评估运动医学研究员如何在纵向运动医学轨道中感知他们的训练

Christopher Fox, Joshua T Goldman
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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.","PeriodicalId":93179,"journal":{"name":"Health education and care","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluating how sports medicine fellows perceived their training during a longitudinal sports medicine track\",\"authors\":\"Christopher Fox, Joshua T Goldman\",\"doi\":\"10.15761/hec.1000161\",\"DOIUrl\":null,\"url\":null,\"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. 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引用次数: 0

摘要

导读:虽然以住院医生为基础的运动医学课程(SMT)越来越受欢迎,但它们是否能增强住院医生为奖学金做准备的能力仍不清楚。本研究1)调查了现有基于居住的smt的组成部分,2)比较了当前smt的主观和客观测量。方法:现任运动医学研究员完成一项在线调查。该调查评估了人口统计数据、受试者在SMT中的参与情况,以及受试者在获得奖学金前的经历和初级保健运动医学奖学金的准备情况。结果:共完成问卷45份,参与SMT的研究员10名。与非SMT受试者相比,更多的SMT受试者报告了正式的MSK超声和程序培训。所有SMT受试者都报告了副业和个人防护用品的覆盖率。SMT受试者在以下方面有较高的自信水平:1)他们进行MSK考试的能力,2)他们诊断MSK损伤的能力,以及3)他们提供MSK损伤患者教育的能力。结论:smt旨在改善住院医生的肌肉骨骼训练、知识和信心。参与以住院医师为基础的smt的研究员在检查和诊断MSK损伤的能力方面具有显着更高的信心水平。他们也有更多的超声波和手术经验。这项研究证明了这些轨道在为住院医生准备奖学金方面的好处。*通讯作者:Christopher Fox,美国密苏里州堪萨斯城医学院和杜鲁门医学中心初级保健运动医学医师,E-mail: chrisfox.m@gmail.com收稿日期:2019年8月23日;录用日期:2019年9月05日;肌肉骨骼疾病仍然是初级保健中最常见的主诉之一。根据Vernec及其同事的研究,15%的家庭医生就诊与肌肉骨骼损伤有关。尽管在初级保健环境中对肌肉骨骼护理的需求很大,但它仍然是医学教育中普遍报道的缺陷之一。此外,研究表明,在家庭医学住院医师期间引入运动医学轮转可以提高肌肉骨骼知识和信心。Watts和他的同事们表明,在PGY-1家庭医学时间表中实施正式的运动医学课程/轮转可以显著改善基本的肌肉骨骼知识bb0。Waterbrook等人的研究表明,在PGY-1年的bbb期间,急诊医学住院医师在实施运动医学轮转(包括在运动医学诊所和训练室的时间)后,对他们的肌肉骨骼训练更满意。初级保健运动医学在家庭医学、内科、儿科和急诊医学住院医师中仍然是一个受欢迎和有竞争力的奖学金。NRMP报告称,在2018年的374名申请者中,有24%的人是无人匹配的。根据NRMP比赛数据,每年有越来越多的申请人申请有限数量的初级保健运动医学奖学金名额。目前,ACGME要求家庭医学住院医师至少接受200小时或8周的运动医学培训。运动医学课程(SMT)是除住院医师ACGME必修课程外,专门针对运动医学教育的一个集中领域。美国运动医学医学会(AMSSM)概述了在住院医师项目中实施SMT的指导方针。这些课程旨在帮助住院医师扩展他们的肌肉骨骼和运动医学知识,提高他们的团队报道经验,创造研究机会,鼓励参加全国会议,并促进成功匹配初级保健运动医学(PCSM)奖学金[6]。尽管有证据支持住院医师项目中运动医学轮转的价值,但缺乏评估这些项目如何提高运动医学研究员的入职前技能、信心水平和经验的数据。因此,我们的研究旨在评估运动医学研究员如何根据AMSSM SMT指南所概述的标准,在以住院医师为基础的SMT中看待他们的培训。我们试图确定在住院医师培训期间参加SMT是否会影响研究员对奖学金的主观和客观准备。Fox C(2019)在纵向运动医学跟踪中评估运动医学研究员如何感知他们的培训vol . 4: 2-4 Health Edu Care, 2019 doi: 10.15761/HEC.1000161方法AMSSM通过电子邮件向2017-2018学年所有即将入学的PCSM研究员分发在线调查问卷。这项调查是去年在对运动医学感兴趣的当地居民中进行的试点。他们的反馈被用来指导问题的修正和澄清。 导读:虽然以住院医生为基础的运动医学课程(SMT)越来越受欢迎,但它们是否能增强住院医生为奖学金做准备的能力仍不清楚。