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The Art of Teaching Undergraduates

  • Yasser El Miedany
Chapter

Abstract

Rheumatic conditions are common in both hospital and community settings. However, this high incidence is not reflected in the coverage of rheumatic disorders in the undergraduate medical school curriculum. Current evidence suggests that there are a number of shortcomings in undergraduate rheumatology training, in terms of the content, how this is delivered and how it is assessed. Moreover, there seems to be considerable variation across medical schools worldwide. To tackle this challenge, there is a need to recognize and prioritize rheumatology teaching within the undergraduate curriculum, to incorporate rheumatology into the core components taught in the medical schools and to have an agreement about methods of delivery and assessment of musculoskeletal clinical skills as well as knowledge. This chapter will enlighten the readers about the current situation of undergraduate teaching, the science and art of teaching the undergraduates and the new concepts in this field. It aims to serve as a resource guide for students and experts alike and provide a review of new innovative strategies to improve musculoskeletal undergraduate teaching. The chapter will conclude with discussing what should be done regarding the future of undergraduate rheumatology teaching.

Keywords

Undergraduate education Teaching undergraduates Education of undergraduates Competence E-learning Virtual education 

References

  1. 1.
    Cividino A. The challenges of developing online learning. J Rheumatol. 2009;36:3–4.CrossRefGoogle Scholar
  2. 2.
    Walker JG, Littlejohn GO. Measuring quality of life in rheumatic conditions. Clin Rheumatol. 2007;26:671–3.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Alonso J, Ferrer M, Gandek B, Ware JE Jr, Aaronson NK, Mosconi P, Rasmussen NK, Bullinger M, Fukuhara S, Kaasa S, Leplege A. Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) project. Qual Life Res. 2004;13:283–98.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Almoallim H, Khojah E, Allehebi R, Noorwali A. Delayed diagnosis of systemic lupus erythematosus due to lack of competency skills in musculoskeletal examination. Clin Rheumatol. 2007;26:131–3.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Beattie KA, Bobba R, Bayoumi I, Chan D, Schabort I, Boulos P, Kean W, Obeid J, Mccallum R, Ioannidis G, Papaioanno A, Cividino A. Validation of the GALS musculoskeletal screening exam for use in primary care: a pilot study. BMC Musculoskelet Disord. 2008;9:115.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Gagne R. The conditions of learning. New York: Holt, Rinehart and Winston; 1977.Google Scholar
  7. 7.
    Thompson A. Improving undergraduate musculoskeletal education: a continuing challenge. J Rheumatol. 2008;35:2298–9.  https://doi.org/10.3899/jrheum.080972.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Abou-Raya A, Abou-Raya S. The inadequacies of musculoskeletal education. Clin Rheumatol. 2010;29:1121–6.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Matzkin E, Smith MEL, Freccero CD, Richardson AB. Adequacy of education in musculoskeletal medicine. J Bone Joint SurgAm. 2005;87:310–4.CrossRefGoogle Scholar
  10. 10.
    Beran MC, Awan H, Rowley D, Samora JB, Griesser MJ, Bishop JY. Assessment of musculoskeletal physical examination skills and attitudes of orthopaedic residents. J Bone Joint Surg. 2012;94:e36.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Comer GC, Liang E, Bishop JA. Lack of proficiency in musculoskeletal medicine among emergency medicine physicians. J Orthop Trauma. 2014;28:e85–7.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Hull P, Chaudry A, Prasthofer A, Pattison G. Optimal sequencing of bedside teaching and computer-based learning: a randomised trial. Med Educ. 2009;43:108–12.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Vioreanu MH, O’Daly BJ, Shelly MJ, Devitt BM, O’Byrne JM. Design, implementation and prospective evaluation of a new interactive musculoskeletal module for medical students in Ireland. Ir J Med Sci. 2013;182:191–9.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Day CS, Yeh AC. Evidence of educational inadequacies in region specific musculoskeletal medicine. Clin Orthop Relat Res. 2008;466:2542–7.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Skelley NW, Tanaka MJ, Skelley LM, LaPorte DM. Medical student musculoskeletal education: an institutional survey. J Bone Joint Surg Am. 2012;94:1–7.CrossRefGoogle Scholar
  16. 16.
