A randomised controlled trial of SAFMEDS to improve musculoskeletal radiology interpretation

Surgeon. 2021 Jan 7;S1479-666X(20)30177-3. doi: 10.1016/j.surge.2020.11.004. Online ahead of print.


Introduction: This study examined the impact of a Say-All-Fast-Minute-Everyday-Shuffled (SAFMEDS) intervention on musculoskeletal radiology interpretation ability. It addressed two research questions: 1) what degree of performance improvement in musculoskeletal radiology interpretation does SAFMEDS engender beyond usual teaching? and; 2) does the degree of improvement differ for participants who achieve behavioural fluency and those who do not?

Materials and methods: This study used a pragmatic randomised controlled trial design. Third-year medical students were randomised to either an intervention group (n = 22), who received SAFMEDS and usual teaching, or a control group (n = 20), who received usual teaching only. Eleven participants (5 intervention group, 6 control group) did not complete participation.

Results: A large effect size of the SAFMEDS intervention was identified (partial η2 = 0.672; M = 38.5 min practice). When controlling for baseline performance, intervention group participants' performance on the post-test was significantly higher (M = 77.4%) than that of control group participants (M = 49.6%). Intervention group participants who achieved fluency performed significantly better at post-test (M = 82.4%) than intervention group participants who did not (M = 72.9%).

Conclusions: SAFMEDS constitutes a powerful adjunct to usual teaching that produces significant improvement with a short duration of engagement, particularly when students achieve fluency in the target behaviour. Future research should consider the application of SAFMEDS, and other fluency training interventions, more widely within musculoskeletal education and orthopaedic surgery training.

Keywords: Behavioural fluency; Behaviourism; Medical education; Musculoskeletal; Orthopaedic; SAFMEDS.