Background: The purpose of this study is to examine the retention of musculoskeletal knowledge in the years following Sports Medicine and Orthopedic Surgery rotations completed during intern year of Emergency Medicine residency programs. A previous study demonstrated increase in knowledge after both rotations.
Methods: A validated, open-ended, short answer exam, composed of 25 questions designed to assess fundamental musculoskeletal knowledge, was administered to Emergency Medicine residents enrolled in two categorical Emergency Medicine programs and one Emergency Medicine/Pediatrics (EM/PEDS) combined residency program. Interns were assessed before and after four-week rotations in either Sports Medicine or Orthopedic Surgery. Juniors and seniors were assessed in the Fall. Two independent evaluators coded the responses based on a pre-determined rubric. The rubric was used by a third evaluator to grade the assessments used in the t-test statistical model.
Results: Seventy-two interns completed post-rotation assessments from 2016 – 2018. Thirty-four junior and senior residents completed the assessment in Spring 2018. There was a statistically significant difference between the mean scores of these two groups (73 vs 67, respectively, p=0.02). Mean scores on intern post-rotation assessments met the minimum standard passing score of 73 while the junior and senior resident assessments did not.
Conclusion: There is a statistically significant difference between the mean scores of interns who had just completed their Sports Medicine or Orthopedic Surgery rotations and junior and senior residents in the spring of their respective years. Retention of musculoskeletal knowledge appears to decline following the end of the rotation. Competency in musculoskeletal medicine is a consistently reported shortcoming in undergraduate and graduate medical education in many specialties. This study demonstrates the need to focus not only on knowledge obtained during a rotation, but also the retention and reinforcement of that knowledge in the years following musculoskeletal-focused rotations.