 9.7±2.0 after (p<0.05). There were also significant improvements in participant-reported confidence related to performing a history and physical exam (p<0.05), developing a differential diagnosis (p<0.05), understanding the basic components of bone and joint emergencies (p<0.05) and fracture management (p<0.05), as well as describing fracture radiographs (p<0.05). A total of 68 participants were considering a career in orthopaedic surgery prior to course participation, as compared to 66 participants after (p=0.43). COSMEC is an effective learning resource for medical students, which can enhance knowledge and confidence is orthopaedic and musculoskeletal topics. It can play a useful role in augmenting core medical school curricula for medical students interested in a variety of specialties. Further studies to determine if participation in COSMEC leads to improved performance in clinical rotations and licencing examinations would be of value.