    Modica RF, Thundiyil JG, Chou C, Diab M, Von Scheven E. Teaching musculoskeletal physical diagnosis using a web-based tutorial and pathophysiology-focused cases. Med Educ Online. 2009;14:13.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Lynch JR, Gardner GC, Parsons RR. Musculoskeletal workload versus musculoskeletal clinical confidence among primary care physicians in rural practice. Am J Orthop (Belle Mead NJ). 2005;34:487–91.Google Scholar
  18. 18.
    Matzkin E, Smith EL, Freccero D, Richardson AB. Adequacy of education in musculoskeletal medicine. J Bone Joint Surg Am. 2005;87:310–4.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Ramani S, Ring BN, Lowe R, Hunter D. A pilot study assessing knowledge of clinical signs and physical examination skills in incoming medicine residents. J Grad Med Educ. 2010;2:232–5.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Di Caprio MR, Covey A, Bernstein J. Curricular requirements for musculoskeletal medicine. J Bone Joint Surg Am. 2003;85:565–7.CrossRefGoogle Scholar
  21. 21.
    Day CS, Yeh AC, Franko O, Ramirez M, Krupat E. Musculoskeletal medicine: an assessment of the attitudes and knowledge of medical students at Harvard Medical School. Acad Med. 2007;82:452–7.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Craton N, Matheson GO. Training and clinical competency in musculoskeletal medicine. Identifying the problem. Sports Med. 1993;15:328–37.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    AAMC. Report VII contemporary issues in medicine: musculoskeletal medicine education, medical school objectives project no. VII. Washington, DC: Association of American Medical Colleges; 2005.Google Scholar
  24. 24.
    Wise EM, Walker DJ, Coady DA. Musculoskeletal education in general practice: a questionnaire survey. Clin Rheumatol. 2014;33:989–94.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Day CS, Ahn CS, Yeh AC, Tabrizi S. Early assessment of a new integrated preclinical musculoskeletal curriculum at a medical school. Am J Orthop. 2011;40:14–8.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Al-Nammari SS, James BK, Ramachandran M. The inadequacy of musculoskeletal knowledge after foundation training in the United Kingdom. Bone Joint J. 2009;19:1413–8.Google Scholar
  27. 27.
    Onetti CM. Undergraduate education in rheumatology in Latin America. J Rheumatol. 1999;26(Suppl 55):22–3.Google Scholar
  28. 28.
    Kalla AA. Undergraduate rheumatology teaching in Africa. J Rheumatol. 1999;26(Suppl 55):26–8.Google Scholar
  29. 29.
    Lien IN. Undergraduate education in rheumatology in Asian Pacific countries (APLAR). J Rheumatol. 1999;26(Suppl 55):19.Google Scholar
  30. 30.
    Nottidge TE, Ekrikpo U, Ifesanya AO, Nnabuko RE, Dim EM, Udoinyang CI. Pre-internship Nigerian medical graduates lack basic musculoskeletal competency. Int Orthop. 2012;36:853–6.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Praemer A, Furner S, Rice D. Musculoskeletal conditions in the United States. Rosemont: American Academy or Orthopaedic Surgeons; 1999.Google Scholar
  32. 32.
    Adebajo A, Windsor K, Hassell A, Dacre J. Rheumatology. 2005;44(9):1202–3.  https://doi.org/10.1093/rheumatology/keh677.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Åkesson K, Dreinhöfer K, Woolf A. Improved education in musculoskeletal conditions is necessary for all doctors. Bull World Health Organ. 2003;81:677–83.PubMedPubMedCentralGoogle Scholar
  34. 34.
