Abstract 445 Poster Session III, Monday, 5/3 (poster 337)

Purpose: The purpose of this study was to develop and measure an educational intervention aimed at improving pediatricians' knowledge and clinical skills involved in the diagnosis of ankle and knee injuries, which are among the most common musculoskeletal complaints seen by primary care physicians. Methods: A two-part pretest/posttest assessment was designed to measure knowledge and skills essential for appropriate diagnosis of ankle and knee injuries. Knowledge was measured using a written 20-question multiple-choice exam. Clinical skills were measured with a clinical skills assessment (CSA) using a standardized patient. Residents and medical students on a one-month adolescent medicine rotation were the subjects in this two-part educational assessment and intervention. At the beginning of each rotation, subjects completed a written pretest, a CSA, and watched a video followed by a live demonstration of ankle and knee exams. At the end of the rotation, the subjects were reevaluated with a written posttest and a second CSA. In the CSA, three raters, two sports medicine physicians and one certified athletic trainer, who also served as the standardized patient, evaluated each of the subjects using a clinical skills checklist. Results: For the first 16 residents and medical students, the written pretest and posttest mean scores were 10.5 (SD=2.8) and 16.0 (SD=2.9) (p< .000) and the CSA pre and post scores were 22.0 (SD=7.3) and 25.2 (SD=6.2) (p< .000) for the ankle and 6.4 (SD=2.9) and 18.4 (SD=4.8) (p< .000) for the knee, representing a successful educational intervention. Interrater reliability for the CSA ranged from .90 to .98. Conclusion: The CSA and pre/post test are reliable tools to measure effectiveness in teaching clinical skills for ankle and knee physical examinations. The educational intervention improved knowledge and clinical skills in the diagnosis of ankle and knee injuries. This study will include at least 50 students and residents per year and has been extended to community pediatricians.