Musculoskeletal examination teaching by patients versus physicians: How are they different? Neither better nor worse, but complementary

Abstract

Background: Musculoskeletal (MSK) complaints comprise 1220% of primary healthcare; however, practicing physicians' MSK physical examination (PE) skills are weak. Further, there is a shortage of specialists able to effectively teach this subject. Previous evaluations of patient educators have yielded mixed results. Aims: The aim of this study is to document how teaching by patient educators and physician tutors in MSK PE skills differs. Methods: A qualitative researcher observed, video-recorded, and took notes during preclerkship MSK PE teaching sessions given by patient educators or physician tutors. The researcher identified themes which were evaluated by collective case study methods. Results: Two patient educator and four physician groups were evaluated. The patient educators were more consistent regarding content and style than the physicians. There appeared to be a continuum in teaching organization from patient educator to novice physician tutors to experienced physician tutors. The patient educators consistently covered all major joints (physicians did not); physicians were more likely to request verbalization of actions, relate findings to history, receive questions, and use opportunistic teaching moments. Conclusions: Understanding preclerkship MSK teaching by patient educators compared to physician tutors is necessary for appropriate targeting of the existing Patient Partners®Â" in Arthritis patient educator program and to guide the development of future MSK teaching initiatives. © 2011 Informa UK Ltd.