An interprofessional teaching approach for medical and physical therapy students to learn functional anatomy and clinical examination of the lower spine and hip

Abstract

Introduction: Pain of the lower back is a frequent symptom and is treated by different health professions. Anatomical as well as clinical knowledge is utmost important for all professions involved in this field. Here, we present a model that brings together an interprofessional team of experts to teach functional and clinical anatomy of the lower spine and hip area to medical and physical therapy students.

Methods: Two groups of medical students (n=60) and physical therapy students (n=77) were designated to two interprofessional clusters, with each cluster of students participating in three workshops, each lasting 40min. Workshops were guided by university anatomists, an orthopedic physician and physical therapists, and each provided specialized training, such as the conduction of clinical, orthopedic functional tests, the identification and palpation of anatomical structures and demonstrations of human anatomical joint prosections. A questionnaire, consisting of 18 questions regarding subjective anatomical and clinical knowledge and application of clinical assessment techniques was used as the evaluation tool before and after participation in the course. Furthermore, the amount of knowledge gained from peer group participants from the other profession versus the knowledge gained from the instructors was assessed. Descriptive statistics of data as well as quantitative data analysis was carried out for pre-post analysis.

Results: A total of 148 students participated in the pre-course evaluation and self-assessment and 113 students completed the post-course evaluation and self-assessment. 11 of the students, who completed the pre-course evaluation, and five students who completed the post-course evaluation failed to reveal their affiliation and these were only included in the general and corresponding cluster analysis. A final 132 pre-questionnaire and 97 post-questionnaire results were included in the analyses due to a likely group response bias. Scores for all combined groups showed an increase in the pre-post evaluation of 11.7% (P<.001). Cluster 1 and 2 (pre-post) score comparisons showed an increase of 13.7% (P<.001) and 8.8% (P<.001) respectively. A subgroup pre-post-questionnaire analysis demonstrated that medical students from both clusters had the highest increase in scores (17.6% and 19.9%) in comparison to their physical therapy counterparts (9.1% and 5.8%) (P<.001). Specifically, medical students profited highly from the anatomy in vivo (palpation) as well as clinical, orthopedic assessment exercises. Sub-question analyses showed that students learned from each other as well as from an interprofessional team of guiding experts/instructors, though mostly from the latter.

Conclusions: This course offers an appropriate and effective model that brings together an interprofessional team of experts to teach functional and clinical anatomy to medical and physical therapy students. Study results demonstrated an increase in subject-specific competencies in functional and clinical anatomy of the lower spine and hip. Medical students demonstrated the highest increase in subjective knowledge, especially in regard to clinical examination and assessment, which highlights the usefulness of this course early in the medical education. All students learned from the exchange with interprofessional group members as well as the instructors.

Keywords: Clinical examination; Functional anatomy; Gross anatomy education; Interprofessional education; Lower spine–hip region; Medical education; Physical therapy.