Evaluating how sports medicine fellows perceived their training during a longitudinal sports medicine track

Abstract

Introduction: While residency-based Sports Medicine Tracks (SMT) are becoming increasingly popular, their ability to augment resident’s preparation for fellowship remains unclear. This study 1) investigates the components of existing residency-based SMTs and 2) compares both subjective and objective measures of current SMTs. Methods: Current Sports Medicine fellows completed an online survey. The survey assessed demographics, subject participation in a SMT, and measures of the subject’s pre-fellowship experiences and preparedness for a Primary Care Sports Medicine fellowship. Results: There were 45 completed surveys with 10 fellows having participated in a SMT. More SMT subjects reported formal MSK ultrasound and procedural training than non-SMT subjects. All SMT subjects reported sideline and PPE coverage. SMT subjects had higher confidence levels in 1) their ability to perform an MSK exam, 2) their ability to diagnose MSK injuries, and 3) their ability to provide MSK injury patient education. Conclusions: SMTs are designed to improve residents’ musculoskeletal training, knowledge, and confidence prior to fellowship. Fellows who were involved in residency-based SMTs had significantly higher confidence levels in their ability to examine and diagnose MSK injuries. They also had significantly more ultrasound and procedural experiences. This study demonstrates the benefit of these tracks in preparing residents for fellowship. *Correspondence to: Christopher Fox, Primary Care Sports Medicine physician at the University of Missouri-Kansas City School of Medicine and Truman Medical Centers in Kansas City, Missouri, USA, E-mail: chrisfox.m@gmail.com Received: August 23, 2019; Accepted: September 05, 2019; Published: September 09, 2019 Introduction Musculoskeletal complaints remain one of the most common chief complaints in primary care. According to Vernec and colleagues, 15% of family physician visits are related to musculoskeletal injuries [1]. Despite the significant demand for musculoskeletal care in the primary care setting, it continues to be one of the commonly reported deficiencies in medical education [2]. Additionally, studies have demonstrated improved musculoskeletal knowledge and confidence with the introduction of Sports Medicine rotations during a Family Medicine Residency. Watts and colleagues showed that implementing a formalized sports medicine curriculum/rotation into a PGY-1 Family Medicine schedule provided significant improvement in basic musculoskeletal knowledge [3]. Waterbrook, et al. showed that Emergency Medicine residents were more satisfied with their musculoskeletal training after implementing a Sports Medicine rotation (including both time in Sports Medicine clinics and training room experience) during the PGY-1 year [4]. Primary Care Sports Medicine remains a popular and competitive fellowship among Family Medicine, Internal Medicine, Pediatric, and Emergency Medicine residents. The NRMP reported 24% of 374 applicants went unmatched in 2018 [5]. Based on NRMP match data, there is an increasing number of applicants yearly for a limited number of Primary Care Sports Medicine fellowship spots [5]. Currently the ACGME requires Family Medicine residents to get at least 200 hours or 8 weeks of exposure to sports medicine [5]. A Sports Medicine Track (SMT) is an area of concentration specifically in sports medicine education that is in addition to the residents ACGME required curriculum. The American Medical Society for Sports Medicine (AMSSM) has outlined guidelines for the implementation of a SMT into a residency program [6]. These tracks are designed to help residents expand their musculoskeletal and sports medicine knowledge, enhance their team coverage experience, create research opportunities, encourage national conference attendance, and promote a successful match into a Primary Care Sports Medicine (PCSM) fellowship [6]. Despite the evidence supporting the value of sports medicine rotations within residency programs, there is a paucity of data evaluating how these programs augment sports medicine fellows prefellowship skills, confidence levels, and experiences. Therefore, our study seeks to evaluate how sports medicine fellows perceived their training during residency-based SMTs in line with the criteria outlined by the AMSSM SMT guidelines [7]. We seek to identify if participation in a SMT during residency training affected fellows’ subjective and objective preparedness for fellowship. Fox C (2019) Evaluating how sports medicine fellows perceived their training during a longitudinal sports medicine track Volume 4: 2-4 Health Edu Care, 2019 doi: 10.15761/HEC.1000161 Methods An online survey was distributed by AMSSM via email to all incoming PCSM fellows for the 2017-2018 academic year. The survey was piloted the previous year with local residents who had an interest in sports medicine. Their feedback was used to guide question revisions and clarifications. The survey included 30 multiple choice and short answer questions. The survey was distributed in August, shortly after the subjects’ transition into fellowship. The questions assessed both the subject’s and their residency program’s demographics. Questions also assessed 1) subjects’ participation status in a SMT, 2) objective measures of the subject’s experiences during residency, and 3) subjective measures of their self-perceived preparedness for a PCSM fellowship. Categorical variables were summarized using frequencies and percentages, and compared between groups using Chi-squared and Fisher’s exact tests. Continuous variables were summarized using means, standard deviations, and quartiles and compared between groups using a t-test format. The UCLA Institutional Review Board approved this study.