Andrea Barker is Codirector; and Michael Battistone is Director; both at the Center of Excellence in Musculoskeletal Care and Education at the George E. Wahlen Veterans Affairs Medical Center in Salt Lake City, Utah. Jeffrey LaRochelle is an Associate Professor of Medicine; and Scott Wiltz is an Assistant Professor of Family Medicine; both at the University of Central Florida College of Medicine in Orlando. Anthony Artino is Professor and Deputy Director, Division of Health Professions Education, Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences in Bethesda, Maryland. Laura Kim is a Health Professions Education Evaluation and Research Fellow; and Scott Wiltz is the Associate Medical Director of Training, both at the VHA Simulation Learning, Education and Research Network (SimLEARN) in Orlando. Andrea Barker is an Adjunct Instructor, Department of Family and Preventive Medicine; and Michael Battistone is Associate Professor in the Department of Internal Medicine, Division of Rheumatology, Health Sciences Center; both at the University of Utah in Salt Lake City. Correspondence: Andrea Barker (andrea.barker@va.gov)
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the US Government, or any of its agencies.
The small number of participants may limit the validity of our conclusions. Although we included an OSCE to measure competence in performing and interpreting the shoulder exam, the durability of these skills is not known. Periodic postcourse OSCEs could help determine this and refresh and preserve accuracy in the performance of specific maneuvers. Second, although this experience was rated highly by participants, we do not know the impact of the program on their daily work or career trajectory. Sustained follow-up of learners, perhaps developed on the model of the Long-Term Career Outcome Study, may increase the value of this experience for future participants.38 This program appealed to a diverse pool of learners, with a broad range of precourse expertise and varied expectations of how course experiences would impact their future work and career development. Some clinical educator attendees came from tertiary care facilities affiliated with academic medical centers, held specialist or subspecialist credentials, and had formal responsibilities as leaders in HPE. Other clinical practitioner participants were solitary PCPs, often in rural or home-based settings; although they may have been eager to apply new knowledge and skills in patient care, they neither anticipated nor desired any role as an educator.
Conclusion
The initial SimLEARN MSK Training Program provides PCPs and clinician educators with rich learning experiences, increasing confidence in addressing MSK problems and competence in performing and interpreting a systematic physical examination of the shoulder. The success of this program has created new opportunities for practitioners seeking to strengthen clinical skills and for leaders in health professions education looking to disseminate similar trainings and connect with a national group of educators.
Acknowledgments
The authors gratefully acknowledge the faculty and staff at the Veterans Health Administration SimLEARN National Simulation Center, the faculty of the Salt Lake City Musculoskeletal Mini-Residency program, the supportive leadership of the George E. Wahlen Salt Lake City Veterans Affairs Medical Center, and the efforts of Danielle Blake for logistical support and data entry.
