Disclosures: Kevin J. Cipriano, MD: No financial relationships or conflicts of interest

Objective: There are currently no guidelines directing how inpatient months should be distributed throughout PM&R residency training curricula. Primary

Objective: To see if early Outpatient Musculoskeletal (MSK) exposure increases resident use of Musculoskeletal examination skills in the inpatient setting. Secondary

Objective: Identify barriers why residents do not perform more frequent MSK exams on inpatient rotations.

Design: Prospective Cohort Study. Collected as an 8 question survey at the end of each inpatient rotation for the 2020-2021 academic year.Setting : Medstar/Georgetown-National Rehabilitation HospitalParticipants : Medstar/Georgetown-National Rehabilitation Hospital PM&R Residents.

Interventions: None

Main Outcome Measures: Number of Complete MSK Physical Exams performed per rotation.

Results: Thirty-nine responses were collected (95% response rate). Residents who completed 0, 1, 2, 3, 4, and 5+ months averaged 4.6, 3.6, 7.2, 7.8, 9, and 6.25 exams, respectively, on each month of inpatient rotation. In most instances (71.8%), residents reported doing MSK exams when indicated. Lack of time (10.3%) and uncertainty of how to perform an MSK exam on a patient with a disability (7.7%) were cited as the most common reasons for not performing more frequent MSK examinations on the inpatient rotation. Most responses (41.0%) indicated that residents felt they would likely perform more MSK examinations on their inpatient rotations if they had more outpatient MSK experience at this point in their training.Conclusions: Residents appear to perform more MSK examinations on their inpatient rotations after their second outpatient MSK month. Most residents in our program complete two months of outpatient experience during their PGY-2 year. We believe that early outpatient MSK experience increases resident use of MSK examination skills in the inpatient setting. This supports residents in learning how to provide comprehensive physiatric care to individuals with disabilities. Early outpatient MSK experience in PM&R residency and a greater focus on teaching MSK examination skills on inpatient populations with disabilities can benefit trainees and positively impact patient care.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/effects-of-early-outpatient-musculoskeletal-exposure-on-inpatient-pmr-rotations/