    Woolf AD, Walsh N, Akesson K. Global core recommendations for a musculoskeletal undergraduate curriculum. Ann Rheum Dis. 2004;63(5):517–24.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA, Bombardier C, Cannon C, Farkouh ME, FitzGerald GA, Goss P, Halls H, Hawk E, Hawkey C, Hennekens C, Hochberg M, Holland LE, Kearney PM, Laine L, Lanas A, Lance P, Laupacis A, Oates J, Patrono C, Schnitzer TJ, Solomon S, Tugwell P, Wilson K, Wittes J, Baigent C. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet. 2013;382(9894):769–79.CrossRefGoogle Scholar
  36. 36.
    Schmale GA. More evidence of educational inadequacies in musculoskeletal medicine. Clin Orthop Relat Res. 2005;437:251–9.CrossRefGoogle Scholar
  37. 37.
    DiGiovanni BF, Chu JY, Mooney CJ, Lambert DR. Maturation of medical student musculoskeletal medicine knowledge and clinical confidence. Med Educ Online 2012;17:17092.CrossRefGoogle Scholar
  38. 38.
    Day CS, Ahn CS, Yu Y. The addition of an upper-extremity curriculum in medical school education and its assessment. J Hand Surg Eur. 2009;34:797–9.CrossRefGoogle Scholar
  39. 39.
    Queally JM, Kiely PD, Shelly MJ, O’Daly BJ, O’Byrne JM, et al. Deficiencies in the education of musculoskeletal medicine in Ireland. Ir J Med Sci. 2008;177:99–105.PubMedCrossRefGoogle Scholar
  40. 40.
    Clawson DK, Jackson DW, Ostergaard DJ. It’s past time to reform the musculoskeletal curriculum. Acad Med. 2001;76:709–10.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Henrickson M. Policy challenges for the pediatric rheumatology workforce: Part I. Education and economics. Pediatr Rheumatol Online J. 2011;29:23.CrossRefGoogle Scholar
  42. 42.
    Monrad SU, Zeller JL, Craig CL, Diponio LA. Musculoskeletal education in US medical schools: lessons from the past and suggestions for the future. Curr Rev Musculoskelet Med. 2011;4:91–8.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Lynch JR, Schmale GA, Schaad DC, Leopold SS. Important demographic variables impact musculoskeletal knowledge and confidence of academic primary care physicians. J Bone Joint Surg Am. 2006;88:1589–95.PubMedCrossRefGoogle Scholar
  44. 44.
    Cannella AC, Moore GF, Mikuls TR, O’Dell JR, McBrien SB, Hearth-Holmes M, Klassen LW, Snow MH, Feely MG, Fowler ZD, Burchell M, Erickson AR. Teaching rheumatology in undergraduate medical education: what are the students saying? [abstract]. Arthritis Rheumatol. 2015;67(suppl 10). http://acrabstracts.org/abstract/teaching-rheumatology-in-undergraduate-medical-education-what-are-the-students-saying/. Accessed 7 Mar 2018.
  45. 45.
    Norcini J, Anderson B, Bollela V. Criteria for good assessment: consensus statement and recommendations from the Ottawa 2010 conference. Med Teach. 2011;33:206–14.PubMedCrossRefGoogle Scholar
  46. 46.
    Harlen W, James M. Assessment and learning differences and relationships between formative and summative assessment. Assess Educ Princ Policy Pract. 1997;4:365–79.Google Scholar
  47. 47.
    Epstein RM. Assessment in medical education. N Engl J Med. 2007;356(4):387–96.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Miller GE. The assessment of clinical skills/ competence/performance. Acad Med. 1990;65(Suppl. 9):S63–7.PubMedCrossRefGoogle Scholar
  49. 49.
    McCoubrie P. Improving the fairness of multiple choice questions: a literature review. Med Teach. 2004;26(8):709–12.PubMedCrossRefGoogle Scholar
  50. 50.
    Gupta M, Sharma G, Pal R, Thaman R, Tikoo D. Strategic use of MCQs in undergraduate medical students to improve objectivity of formative assessment. NJIRM. 2012;3(2):113–8.Google Scholar
  51. 51.
