Real patient learning integrated in a preclinical block musculoskeletal disorders. Does it make a difference?

Clin Rheumatol. 2011 Aug;30(8):1029-37. doi: 10.1007/s10067-011-1708-3. Epub 2011 Feb 24.


Although musculoskeletal disorders are the most common reason for general practitioner visits, training did not keep pace. Implementation of learning from patients with rheumatologic disorders linked together with the teaching of theoretical knowledge in the preclinical medical education might be an important step forward in the improvement of quality of care for these patients. The Leiden Medical School curriculum has implemented two non-obligatory real patient learning (RPL) practicals integrated within the preclinical block musculoskeletal disorders. This study investigates the educational effectiveness of the practicals, the expectations students have of RPL, and students' satisfaction. Participants' grades on the end-of-block test served as the test results of the educational effectiveness of the practicals and were compared with those of the non-participants. Qualitative data was collected by means of questionnaires generated by focus groups. The participants in practicals scored significantly higher at the end-of-block test. The expected effects of the contact with real patients concerned positive effects on cognition and skills. 'Contextualizing of the theory', 'better memorizing of clinical pictures', and 'understanding of the impact of the disease' were the most frequently mentioned effects of the practicals. Overall, the participants were (very) enthusiastic about this educational format. The RPL practicals integrated within a preclinical block musculoskeletal disorders are a valuable addition to the Leiden medical curriculum. This relatively limited intervention exhibits a strong effect on students' performance in tests. Future research should be directed towards the long-term effects of this intervention.

MeSH terms

  • Clinical Competence / standards*
  • Clinical Medicine / education*
  • Curriculum
  • Education, Medical, Undergraduate / methods*
  • Educational Measurement / statistics & numerical data
  • Humans
  • Musculoskeletal Diseases / therapy*
  • Problem-Based Learning / methods*
  • Rheumatology / education*