A RANDOMIZED CONTROLLED TRIAL TO EXAMINE THE EFFECTIVENESS OF 20 MUSCULOSKELETAL “SHORT” CASE SIMULATIONS ON FAMILY MEDICINE RESIDENTS’ DEVELOPMENT OF KNOWLEDGE AND SKILLS: A PILOT STUDY

Musculoskeletal (MSK) complaints comprise up to 30% of primary care visits and training is variable among institutions (1). The COVID pandemic contributed to learners feeling unprepared for practice due to the abrupt cessation of clinical exposure (2). Strategies to optimize learning of MSK conditions to prepare learners for real-world clinical encounters is important (3). A 20 module MSK case simulation educational tool was previously developed and tested to be useful in improving knowledge and skills. The purpose of this study was to determine if Family Medicine residents completing the 20 MSK Short Case Simulations delivered through on-line links would improve their knowledge, skills and satisfaction in learning about how to identify and initially manage patients with various MSK conditions when compared to learners not exposed to the same educational tool. Study Design: Randomized Control Trial. Fourteen post-graduate year one (PGY1) and 12 post-graduate year two (PGY2) family medicine residents were randomized to the CTL (N=13) or EXP (13) groups. Residents attended an orientation session outlining the study protocol and consents for participation were obtained. The CTL group completed an online questionnaire (T1) with the same MCQ questions that are contained within the 20 MSK Short Case Simulations. The CTL group had no exposure to the MSK modules. The EXP Group experienced the intervention of doing the 20 MSK Case Simulations which contained a demographics questionnaire, pre-MCQs (T1); the MSK case module (intervention); post-MCQs and a satisfaction questionnaire. One month after the EXP group completed their MSK modules, both the CTL and EXP group completed a T2 questionnaire with the same 100 MCQs reflecting the same questions in the 20 MSK case simulation modules. A quantitative analysis using paired t-tests comparing the two groups were computed. Satisfaction scores were assessed. Twenty-six residents consented and were randomized for the study (CTL=13; EXP=13). One resident in both the CTL and EXP group withdrew from the study. The EXP group (N=12) completed 218 modules. Additional data was lost due to 2 residents in each group not completing theT1 questionnaires. No significant differences (p=.73) were observed among the two groups thus indicating both CTL and EXP groups to be equal at the start of the study. The EXP group (N=12) completing MSK short case simulations had 2 residents complete some but not all 20 modules. The analysis demonstrated a significant difference in knowledge in the EXP group (p<.04) as demonstrated in the T2 questionnaire. One hundred percent of participants in the EXP group indicated they would recommend 11 of the 20 modules to a colleague for learning. Ninety percent of the participants indicated they would recommend the other 9 MSK modules to a colleague for learning. All EXP group participants were very satisfied with the modules and would do them again. Online interactive MSK case simulations were useful as a learning tool for family medicine residents. Current studies are ongoing to determine patient satisfaction and resident competency in MSK knowledge and skills based on patient experience and faculty observations respectively.