    Srivastava A, Dhar A, Aggarwal CS. Why MCQ? Indian J Surg. 2004;66:246–8.Google Scholar
  52. 52.
    Frederiksen N. The real test bias influences of testing on teaching and learning. Am Psychoanal. 1984;39:193–202.Google Scholar
  53. 53.
    Schuwrith LW, Van der Vleuten CP, Donkers HH. A closer look at cueing effects in multiple choice questions. Med Educ. 1996;30:44–9.CrossRefGoogle Scholar
  54. 54.
    Schuwirth LW, Van der Vleuten CP. Different written assessment methods: what can be said about their strengths and weaknesses? Med Educ. 2004;38:974–9.PubMedCrossRefGoogle Scholar
  55. 55.
    McDonald E. The new teacher advisor: student portfolios as an assessment tool. Educ World. http://www.educationworld.com/a_curr/columnists/mcdonald/mcdonald025.shtml. Accessed 9th Mar 2018.
  56. 56.
    Van Der Vleuten CPM. The assessment of professional competence: developments, research and practical implications. Adv Health SciEduc. 1996;1:41–67.CrossRefGoogle Scholar
  57. 57.
    Singh T. Evaluation of knowledge. In: Singh T, Singh D, Paul VK, editors. Principles of medical education. 2nd ed. New Delhi: IAP Education Centre; 2000. p. 54.Google Scholar
  58. 58.
    Harden RM, Gleeson FA. Assessment of clinical competence using an objective structured clinical examination (OSCE). Med Educ. 1979;13(1):41–54.PubMedCrossRefGoogle Scholar
  59. 59.
    Swanson DB, Case SM. Assessment in basic science instructions: direction for practice and research. Adv Health Sci Educ. 1997;2:71–84.CrossRefGoogle Scholar
  60. 60.
    Van Der Vleuten CP, Norman GR, De Graaff E. Pitfalls in the pursuit of objectivity: issue of reliability. Med Educ. 1991;25:110–8.PubMedCrossRefGoogle Scholar
  61. 61.
    Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287:226–35.PubMedCrossRefGoogle Scholar
  62. 62.
    Epstein RM, Dannefer EF, Nofziger AC, et al. Comprehensive assessment of professional competence: the Rochester experiment. Teach Learn Med. 2004;16:186–96.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Mandell B. Energizing rheumatology training: put teaching back into the academic limelight. J Rheumatol. 2013;40:2.  https://doi.org/10.3899/jrheum.120935.CrossRefGoogle Scholar
  64. 64.
    Birrane J, Misran H, Creaney M, Shorten G, Nix C. A scoping review of ultrasound teaching in undergraduate medical education. Med Sci Educ. 2017;  https://doi.org/10.1007/s40670-017-0491-4.CrossRefGoogle Scholar
  65. 65.
    Oswald A, Bell M, Snell L, Wiseman J. The current state of musculoskeletal clinical skills teaching for pre-clerkship medical students. J Rheumatol. 2008;35:2419–26.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Miedany YE, Gaafary ME, Arousi NE, et al. Flipped learning: can rheumatology lead the shift in medical education? Ann Rheum Dis. 2017;76:431.Google Scholar
  67. 67.
    Raj N, Badcock LJ, Brown GA, Deighton CM, O’Reilly SC. Undergraduate musculoskeletal examination teaching by trained patient educators—a comparison with doctor-led teaching. Rheumatology (Oxford). 2006;45:1404–8.CrossRefGoogle Scholar
  68. 68.
    Kosmahl E. Instructional use of computers for entry-level physical therapy education. J Phys Ther Educ. 1994;8:25–31.CrossRefGoogle Scholar
  69. 69.
    Simpson B. Web-based and computer-assisted instruction in physical therapy education. J Phys Ther Educ. 2003;17:45–9.CrossRefGoogle Scholar
  70. 70.
    Barzak M, Ball P, Ledger R. The rationale and efficiency of problem-based learning and computer assisted learning in pharmaceutical education. Pharm Educ. 2001;1:105–13.CrossRefGoogle Scholar
  71. 71.
