The musculoskeletal learning needs of doctors in training for general practice

Abstract

General practitioners must be able to respond appropriately to the full range of medical conditions that present to them during their surgeries. To do this they require adequate training in a variety of specialties. Concerns have been raised regarding general practitioners training in certain areas. One of these is the management of musculoskeletal conditions. The overall aim of this study was to explore the musculoskeletal learning needs of trainee general practitioners by identifying the conditions they see during their day to day work and then asking them to reflect on these. A secondary aim was to create an educational package focused on one area of learning need and to evaluate this. A questionnaire study initially performed in 1995, which highlighted concerns regarding training in this area, was repeated to see if the situation had changed. Thereafter thirteen trainees kept a diary documenting all of their musculoskeletal consultations for a month. They were also asked to document any perceived learning needs regarding these consultations. The trainees were then interviewed and their identified learning needs were further explored. Any others learning needs in musculoskeletal medicine were also discussed. Focus groups with a further two groups of registrars were performed, along with interviews with eight trainers, in order to triangulate the data and to explore their ideas. An educational package on the management of shoulder pain, one of the areas identified by the trainees, was developed and trialled with a different group of doctors by using a pre- and post- knowledge test. Confidence in managing musculoskeletal disorders in doctors currently training for a career in general practice remains poor. Learning needs were identified in a variety of different areas. It is possible to create an educational package focused on a specific area which can address these needs.