Teaching the Musculoskeletal Examination: Are Patient Educators as Effective as Rheumatology Faculty?

BACKGROUND: Effective education of clinical skills is essential if doctors are to meet the needs of patients with rheumatic disease, but shrinking faculty numbers has made clinical teaching difficult. A solution to this problem is to utilize patient educators. PURPOSE: This study evaluates the teaching effectiveness of patient educators compared to rheumatology faculty using the musculoskeletal (MSK) examination. METHOD: Sixty-two 2nd-year medical students were randomized to receive instruction from patient educators or faculty. Tutorial groups received instructions during three, 3-hr sessions. Clinical skills were evaluated by a 9 station objective structured clinical examination. Students completed a tutor evaluation form to assess their level of satisfaction with the process. RESULTS: Faculty-taught students received a higher overall mark (66.5% vs. 62.1%,) and fewer failed than patient educator-taught students (5 vs. 0, p = 0.02). Students rated faculty educators higher than patient educators (4.13 vs. 3.58 on a 5-point Likert scale). CONCLUSION: Rheumatology faculty appear to be more effective teachers of the MSK physical exam than patient educators.