    Schittek-Janda M, Mattheos N, Nattestad A, Wagner A, Nebel D, Farbom D, Le D, Attstrom R. Simulation of patient encounters using a virtual patient in periodontology instruction of dental students: design, usability, and learning effect in history taking skills. Eur J Dent Educ. 2004;8:111–9.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Velan G, Killen M, Dziegielewski M, Kumar R. Development and evaluation of a computer-assisted learning module on glomerulonephritis for medical students. Med Teach. 2002;24:412–6.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Vichitvejpaisal P, Siithikongsak S, Preechakoon B, Kraiprasit K, Parakkamodom S, Manon C, Petcharatana S. Does computer-assisted instruction really help to improve the learning process? Med Teach. 2001;35:983–9.Google Scholar
  74. 74.
    Humphrey-Murto S, Smith CD, Touchie C, Wood TC. Teaching the musculoskeletal examination: are patient educators as effective as rheumatology faculty? Teach Learn Med. 2004;16:175–80.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Roesch A, Gruber H, Hawelka B, Hamm H, Arnold N, Popal H, Segerer J, Landthaler M, Stolz W. Computer assisted learning in medicine: a long-term evaluation of the Practical Training Programme Dermatology 2000. Med Inf Internet Med. 2003;28:147–59.CrossRefGoogle Scholar
  76. 76.
    Stow RC. A study of students’ attitudes, perceptions, and satisfaction regarding the use of video streaming for patient assessments in the athletic training and physical therapy classroom [Dissertation]. Bowling Green State University; 2003.Google Scholar
  77. 77.
    Veneri D. The role and effectiveness of computer-assisted learning in physical therapy education: a systematic review. Physiother Theory Pract. 2010;26(6):1–12.  https://doi.org/10.3109/09593985.2010.493192.CrossRefGoogle Scholar
  78. 78.
    Averns H, Maraschiello M, van Melle E, Day A. Evaluation of a web-based teaching module on examination of the hand. J Rheumatol. 2009;36:623–7.PubMedCrossRefGoogle Scholar
  79. 79.
    So HJ. Is blended learning a viable option in public health education? A case study of student satisfaction with a blended graduate course. J Public Health Manag Pract. 2009;15:59–66.PubMedCrossRefGoogle Scholar
  80. 80.
    Cividino A. The challenges of developing online learning. J Rheumatol. 2009;36:470–1.  https://doi.org/10.3899/jrheum.090007.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Fodor D, Badea R, Poanta L, Dumitrascu DL, Buzoianu AD, Mircea PA. The use of ultrasonography in learning clinical examination: a pilot study involving third year medical students. Med Ultrasonogr. 2012;14:177–81.CrossRefGoogle Scholar
  82. 82.
    Hoppmann RA, Rao VV, Poston MB, et al. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience. Crit Ultrasound J. 2011;3:1–12.PubMedCrossRefPubMedCentralGoogle Scholar
  83. 83.
    Afonso N, Amponsah D, Yang J, et al. Adding new tools to the black bag: introduction of ultrasound into the physical diagnosis course. J Gen Intern Med. 2010;25:1248–52.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Brown B, Adhikari S, Marx J, Lander L, Todd GL. Introduction of ultra-sound into gross anatomy curriculum: perceptions of medical students. J Emerg Med. 2012;43:1098–102.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Dreher SM, DePhilip R, Bahner D. Ultrasound exposure during gross anatomy. J Emerg Med. 2014;46:231–40.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Dinh V, Fu J, Lu S, Chiem A, Fox C, Blaivas M. Integration of ultrasound in medical education at United States Medical Schools. J Ultrasound Med. 2016;35:413–9.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med. 2011;364:749–57.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Anderson KL, Jenq KY, Fields JM, Panebianco NL, Dean AJ. Diagnosing heart failure among acutely dyspneic patients with cardiac, inferior vena cava, and lung ultrasonography. Am J Emerg Med. 2013;31:1208–14.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Kirkpatrick AW. Clinician-performed focused sonography for the resus-citation of trauma. Crit Care Med. 2007;35(suppl):S162–72.PubMedCrossRefPubMedCentralGoogle Scholar
  90. 90.
