Adult Rheumatology — Foundation of Discipline

F3 Detecting MSK abnormalities through physical examination

Key Features:
- The focus of this EPA is the application of knowledge of MSK anatomy and the ability to describe clinical findings and document them in a timely manner.
- This EPA includes the assessment of synovitis, joint damage and soft tissue abnormalities, as well as patient comfort and privacy/draping during the physical exam.
- This EPA requires the supervisor to directly observe the performance of the MSK exam.

Assessment Plan:
Direct observation by supervisor
Use Form 1. Form collects information on:
- Joint (select all that apply): shoulder; knee; hip
- Case mix: established inflammatory arthritis; early inflammatory arthritis; axial SpA/JSpA; non-inflammatory MSK
Collect 3 observations of achievement
- At least 1 of each joint
- A variety of the case mix
- At least 2 assessors

Form

F1: Observation

Milestones

• COM 1.2. Optimize the physical environment for patient comfort, dignity, privacy, and safety

• ME 1.3. Apply knowledge of MSK anatomy, including synovial membrane, joints, and soft tissue

• ME 2.2. Perform the MSK examination in a focused, time-effective manner without excluding key elements

• ME 2.2. Interpret the results of the MSK examination in the context of the patient’s presentation

• ME 1.4. Present clinical findings in an organized and well synthesized manner

• COM 5.1. Document the essential elements of an MSK examination, including abnormal findings

Context Variables

• Joint (multiple-choice)
  • shoulder
  • knee
  • hip
• Case mix (single-choice)
  • established inflammatory arthritis
  • early inflammatory arthritis
  • axial SpA/JSpA
  • non-inflammatory MSK

Requirements

• Collect 3 observations of achievement (minimum 3)
• At least 1 of each joint (minimum 1)
  • Only counts when Joint is shoulder
• At least 1 of each joint (minimum 1)
  • Only counts when Joint is knee
• At least 1 of each joint (minimum 1)
  • Only counts when Joint is hip
• At least 2 assessors (minimum 2)
  • Counted once per distinct Assessor