本研究1)调查了现有基于居住的smt的组成部分,2)比较了当前smt的主观和客观测量。方法:现任运动医学研究员完成一项在线调查。该调查评估了人口统计数据、受试者在SMT中的参与情况,以及受试者在获得奖学金前的经历和初级保健运动医学奖学金的准备情况。结果:共完成问卷45份,参与SMT的研究员10名。与非SMT受试者相比,更多的SMT受试者报告了正式的MSK超声和程序培训。所有SMT受试者都报告了副业和个人防护用品的覆盖率。SMT受试者在以下方面有较高的自信水平:1)他们进行MSK考试的能力,2)他们诊断MSK损伤的能力,以及3)他们提供MSK损伤患者教育的能力。结论:smt旨在改善住院医生的肌肉骨骼训练、知识和信心。参与以住院医师为基础的smt的研究员在检查和诊断MSK损伤的能力方面具有显着更高的信心水平。他们也有更多的超声波和手术经验。这项研究证明了这些轨道在为住院医生准备奖学金方面的好处。*通讯作者:Christopher Fox,美国密苏里州堪萨斯城医学院和杜鲁门医学中心初级保健运动医学医师,E-mail: chrisfox.m@gmail.com收稿日期:2019年8月23日;录用日期:2019年9月05日;肌肉骨骼疾病仍然是初级保健中最常见的主诉之一。根据Vernec及其同事的研究,15%的家庭医生就诊与肌肉骨骼损伤有关。尽管在初级保健环境中对肌肉骨骼护理的需求很大,但它仍然是医学教育中普遍报道的缺陷之一。此外,研究表明,在家庭医学住院医师期间引入运动医学轮转可以提高肌肉骨骼知识和信心。Watts和他的同事们表明,在PGY-1家庭医学时间表中实施正式的运动医学课程/轮转可以显著改善基本的肌肉骨骼知识bb0。Waterbrook等人的研究表明,在PGY-1年的bbb期间,急诊医学住院医师在实施运动医学轮转(包括在运动医学诊所和训练室的时间)后,对他们的肌肉骨骼训练更满意。初级保健运动医学在家庭医学、内科、儿科和急诊医学住院医师中仍然是一个受欢迎和有竞争力的奖学金。NRMP报告称,在2018年的374名申请者中,有24%的人是无人匹配的。根据NRMP比赛数据,每年有越来越多的申请人申请有限数量的初级保健运动医学奖学金名额。目前,ACGME要求家庭医学住院医师至少接受200小时或8周的运动医学培训。运动医学课程(SMT)是除住院医师ACGME必修课程外,专门针对运动医学教育的一个集中领域。美国运动医学医学会(AMSSM)概述了在住院医师项目中实施SMT的指导方针。这些课程旨在帮助住院医师扩展他们的肌肉骨骼和运动医学知识,提高他们的团队报道经验,创造研究机会,鼓励参加全国会议,并促进成功匹配初级保健运动医学(PCSM)奖学金[6]。尽管有证据支持住院医师项目中运动医学轮转的价值,但缺乏评估这些项目如何提高运动医学研究员的入职前技能、信心水平和经验的数据。因此,我们的研究旨在评估运动医学研究员如何根据AMSSM SMT指南所概述的标准,在以住院医师为基础的SMT中看待他们的培训。我们试图确定在住院医师培训期间参加SMT是否会影响研究员对奖学金的主观和客观准备。Fox C(2019)在纵向运动医学跟踪中评估运动医学研究员如何感知他们的培训vol . 4: 2-4 Health Edu Care, 2019 doi: 10.15761/HEC.1000161方法AMSSM通过电子邮件向2017-2018学年所有即将入学的PCSM研究员分发在线调查问卷。这项调查是去年在对运动医学感兴趣的当地居民中进行的试点。他们的反馈被用来指导问题的修正和澄清。 调查包括30道选择题和简答题。这项调查是在8月份发布的,就在研究对象转变为研究员后不久。这些问题评估了受试者及其住院医师项目的人口统计数据。问题还评估了1)受试者在SMT中的参与状态,2)受试者在住院期间的经验的客观测量,以及3)他们对PCSM奖学金的自我感知准备的主观测量。使用频率和百分比总结分类变量,并使用卡方检验和Fisher精确检验进行组间比较。用均值、标准差和四分位数对连续变量进行汇总,并使用t检验格式对组间进行比较。加州大学洛杉矶分校机构审查委员会批准了这项研究。 调查包括30道选择题和简答题。这项调查是在8月份发布的,就在研究对象转变为研究员后不久。这些问题评估了受试者及其住院医师项目的人口统计数据。问题还评估了1)受试者在SMT中的参与状态,2)受试者在住院期间的经验的客观测量,以及3)他们对PCSM奖学金的自我感知准备的主观测量。使用频率和百分比总结分类变量,并使用卡方检验和Fisher精确检验进行组间比较。用均值、标准差和四分位数对连续变量进行汇总,并使用t检验格式对组间进行比较。加州大学洛杉矶分校机构审查委员会批准了这项研究。
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Evaluating how sports medicine fellows perceived their training during a longitudinal sports medicine track
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.
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