    Wu SY, Ling Q, Cao LH, Wang J, Xu MX, Zeng WA. Real-time two-dimensional ultrasound guidance for central venous cannulation: a meta-analysis. Anesthesiology. 2013;118:361–75.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    Mercaldi CJ, Lanes SF. Ultrasound guidance decreases complications and improves the cost of care among patients undergoing thoracentesis and paracentesis. Chest. 2013;143:532–8.PubMedCrossRefPubMedCentralGoogle Scholar
  92. 92.
    Nicolaou S, Talsky A, Khashoggi K, Venu V. Ultrasound-guided interventional radiology in critical care. Crit Care Med. 2007;35(suppl):S186–97.PubMedCrossRefPubMedCentralGoogle Scholar
  93. 93.
    Perera P, Mailhot T, Riley D, Mandavia D. The RUSH exam: rapid ultrasound in SHock in the evaluation of the critically ill. Emerg Med Clin N Am. 2010;28:29–56. viiCrossRefGoogle Scholar
  94. 94.
    Smith-Bindman R, Aubin C, Bailitz J, et al. Ultrasonography versus computed tomography for suspected nephrolithiasis. N Engl J Med. 2014;371:1100–10.PubMedCrossRefPubMedCentralGoogle Scholar
  95. 95.
    Shmueli H, Burstein Y, Sagy I, et al. Briefly trained medical students can effectively identify rheumatic mitral valve injury using a hand-carried ultra-sound. Echocardiography. 2013;30:621–6.PubMedCrossRefPubMedCentralGoogle Scholar
  96. 96.
    Mollenkopf M, Tait N. Is it time to include point-of-care ultrasound in general surgery training? A review to stimulate discussion. ANZ J Surg. 2013;83:908–11.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Beggs AD, Thomas PR. Point of use ultrasound by general surgeons: review of the literature and suggestions for future practice. Int J Surg. 2013;11:12–7.PubMedCrossRefPubMedCentralGoogle Scholar
  98. 98.
    Duvall WL, Croft LB, Goldman ME. Can hand-carried ultrasound devices be extended for use by the non-cardiology medical community? Echocardiography. 2003;20:471–6.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    General Medical Council. The new doctor. Recommendations on general clinical training. London: GMC; 1997.Google Scholar
  100. 100.
    Zeidler H. Methods in undergraduate education in rheumatology. J Rheumatol. 1999;26(Suppl. 55):35–7.Google Scholar
  101. 101.
    Doherty M, Woolf A. Guidelines for rheumatology undergraduate core curriculum. Ann Rheum Dis. 1999;58:133–5.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Doherty M, Dacre J, Dieppe M, Snaith M. The ‘GALS’ locomotor screen. Ann Rheum Dis. 1992;51:1165–9.PubMedCrossRefPubMedCentralGoogle Scholar
  103. 103.
    Walker DJ, Kay LJ. Musculoskeletal examination for medical students: the need to agree what we teach. Rheumatology. 2002;41:1221–3.PubMedCrossRefPubMedCentralGoogle Scholar
  104. 104.
    El Miedany Y, El Aroussy N, Youssef S, Almedany S, Palmer D. Teaching the millennials: using Youtube for teaching rheumatology in the standard educational settings. Ann Rheum Dis. 2018;77:1782.Google Scholar
  105. 105.
    Doherty M, Lanyon P. Rheumatology: what should all doctors know? Ann Rheum Dis. 2000;59:409–13.PubMedCrossRefPubMedCentralGoogle Scholar
  106. 106.
    Michaelsen LK, Bauman KA, Fink LD. Team-based learning: a transformative use of small groups in college teaching. Sterling: Stylus Publishing Press; 2004.Google Scholar
  107. 107.
