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Makhdom AM, Jan MA. Knowledge and attitude toward total knee arthroplasty among senior medical students in comparison to public population in Saudi Arabia: cross-sectional study. Ann Med Surg (Lond) 2024; 86:2555-2561. [PMID: 38694327 PMCID: PMC11060264 DOI: 10.1097/ms9.0000000000001912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/25/2024] [Indexed: 05/04/2024] Open
Abstract
Background Total knee arthroplasty (TKA) is currently considered one of the most common and successful orthopaedic procedures. It plays an essential role in the long-term treatment of osteoarthritis and enhances the patient's quality of life. Very little is known about public and medical students' perceptions of this procedure. The purpose of the current study was to assess the knowledge and attitudes toward TKA among medical students in comparison with the general population in Saudi Arabia. Method A cross-sectional study was conducted between February and March 2023. Senior-year (interns and the fifth and sixth year) medical school students (Group A) as well as the general population (Group B) were surveyed online. The distributed questionnaire was divided into three main segments: demographics, knowledge, and the prognosis of TKA. The answers were statistically compared among participants. Results Three hundred thirty-one participants were involved in this study, of whom 202 were from the general population and 128 were medical students. Most of the participants were males (68.3%), and the mean age was 32.95±15.22. The results were divided into three groups: demographic, knowledge, and prognosis. Medical students demonstrated a higher knowledge score (111.25±42.38) compared to the general population knowledge score (64.68±44.29), (P<0.001). Conclusion Senior-year medical school students and the general population showed a low level of knowledge regarding TKA. However, the students had a better awareness of the procedure. The authors recommend frequent public education programs for the benefits of TKA. In addition, medical schools are encouraged to emphasize the benefits of TKA as a treatment choice for end-stage knee arthritis in their curriculum and training.
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Patel J, Anand D, Sayani C, Tam A, Green A, Katt BM. Early Exposure to Orthopaedic Surgery. Cureus 2024; 16:e57422. [PMID: 38699112 PMCID: PMC11062888 DOI: 10.7759/cureus.57422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION Disparities in early orthopaedic experiences among medical students prompt a critical examination of factors influencing the availability and nature of these exposures. While the current body of literature underscores the significance of early surgical exposure and mentorship in medical education, a notable gap exists in investigating early orthopaedic exposure and its specific impact on students from diverse backgrounds. METHODS A 16-item questionnaire, approved by our institutional review board, was administered to fourth-year medical students (MS4) and first-year orthopaedic residents (PGY-1) across U.S. orthopaedic surgery programs during the 2022-2023 application cycle. The questionnaire assessed participants' initial orthopaedic exposures and factors influencing interest in the field. Two-proportion Z-test analyses were conducted to analyze the data, and thematic analysis was used to assess qualitative data involving free-response questions. RESULTS Out of 72 total respondents, the study revealed that 83% of respondents encountered orthopaedics before medical school, with initial exposures stemming from various sources such as familial connections (28%), athletics (17%), and high school or college exposures (15%), including shadowing, athletics participation, and occupation-related exposure. Disparities were observed in the availability of orthopaedic mentors and early exposure opportunities between demographic groups. Statistical analyses highlighted significant differences in access to mentors who reflected students' identities between male and non-male participants (70% vs. 39%, p=0.02) and between white and non-white participants (69% vs. 36%, p=0.02). White participants were also more likely to first interact with a surgeon who treated them or their family members than non-white participants (35% vs 7%, p=0.04). Non-white participants were more likely than white participants to come by their first orthopaedic opportunity by searching for it independently (21% vs. 4%, p=0.03). Family and friend connections in orthopaedics were found to be influential in motivating students to pursue orthopaedics, with 40% of respondents indicating personal connections in medicine and 12% reporting family members who are orthopaedic surgeons. Research experiences were identified as important contributors to students' initial interest and motivation to ultimately pursue orthopaedics, especially those with diverse backgrounds. CONCLUSION The findings underscore the importance of early orthopaedic exposures in shaping students' interest in the field, highlighting the need for more immersive pre-clinical year opportunities and enhanced mentorship programs. Addressing disparities in mentorship access and early exposure opportunities requires systemic changes and increased support for underrepresented minorities in orthopaedics. Initiatives like mentorship programs and research opportunities can help bridge gaps in access to early orthopaedic experiences. Medical schools should prioritise targeted early access to orthopaedic exposures for all students, regardless of background. This initiative aims to promote inclusivity and cultivate a more diverse orthopaedic workforce capable of meeting the evolving healthcare needs of society.
