Teaching knee joint aspiration to medical students--an effective training with long-term benefits

Clin Rheumatol (2010) 29:921925

DOI 10.1007/s10067-010-1433-3

BRIEF REPORT

Teaching knee joint aspiration to medical students an effective training with long-term benefits

Pippa Watson & Louise Hamilton & Klaudine Simpson &

Nicola Riley & Mark Lillicrap &

on behalf of the Medical Education Research Group

Received: 29 January 2010 /Revised: 1 March 2010 /Accepted: 11 March 2010 /Published online: 2 April 2010 # Clinical Rheumatology 2010

Abstract The objective of this study was to assess the effectiveness of undergraduate training in knee aspiration and to determine the impact this had on subsequent postgraduate clinical practice. This paper is a cohort study of undergraduate training with a cross-sectional questionnaire study of postgraduate practice. The study was held at the University of Cambridge and NHS hospitals in the Eastern Region Postgraduate Deanery (England). The main outcome measures are the undergraduate competence in practical skills in a simulated setting and the differences in postgraduate practice with or without prior undergraduate training in knee aspiration. Implementing an undergraduate training programme in knee aspiration resulted in student competence in this skill. Undergraduate teaching of knee aspiration also improved postgraduate clinical practice, significantly increasing trainee doctor confidence and also increasing the frequency with which knee aspiration was undertaken. Postgraduate reinforcement of learning was identified as an additional requirement. Undergraduate teaching of knee aspiration not only results in competent performance in end of course assessments but also improves postgraduate confidence that potentially translates into improved clinical practice.

Keywords Education . Joint aspiration . Knee . Practical skills . Septic arthritis

Introduction

Acute monoarthritis is the most common rheumatological emergency that junior doctors encounter, and the knee is the most commonly affected joint [13]. Early identification of septic arthritis is the most important aspect of clinical management; any joint suspected of harbouring infection needs to be aspirated promptly, and synovial fluid sent to the laboratory for immediate analysis [4, 5]. Knee aspiration is, therefore, a practical skill frequently required by junior doctors [6].

Despite the importance of knee aspiration in clinical practice, it has often been perceived as a postgraduate, rather than an undergraduate, competency [7]. However, the University of Cambridge has developed a knee aspiration training programme for all undergraduate medical students (see Methods for details).

In the context of practical skills teaching,...