Effectiveness of video learning materials for musculoskeletal physical examinations in medical skills: a randomized controlled trial

BACKGROUND: Medical students frequently report low confidence in performing musculoskeletal (MSK) physical examinations despite the high prevalence of MSK complaints in clinical practice. Traditional instructional resources have often emphasized procedural demonstrations with limited integration of anatomy and pathology. Video-based learning has emerged as a promising addition, however the optimal design for MSK education remains unclear. This study aims to evaluate the effectiveness of integrated instructional videos on medical student confidence and perceived understanding of MSK physical examinations. METHODS: First year medical students enrolled in a medical skills course at an accredited US medical school were randomized into control and intervention groups across multiple MSK examination modules (spine/gait, upper limb, knee, and hip/ankle/foot). The control groups received standard preparatory materials, while the intervention groups received additional custom-designed videos that incorporated anatomy and pathological correlations. All students participated in corresponding hands-on workshops. Anonymous post-workshop surveys with Likert-style questions were administered to quantify self-reported confidence and perception, along with free response questions. Quantitative data was analyzed using the Mann-Whitney U and chi squared tests, and qualitative data was organized using Taguette Software (version 1.5.2) and chi squared. RESULTS: The number of responses for each study section ranged from 25 to 63. Participants in the intervention group reported significantly greater confidence performing spine and gait examinations (p = 0.0005), along with the upper limb examinations (p < 0.05), with higher comfort levels in interpreting anatomy, pathology and special tests. For the hip/ankle/foot group, anatomical and special test explanations were rated higher, though overall confidence did not differ from the control group. No significant differences were observed for the knee examination. Qualitative analysis indicated that intervention videos were frequently described as helpful and comprehensive, with a statistically significant difference in anatomy content between groups. CONCLUSION: In this group of first-year medical students, integrated instructional videos that incorporate anatomy and pathology were associated with improved self-reported confidence and perceived understanding in specific areas of MSK physical examinations. Variation in impact may reflect differences in video length, content, or student engagement, highlighting the need for standardized instructional design materials in future studies.