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Affiliation(s)
- Jhillika Patel
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Divya Anand
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Chandravathi Sayani
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Alyanna Tam
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Anna Green
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
| | - Brian M Katt
- Department of Orthopaedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA
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Murphy DR, Justice BD, Borkan J. Using medical storytelling to communicate problems and solutions in the low back pain conundrum: an evidence-based tale of twins. Chiropr Man Therap 2023; 31:25. [PMID: 37553703 PMCID: PMC10410981 DOI: 10.1186/s12998-023-00499-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/14/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES Low back pain (LBP) is the number one cause of disability world-wide. It is also the most expensive area in healthcare. Patient-centered innovations are needed. This paper uses medical storytelling to illustrate the common problems that often lead to unnecessary suffering for patients, and costs to society. We present innovative solutions, including narrative interventions. METHODS We use medical storytelling to present a scenario in which hypothetical twin patients with identical LBP episodes enter the healthcare system, with one twin managed in an appropriate manner, and the other inappropriately. RESULTS One twin becomes a chronic LBP sufferer, while the other experiences quick resolution, despite identical conditions. Recommendations are made to de-implement inappropriate action and to implement a more productive approach. CONCLUSIONS Many patients with LBP descend into chronic pain. This is rarely inevitable based on clinical factors. Much of chronic LBP results from how the condition is handled within the healthcare system. Medical narrative may be one innovation to illustrate the problem of current LBP management, recommend solutions and foster changes in clinical behavior. PRACTICAL IMPLICATIONS The starkly different outcomes for each identical twin are illustrated. Recommendations are made for reframing the situation to de-implement the inappropriate and to implement a more appropriate approach.
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Affiliation(s)
- Donald R Murphy
- Department of Family Medicine, Alpert Medical School of Brown University, 133 Dellwood Road, Cranston, RI, 02920, USA.
| | - Brian D Justice
- Excellus BlueCross BlueShield, 165 Court Street, Rochester, NY, 14647, USA
| | - Jeffrey Borkan
- Department of Family Medicine, Alpert Medical School of Brown University, 111 Brewster St, Pawtucket, RI, 02860, USA
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Hetaimish BM, Abualross O, Alesawi A, Namenkani M, Alramadhani A, Samargandi R. The Current State of Undergraduate Trauma and Orthopedics Training in Saudi Arabia: A Survey-Based Study of Sixth-Year Medical Students' and Interns' Learning Experience and Subjective Clinical Competence. Cureus 2023; 15:e39974. [PMID: 37416005 PMCID: PMC10321025 DOI: 10.7759/cureus.39974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 07/08/2023] Open
Abstract
Background and objective Students frequently complain about the lack of practical skill learning and the poor quality of the medical school curriculum. In light of this, the purpose of this study was to assess the learning experience and subjective clinical competence of final-year medical students and interns in the field of orthopedics in Saudi Arabia (SA). Methods A cross-sectional observational descriptive study utilizing an electronically validated survey was conducted, which included the following six main sections: introduction, demographics, self-assessment of competency regarding certain orthopedic skills, clinical experience in orthopedics, orthopedics curriculum assessment, and choice of future career specialty. Results The total number of participants was 794. Among them, 33% (n=160) and 37.1% (180) had attended no "trauma meetings" or "operating room (OR)" sessions respectively, and only 21.9% (n=106) had attended more than five clinics. Subjective competence in history taking was highest (mean: 8.925 ±1.299) among students who had received more than four weeks of orthopedic rotation and attended more than six clinics. The students who had completed more than four weeks of orthopedic rotation and more than six bedside sessions scored the highest in terms of subjective competence in handling orthopedic patients in primary care settings (mean: 8.014 ±1.931). Conclusion The survey indicates that the amount of orthopedic training provided by institutions varies, with some students receiving less training than recommended. However, longer rotations lead to greater perceived orthopedic competence. Students and interns with more exposure to orthopedics through curriculum and elective rotations demonstrated a greater interest in pursuing orthopedics as a future career.
