Greater focus on clinical rheumatology is required for training in internal medicine.

Hdl Handle:
http://hdl.handle.net/10147/207780
Title:
Greater focus on clinical rheumatology is required for training in internal medicine.
Authors:
McCarthy, Eoghan M; Sheane, Barry J; Cunnane, Gaye
Affiliation:
Department of Rheumatology, St James' Hospital, Dublin 8, Ireland.
Citation:
Clin Rheumatol. 2009 Feb;28(2):139-43. Epub 2008 Sep 3.
Journal:
Clinical rheumatology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207780
DOI:
10.1007/s10067-008-0997-7
PubMed ID:
18766425
Abstract:
Early intervention for rheumatic disease has been shown to improve prognosis, but is dependent on the recognition of pertinent symptoms and signs. This study was undertaken to identify the attitudes of junior doctors toward musculoskeletal assessment. The charts of 100 randomly selected medical patients admitted via the Emergency Department were reviewed for documentation of the musculoskeletal system. In addition, junior doctors were interviewed regarding their views on musculoskeletal assessment. Only 16% of medical admission notes contained a reference to the musculoskeletal system and the recording of joint examinations was incomplete in all cases. Prior training in musculoskeletal assessment depended on the joint area involved (hand, 100%; foot, 36.2%). Most doctors felt competent in hand assessment (68.8%) but only 12.5% could examine the foot. More than one third could not confidently diagnose common rheumatic conditions, while 75% felt unable to diagnose a connective tissue disorder. The majority (88.7%) regarded the musculoskeletal assessment as difficult/challenging and 61.3% thought that it should not be included as part of a general medical examination. However, 80% of doctors felt that they had not received adequate teaching in musculoskeletal assessment and would welcome further training. The omission of the musculoskeletal assessment for medical patients admitted to hospital is reflected in the fact that doctors lack training in this area. Furthermore, doctors lack confidence in their ability to recognise both common and rare rheumatic diagnoses, a problem likely to impact adversely on the outcome of patients with these conditions.
Language:
eng
MeSH:
*Attitude of Health Personnel; Clinical Competence/*statistics & numerical data; Clinical Medicine/*education/trends; Data Collection; Education, Medical/trends; Humans; Internal Medicine/*education/trends; Ireland; Musculoskeletal System/physiopathology; Rheumatic Diseases/*diagnosis/physiopathology; Rheumatology/*education/trends
ISSN:
1434-9949 (Electronic); 0770-3198 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMcCarthy, Eoghan Men_GB
dc.contributor.authorSheane, Barry Jen_GB
dc.contributor.authorCunnane, Gayeen_GB
dc.date.accessioned2012-02-01T10:44:29Z-
dc.date.available2012-02-01T10:44:29Z-
dc.date.issued2012-02-01T10:44:29Z-
dc.identifier.citationClin Rheumatol. 2009 Feb;28(2):139-43. Epub 2008 Sep 3.en_GB
dc.identifier.issn1434-9949 (Electronic)en_GB
dc.identifier.issn0770-3198 (Linking)en_GB
dc.identifier.pmid18766425en_GB
dc.identifier.doi10.1007/s10067-008-0997-7en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207780-
dc.description.abstractEarly intervention for rheumatic disease has been shown to improve prognosis, but is dependent on the recognition of pertinent symptoms and signs. This study was undertaken to identify the attitudes of junior doctors toward musculoskeletal assessment. The charts of 100 randomly selected medical patients admitted via the Emergency Department were reviewed for documentation of the musculoskeletal system. In addition, junior doctors were interviewed regarding their views on musculoskeletal assessment. Only 16% of medical admission notes contained a reference to the musculoskeletal system and the recording of joint examinations was incomplete in all cases. Prior training in musculoskeletal assessment depended on the joint area involved (hand, 100%; foot, 36.2%). Most doctors felt competent in hand assessment (68.8%) but only 12.5% could examine the foot. More than one third could not confidently diagnose common rheumatic conditions, while 75% felt unable to diagnose a connective tissue disorder. The majority (88.7%) regarded the musculoskeletal assessment as difficult/challenging and 61.3% thought that it should not be included as part of a general medical examination. However, 80% of doctors felt that they had not received adequate teaching in musculoskeletal assessment and would welcome further training. The omission of the musculoskeletal assessment for medical patients admitted to hospital is reflected in the fact that doctors lack training in this area. Furthermore, doctors lack confidence in their ability to recognise both common and rare rheumatic diagnoses, a problem likely to impact adversely on the outcome of patients with these conditions.en_GB
dc.language.isoengen_GB
dc.subject.mesh*Attitude of Health Personnelen_GB
dc.subject.meshClinical Competence/*statistics & numerical dataen_GB
dc.subject.meshClinical Medicine/*education/trendsen_GB
dc.subject.meshData Collectionen_GB
dc.subject.meshEducation, Medical/trendsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInternal Medicine/*education/trendsen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshMusculoskeletal System/physiopathologyen_GB
dc.subject.meshRheumatic Diseases/*diagnosis/physiopathologyen_GB
dc.subject.meshRheumatology/*education/trendsen_GB
dc.titleGreater focus on clinical rheumatology is required for training in internal medicine.en_GB
dc.contributor.departmentDepartment of Rheumatology, St James' Hospital, Dublin 8, Ireland.en_GB
dc.identifier.journalClinical rheumatologyen_GB
dc.description.provinceLeinster-
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