A Paediatric Orthopaedic Curriculum for Medical Students: The Australian consensus

Background : Orthopaedic related injuries are a leading cause of paediatric emergency department presentations. However, no more than 2% of medical curriculum is dedicated to orthopaedics, with paediatric orthopaedics, receiving less than 0.5%. Currently, there is no consensus education regarding paediatric orthopaedic curriculum within medical education. This study sought to develop a consensus curriculum for medical students in Australia. Methods : This study utilised a 2-stage Delphi method, developing the initial questionnaire of learning objectives (LO) from Miller’s Review of Orthopaedics and Orthobullets pediatric high yield topics. The LOs were then circulated via the Australian Paediatric Orthopaedic Society membership registry. The LOs were categorised as, “must know”, “should know” and “do not need to know”. “Must know”, topics were ones they believed would be explicitly taught and “Should know” LO’s were to be regarded as those for which resources could be supplied for self-directed learning. In the second stage, aggregated and deidentified results were recirculated to participants, providing an opportunity for respondents to adjust their responses in accordance with other respondents. Consensus was reached where >60% of respondents agreed on the classification of an LO. Results : 161 LO’s were circulated. 35 individuals responded to the first round, with 31 responding to the second phase survey. 126 topics reached consensus; 15 as “must know”; 16 as “should know”; and 95 as “do not need to know”. These LOs were then grouped into broader units to assist with organisation within the curriculum. “Must know” LOs included; non-accidental injury, supracondylar fractures, lateral condyle fracture, Monteggia fracture, both bone forearm fracture, Galeazzi fractures, distal radial fractures, osteomyelitis, septic arthritis, transient synovitis, slipped capital femoral epiphysis, Perthes disease, developmental dysplasia, cerebral palsy and club-foot. “Should know” LOs included; Salter-Harris classification, remodelling potential, clavicle fractures, proximal humerus, humerus shaft, olecranon fracture, radial head & neck fracture, elbow dislocation, obstetric bracialeopathy, proximal tibial metaphyseal fractures, tibial shaft fracture, osteochondritis dissecans, osteogenesis imperfecta, and Duchenne dystrophy. Conclusions : Consensus was reached on 79% of circulated LOs. This content will provide a framework for medical student teaching ensuring graduates are equipped to manage the array of orthopaedic conditions necessary as a junior doctor.