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Affiliation(s)
- Bandar M Hetaimish
- Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, SAU
| | - Osamah Abualross
- Medicine, Faculty of Medicine, University of Jeddah, Jeddah, SAU
| | | | | | | | - Ramy Samargandi
- Orthopedic Surgery, CHRU de Tours, Tours, FRA
- Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, SAU
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Greenslade K, Nelson J, Murray A, McCrea-Routray R, Hall AJ. Is medical training adequate to promote health and give patients what they need? The role of Sport and Exercise Medicine in 21st century healthcare. Br J Sports Med 2023; 57:558-559. [PMID: 36702507 DOI: 10.1136/bjsports-2022-106359] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2023] [Indexed: 01/28/2023]
Affiliation(s)
- Kathryn Greenslade
- College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - James Nelson
- College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Andrew Murray
- Sport and Physical Activity Policy Team, Scottish Government, Edinburgh, UK.,Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | | | - Andrew J Hall
- College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK .,Department of Orthopaedics, Golden Jubilee University National Hospital, Clydebank, UK
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Wijenayake L, Conroy S, McDougall C, Glasziou P. Knowledge of Musculoskeletal Medicine in Junior Doctors in Australia: Is It Adequate? Med Sci Educ 2022; 32:1337-1342. [PMID: 36532385 PMCID: PMC9755441 DOI: 10.1007/s40670-022-01637-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE The incidence of musculoskeletal disease is increasing in Australia and around the world. However, medical student education does not necessarily reflect current and projected trends in musculoskeletal medicine. The aim of this study was to assess junior doctors' competency in musculoskeletal medicine using the Freedman and Bernstein Basic Competency Examination in Musculoskeletal Medicine questionnaire. METHODS We conducted a cohort study of interns (first year post medical school) across four teaching hospitals in Australia. Interns were asked to take the Freedman and Bernstein examination during organised intern teaching sessions, and results were analysed using the original Freedman and Bernstein marking criteria and validated pass mark. RESULTS The mean score for the 92 interns was 13.9 out of 25 (55%) with scores ranging from 8 to 20.8 (29-83%). Only 8 of the 92 interns (8.7%) achieved a score of greater than 73%, the pre-specified pass mark. CONCLUSION Our study identifies inadequacies in musculoskeletal medical knowledge in Australian interns. Review of undergraduate medical education may be required to reflect current and predicted trends in the prevalence of musculoskeletal disease and adequately prepare junior doctors.
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Affiliation(s)
- Lahann Wijenayake
- Orthopaedic Department, Queensland Childrens’ Hospital, Brisbane, QLD Australia
- The University of Queensland, Brisbane, Australia
- Bond University, Gold Coast, QLD Australia
| | - Sophie Conroy
- Princess Alexandra Hospital, Brisbane, QLD Australia
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Mabry LM, Severin R, Gisselman AS, Ross MD, Davenport TE, Young BA, Keil AP, Goss DL. Physical Therapists Are Routinely Performing the Requisite Skills to Directly Refer for Musculoskeletal Imaging: An Observational Study. J Man Manip Ther 2022; 30:261-272. [PMID: 35968741 PMCID: PMC9487956 DOI: 10.1080/10669817.2022.2106729] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVES To explore if physical therapists are practicing skills necessary to refer patients for musculoskeletal imaging. METHODS An expert panel established a list of nine requisite skills to refer for musculoskeletal imaging. A blinded expert panel validated the list using a 5-point Likert scale. The skills list was examined via an electronic survey distributed to United States physical therapists. RESULTS 4,796 respondents were included. Each of the nine skills were routinely performed by a majority of the respondents (range: 54.52-94.72%). Respondents routinely performed 6.95 (± 0.06) skills, with 67.41% routinely performing seven or more skills. Doctors of physical therapy routinely performed more imaging skills (7.15 ± 0.06) compared to their masters- (6.44 ± 0.19) and bachelors-trained (5.95 ± 0.21) counterparts (p < 0.001). Residency/fellowship-trained physical therapists were more likely to routinely perform more imaging skills (7.60 ± 0.11 vs. 6.79 ± 0.07, p < 0.001). Imaging skill performance was greater among board-certified physical therapists (7.39 ± 0.09 vs. 6.71 ± 0.08, p < 0.001) and APTA members (7.06 ± 0.07 vs. 6.65 ± 0.12, p < 0.001). CONCLUSION Physical therapists are routinely practicing the requisite imaging skills to directly refer to a radiologist for musculoskeletal imaging.
