Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

A Case-Controlled Study of a Multimodal Rheumatology Elective for Medical Residents.

Lazaro4,  Deana M., Lim2,  Sheen Yee, Blumenthal3,  David R., Scheers-Masters1,  Joshua, Macrae1,  Jeanne, Avitable1,  Matthew

SUNY Downstate Medical Center
SUNY Downstate-Brooklyn, Brooklyn, NY
VA New York Harbor Healthcare System, Short Hills, NJ
VA New York Harbor Healthcare System and SUNY Downstate Medical Center, Brooklyn, NY


Training medical residents to treat patients with musculoskeletal complaints is highly desirable because of the aging United States population and relative shortage of rheumatologists. To address this concern, we tested whether first year medical residents who have clinical experience in Rheumatology clinic and an enhanced curriculum will perform better than residents without such experience on a multiple choice examination and an objective structured clinical examination (OSCE). We also surveyed the residents on their confidence and attitudes regarding musculoskeletal diseases.


Thirty-five SUNY Downstate first-year medical residents were randomized to participate in the ambulatory Rheumatology elective or another subspecialty experience for four weeks. All residents reviewed the MedStudy guide for Rheumatology and several Hopkins modules and received a copy of the Primer on the Rheumatic Diseases. The residents assigned to Rheumatology clinic were given access to 12 case-based learning modules with questions based upon the material, a video on the musculoskeletal physical examination, instruction on arthrocentesis and injection techniques using simulators, approximately 3 out-patient Rheumatology clinic sessions each week and weekly journal club. All residents completed a 45 question pre- and post-test, 4 OSCE stations focused on the evaluation and treatment of musculoskeletal diseases and completed a pre- and post- questionnaire to gather information on the confidence of the residents in their knowledge of Rheumatology.

Summary of the Results:

All residents improved performance on the multiple choice examination after the clinical rotations, however, there was no significant difference in the improvement rate pre- and post- rotation between the groups (p=0.18). Likewise performance on the OSCE was similar with the exception of the station on arthrocentesis. The residents who received a training session on arthrocentesis and injection technique and had the opportunity to interact with patients in the rheumatology clinic performed significantly better (p=0.02). The residents assigned to the rheumatology clinic reported greater confidence in their ability to treat patients with arthritis (p=<0.001).


Exposure of medical residents to an enhanced curriculum and experience in rheumatology clinic improved performance of arthrocentesis as demonstrated on a simulator and increased their perception of their abilities. Rate of improvement on the multiple choice examination and the other OSCE stations were not significantly different between the two groups.

Funding for this project was provided by the American College of Rheumatology Research and Education Foundation Clinician Scholar Educator Award

To cite this abstract, please use the following information:
Lazaro, Deana M., Lim, Sheen Yee, Blumenthal, David R., Scheers-Masters, Joshua, Macrae, Jeanne, Avitable, Matthew; A Case-Controlled Study of a Multimodal Rheumatology Elective for Medical Residents. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1431
DOI: 10.1002/art.29197

Abstract Supplement

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