18 August 2020
Dr Pippa Watson was one of the reviewers and wrote the foreword for the Guide To The Clinical Assessment Of Patients With Musculoskeletal Conditions.
Tell us about the student handbook.
The handbook was originally produced by Professor Paul Dieppe in 1991 and has been used by countless medical students (including myself!) since. It was updated by David Coady and Dr Mark Lillicrap recently to ensure it meets its purpose of providing students with the best guide for musculoskeletal training. Historically there has only been a small amount of hours of MSK training that medical students are getting, so to provide education resources to complement formal training is important.
It's sometimes difficult for people to learn how to examine patients, and joint examination particularly can be quite daunting, because there are a lot of different joints in the body. The basic concept is that musculoskeletal examination is straightforward- it’s not a specialist area but a core examination that everyone can feel confident doing. A simple structure of Look, Feel, Move can be applied to the examination of all joints.
It’s written with all kinds of students in mind: doctors, physios, specialist nurses, and not just rheumatology doctors, but also other trainees. We wanted to make it accessible, so this latest version is available digitally as well as in print - it’s easier to navigate, with more images and diagrams.
How could people practically use the handbook?
At Manchester Medical School we've provided it to all of our students and we're hoping other medical schools will as well. It will also be a useful resource for postgraduate trainees and allied healthcare professionals.
In terms of education, the best way to learn, or to get the most out of a teaching session is to come along with a really good idea of what to do and then test out that knowledge and take it a bit further. And so any sort of preloading that we can do with electronic content will allow learners to get more out of a face-to-face session.
The handbook focuses on the clinical aspects of patients with musculoskeletal conditions, on taking a musculoskeletal history and then examinations. There is also a bit on investigations, and other important things like how to record your examination. That's often something that people find quite difficult: what you actually write in the notes when you do it.
Whatever field you’re working in, I encourage you to get ahead. If you can understand what you should be doing before you get the opportunities to practice you’ll improve much more.
Is there anything else you’d like to say about the handbook?
We need to start teaching about pathology as well as just what normal looks like. If you can do a normal examination, that's the first step, but then the next step is to start using your clinical reasoning skills to pick findings up and then interpret them and try and work out what they mean for a patient. That's what's really important as a clinician. We are hoping that the handbook, especially when used in conjunction with the recorded videos will allow learners to do this.
During the COVID pandemic, there are real challenges to delivering face-to-face training, so any resource that can help with that is going to be really valuable.