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Affiliation(s)
- Lance M. Mabry
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, One University Parkway, High Point, NCUSA
| | - Richard Severin
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University , Waco, TX, USA
| | - Angela S. Gisselman
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, School of Medicine, Tufts University, Phoenix, AZ, USA
| | - Michael D. Ross
- Department of Physical Therapy, Daemen University, Amherst, NY, USA
| | - Todd E. Davenport
- Department of Physical Therapy, School of Health Sciences, University of the Pacific, Stockton, CA, USA
| | - Brian A. Young
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University , Waco, TX, USA
| | - Aaron P. Keil
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Don L. Goss
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, One University Parkway, High Point, NCUSA
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Murphy DR, Justice B, Bise CG, Timko M, Stevans JM, Schneider MJ. The primary spine practitioner as a new role in healthcare systems in North America. Chiropr Man Therap 2022; 30:6. [PMID: 35139859 PMCID: PMC8826679 DOI: 10.1186/s12998-022-00414-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background In an article published in 2011, we discussed the need for a new role in health care systems, referred to as the Primary Spine Practitioner (PSP). The PSP model was proposed to help bring order to the chaotic nature of spine care. Over the past decade, several efforts have applied the concepts presented in that article. The purpose of the present article is to discuss the ongoing need for the PSP role in health care systems, present persistent barriers, report several examples of the model in action, and propose future strategies. Main body The management of spine related disorders, defined here as various disorders related to the spine that produce axial pain, radiculopathy and other related symptoms, has received significant international attention due to the high costs and relatively poor outcomes in spine care. The PSP model seeks to bring increased efficiency, effectiveness and value. The barriers to the implementation of this model have been significant, and responses to these barriers are discussed. Several examples of PSP integration are presented, including clinic systems in primary care and hospital environments, underserved areas around the world and a program designed to reduce surgical waiting lists. Future strategies are proposed for overcoming the continuing barriers to PSP implementation in health care systems more broadly. Conclusion Significant progress has been made toward integrating the PSP role into health care systems over the past 10 years. However, much work remains. This requires substantial effort on the part of those involved in the development and implementation of the PSP model, in addition to support from various stakeholders who will benefit from the proposed improvements in spine care.
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Affiliation(s)
- Donald R Murphy
- Department of Family Medicine, Alpert Medical School of Brown University, 133 Dellwood Road, Cranston, RI, 02920, USA
| | - Brian Justice
- Excellus BlueCross BlueShield, 165 Court Street, Rochester, NY, 14647, USA
| | - Christopher G Bise
- Department of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 210, Pittsburgh, PA, 15219-3130, USA
| | - Michael Timko
- Department of Physical Therapy, University of Pittsburgh, Bridgeside Point Suite 228, 100 Technology Drive, Suite 210, Pittsburgh, PA, 15219-3130, USA
| | - Joel M Stevans
- Department of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 500, Pittsburgh, PA, 15219-3130, USA
| | - Michael J Schneider
- Department of Physical Therapy, University of Pittsburgh, Bridgeside Point 1, 100 Technology Drive, Suite 500, Pittsburgh, PA, 15219-3130, USA.
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