Adaptation of a National Musculoskeletal Curriculum to a Nurse Practitioner Residency Program at a Veterans Affairs Medical Center

There is an increasing need for primary care providers to manage common musculoskeletal (MSK) pain complaints. Unfortunately, clinical education in this area is lacking. To address this gap at Boise Veterans Affairs Medical Center (BVAMC), we introduced a new MSK curriculum for early Nurse Practitioner (NP) residents, based on the interprofessional multidisciplinary program established by the Salt Lake City Veterans Affairs Center of Excellence in Musculoskeletal Care and Education (SLC COE). The pilot program was funded through an Innovation Network Award. BVAMC faculty studied MSK courses at SimLEARN National Center in Orlando, Florida, and at SLC COE, and tailored the established curriculum to the needs of early NP residents. The new curriculum was delivered over three days and focused on shoulder and knee anatomy, examination, pathology, and medical management. It included didactic presentations, video demonstrations, small group simulation with standardized patients, and arthrocentesis task trainers. We documented each individual learner's performance with validated Objective Structured Clinical Examinations (OSCEs). The trainees were subsequently supervised in the musculoskeletal clinic. Three NP residents were enrolled in the pilot program. Their OSCE scores were 89%, 95%, and 96% for the shoulder exam; 81%, 91%, and 99% for the knee exam; 85%, 88%, and 96% for subacromial injection; and 81%, 85%, and 92% for knee injection. All trainees reported high levels of satisfaction with the course and greater confidence in clinical skills, consistent with observations previously reported. An established MSK curriculum was successfully adapted for training early NP residents. The program will be incorporated into the curriculum for future classes. References: 1) Battistone MJ, Barker AM, Grotzke MP, et al. Effectiveness of an interprofessional and multidisciplinary musculoskeletal training program. J Grad Med Educ 2016;8(3):398-404. 2) Battistone MJ, Barker AM, Grotzke MP, Beck JP, Lawrence P, Cannon GW. "Mini-residency" in musculoskeletal care: A national continuing professional development program for primary care providers. J Gen Intern Med 2016;31(11):1301-7. 3) Battistone MJ, Barker AM, Beck JP, Tashjian RZ, Cannon GW. Validity evidence for two objective structured clinical examination stations to evaluate core skills of the shoulder and knee assessment. BMC Med Educ 2017;17(1):13. 4) Battistone MJ, Barker AM, Lawrence P, Grotzke MP, Cannon GW. Mini-res