O exame físico musculoesquelético associado à anatomia clínica: proposta para um currículo integrado em medicina

Abstract

Introduction: Musculoskeletal diseases have a significant impact on society, due to the morbidity and costs they entail. Despite its high prevalence, the teaching of the musculoskeletal system is neglected in medical schools, making it difficult to address these complaints, especially in primary care. Efforts are being made to fill this gap and, among these, the teaching of musculoskeletal physical examination associated with clinical anatomy. Objective: to implement the teaching of the musculoskeletal physical examination, associated with clinical anatomy, in an integrated medical curriculum and to evaluate the students' perception of the strategy used and the skills acquired about it. Methodology: Descriptive study that used the action research methodology. Students from the Multicampi School of Medical Sciences (EMCM) of the Federal University of Rio Grande do Norte (UFRN) participated during two curricular components. In the second year, there were 5 theoretical-practical activities, aimed at teaching the musculoskeletal physical examination associated with clinical anatomy. Using common clinical situations on a daily basis, such as shoulder pain, low back pain and knee pain, rheumatology and anatomy teachers led students to search for related anatomical structures on full-body mannequins and segments, leading to the understanding of relevant points musculoskeletal examination. At the end of this year, an Objective Structured Clinical Examination (OSCE) assessment was applied. In the third year, the same students performed a musculoskeletal physical examination in outpatients, under the supervision of a professor. At the end, a questionnaire (Likert) was applied to assess the students' perception of the strategy used and the acquired skills. Results: Regarding the strategy used, all students agreed that clinical anatomy guided the learning of the physical examination and helped with clinical reasoning regarding musculoskeletal complaints. The students also replied that they are safe in performing the physical examination of most of the surveyed segments. Final Considerations: The use of clinical anatomy for training the musculoskeletal physical examination in an integrated curriculum may be a way to improve this ability of the future physician thinking about general training. The maintenance and improvement of the curriculum strategy at EMCM, can be experienced in other medical schools, especially those with a curriculum based on active and student-centered methodologies.