    Burgess AW, Mcgregor DM, Mellis CM. Applying established guidelines to team-based learning programs in medical schools: a systematic review. Acad Med. 2014;89(4):678–88.PubMedCrossRefPubMedCentralGoogle Scholar
  108. 108.
    Michaelsen LK, Parmelee DX, McMahon KK, Levine RE. Team-based learning for health professions education: a guide to using small groups for improving learning. Sterling: Stylus Publishing Press; 2008.Google Scholar
  109. 109.
    Kilgour JM, Grundy L, Monrouxe LV. A rapid review of the factors affecting healthcare students’ satisfaction with small-group, active learning methods. Teach Learn Med. 2016;28(1):15–25.PubMedCrossRefPubMedCentralGoogle Scholar
  110. 110.
    Thompson BM, Schneider VF, Haidet P, et al. Team-based learning at ten medical schools: two years later. Med Educ. 2007;41(3):250–7.PubMedCrossRefPubMedCentralGoogle Scholar
  111. 111.
    Gray J, Fana GT, Campbell TB, Hakim JG, Borok MZ, Aagaard EM. Feasibility and sustainability of an interactive team-based learning method for medical education during a severe faculty shortage in Zimbabwe. BMC Med Educ. 2014;28(1):14–63.Google Scholar
  112. 112.
    Hunt DP, Haidet P, Coverdale JH, Richards B. The effect of using team learning in an evidence-based medicine course for medical students. Teach Learn Med. 2003;15(2):131–9.PubMedCrossRefPubMedCentralGoogle Scholar
  113. 113.
    Nieder GL, Parmelee D, Stolfi A, Hudes PD. Team-based learning in a medical gross anatomy and embryology course. Clin Anat. 2005;18(1):56–63.PubMedCrossRefGoogle Scholar
  114. 114.
    Wiener H, Plass H, Marz R. Team-based learning in intensive course format for first-year medical students. Croat Med J. 2009;50(1):69–76.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Fatmi M, Hartling L, Hillier T, Campbell S, Oswald AE. The effectiveness of team-based learning on learning outcomes in health professions education: BEME Guide No.30. Med Teach. 2013;35(12):1608–24.CrossRefGoogle Scholar
  116. 116.
    Yang LH, Jiang LY, Xu B, et al. Evaluating team-based, lecture-based, and hybrid learning methods for neurology clerkship in China: a method comparison study. BMC Med Educ. 2014;20(1):14–8.Google Scholar
  117. 117.
    Zeng R, Xiang LR, Zeng J, Zuo C. Applying team-based learning of diagnostics for undergraduate students: assessing teaching effectiveness by a randomized controlled trial study. Adv Med Educ Pract. 2017;8:211–8.PubMedCrossRefPubMedCentralGoogle Scholar
  118. 118.
    Petrusa ER, Blackwell TA, Ainsworth MA. Reliability and validity of an objective structured clinical examination for assessing the clinical performance of residents. Arch Intern Med. 1990;150:573–7.PubMedCrossRefPubMedCentralGoogle Scholar
  119. 119.
    Gleeson F. Assessment of clinical competence using the objective structured long examination record (OSLER). Med Teach. 1997;19:7–14.CrossRefGoogle Scholar
  120. 120.
    Goh L, Samanta A, Cavendish S, Heney D. Rheumatology curriculum: passport to the future successful handling of the musculoskeletal burden? Rheumatology. 2004;43:1468–72.PubMedCrossRefPubMedCentralGoogle Scholar
  121. 121.
    McKinley RK, Fraser RC, Van der Vleuten C, Hastings AM. Formative assessment of the consultation performance of medical students in the setting of general practice using a modified version of the Leicester assessment package. Med Educ. 2000;34:573–9.PubMedCrossRefPubMedCentralGoogle Scholar
  122. 122.
    Pritchard L. Lifelong lessons in competence. Med Educ. 2003;37:848–9.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Yasser El Miedany
    • 1
    • 2
  1. 1.King’s College London, Darent Valley HospitalDartfordUK
  2. 2.Rheumatology and RehabilitationAin Shams UniversityCairoEgypt

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