Knowledge and competency in orthopaedic training among level six medical students at The College of Health Sciences, University of Nairobi, Kenya

Abstract

Background: Knowledge of trauma and orthopaedic surgery is a key component in the practice of medicine in Kenya, with an increase in morbidity and mortality from road traffic accidents. Medical officers play a fundamental role in the initial management of these fractures, underscoring the need to assess medical students’ competency. Lower practical skill acquisition noted in undergraduate students points out how musculoskeletal conditions may be handled subpar by physicians, and the study suggests possible remedies for future undergraduate training.

Objective: To determine the level of knowledge and competency and association between the two in orthopaedic training among undergraduate medical students at the Faculty of Health Sciences, University of Nairobi, Kenya.

Methods: This was a cross sectional study. The study recruited 237 out of 440 level six medical students who had finished their orthopaedic surgery rotations at the University of Nairobi. Consecutive sampling technique was utilized. Data collection was done using a structured questionnaire, which included the Friedman and Bernstein musculoskeletal competence test. Descriptive statistics were used to analyse the characteristics of participants. Binary logistic regression was used to investigate the factors associated with competency among level six medical students.

Results: Students who had adequate knowledge in orthopaedic training were 25 (10.5%). Some 33% of the students were willing and interested in pursuing further orthopaedic training. Using the Friedmann and Bernstein competency examination tool, the results showed a mean score of 47.5% (SD ± 26.2). The competency cut-off was set at 73.1%, and only 11.8% of the respondents scored above this threshold. Respondents who had adequate knowledge of orthopaedic surgery training were found to be 2.7 times more likely to have high competency compared to those with inadequate knowledge, Odds Ratio (OR) = 2.73, 95% Confidence Interval (CI): 1.99 – 7.55, p =0.005.

Conclusion and recommendations: The levels of both knowledge and competency were low in level six undergraduate orthopaedic surgery training, highlighting a major gap. Adequacy of knowledge was more likely to improve competency. Thus, there is need to revise the curriculum to include more comprehensive and structured orthopaedic modules, to have more confidence in basic practical skills.