Evaluation of Educational Advancement following a Sports Medicine Rotation

Background: The competency in orthopaedic surgery and sports medicine has been reported as a deficiency. Sports medicine clinical rotations may improve both medical students’ and residents’ musculoskeletal knowledge, but none have evaluated the knowledge and skills a resident may gain during the rotation in sports medicine. Objective: The purpose of this study is to determine (1) The knowledge gained by residents at varying levels after rotating within our sports medicine program and (2) The performance of residents in a standardized sports medicine test at the start and end of each resident’s rotation in sports medicine. Methods: Total of 136 residents and fellows participated in this study following the Model Curriculum and Guidelines for Orthopaedic Surgery Sports Medicine Fellowship Training created by the American Orthopaedic Society for Sports Medicine Accreditation Council of Graduate Medical Education. Multiple modalities training program were administered, including clinical rotation, laboratory research project, covering professional sport team training, and conference presentation. Their performances were assessed and compared by preand post-rotation tests with statistical analysis to determine the improvement of their orthopaedic knowledge. Results: The residents at the fifth of Post-Graduate-Year (PGY 5) scored the highest followed by fellows. PGY5 had the lowest percent change between preand post-test. PGY 2 and PGY3 residents scored the lowest overall while having the largest percent change before and after the rotation thereby showing the most improvement. Conclusions: Multiple modalities training program improved residents and fellows’ performance and knowledge in sports medicine. Introduction The musculoskeletal complaint is one of the most common reasons for visiting a physician and accounts for 92.1 million cases annually [1] with approximately 30% of visits to primary care physicians and 20% of visits to the Emergency Department (ED) [2,3]. Despite the prevalence of musculoskeletal disorders, competency in musculoskeletal medicine including sports medicine has still been reported as a deficiency in medical education in the USA [4-9]. This deficiency is well documented through studies at both the undergraduate and graduate medical education levels [7,8,10-12]. This deficiency is noted even among orthopedic surgery residents [12]. Residents have failed to demonstrate basic competency in musculoskeletal medicine, revealing medical school preparation regarding this topic is inadequate. Because of this deficiency of knowledge and skills at all levels of medical education, more than half of residents did not feel they had adequate training in musculoskeletal medicine [13]. It has been reported that sports medicine clinical rotations improve both medical students’ and residents’ musculoskeletal knowledge [7,14-17] but none have tried to evaluate the knowledge and skills a resident may gain during his/her rotation in sports medicine. We hypothesized that in addition to look at the predictors of residency, or success on orthopaedic surgery board examinations as showed in the previous studies [7,1417] it is necessary to quantify the knowledge and skills ISSN: 2469-5718 DOI: 10.23937/2469-5718/1510196 Rozek et al. Int J Sports Exerc Med 2021, 7:196 • Page 2 of 6 • covering games for professional teams including the Detroit Tigers (MLB) and the Detroit Red Wings (NHL). In addition to game coverage, SM fellows also travelled to and participated in spring training, training camps, and pre-season physicals. They worked with physicians to cover sport events and outreach including the Detroit Free Press Marathon, Detroit Grand Prix and other events sponsored by DMC Sports Medicine. They also worked with physician to cover amateur high school teams throughout the year. Academic conference presentations Residents and fellows presented academic lectures at weekly fellow conferences, as well as case presentations at the monthly DMC Sports Medicine Visiting Lecture Series and monthly Journal Clubs. They attended orthopaedic surgery resident conferences and other local sports medicine orthopaedic surgery meetings. All Sports Medicine Fellows attended the annual American Orthopaedic Society for Sports Medicine (AOSSM) Conference as well as the Michigan Orthopaedic Society Fall and Spring conferences. Sports Medicine Fellows also attended various arthroscopy courses locally, regionally, and nationally. All Sports Medicine Fellows presented their research findings and attended a two-day event in July hosting speakers from the Metro Detroit area and national Keynote Speakers. All DMC Sports Medicine Orthopaedic Fellowship alumni, present fellows, and incoming fellows were invited as a way for fellows to stay connected with each other and the Program. Training in laboratory settings Residents and fellows attended weekly Bioskills Labs focusing on improving arthroscopic skills of the shoulder, elbow, wrist, hip, knee, and ankle. There was also a musculoskeletal ultrasound component to the Bioskills Lab for training. A 12-week rotating schedule in the Bioskills Lab ensured that fellows participated and gained mastery of skills which enables the fellows to teach the lab for residents and students during the last quarter of the Fellowship year.