Background: Patients with osteoporosis are not adequately managed. This pilot study was aimed at evaluating primary care medical residents’ confidence and knowledge to diagnose and treat osteoporosis.
Methods: A 16-item, a paper-based de-identified survey was administered to all participating primary care medical residents at two independent University programs. Questions collected information on resident demographics, prior endocrinology exposure through a rotation or a didactic in osteoporosis, future career plan, and assessed confidence and knowledge about screening, diagnosis, and management of osteoporosis. Wilcoxon rank-sum tests were used to compare mean ranks and tetrachoric correlations were used to assess the correlation between variables.
Results: A total of 66 (24.4%) residents completed the survey with 59% being male, 64% were in the 1st and 2nd year of training (junior residents) and 36% were in their 3rd and 4th year of training (senior residents). Forty-eight percent had completed endocrinology rotation and 74% had attended a didactic in osteoporosis.
Residents who had an endocrine rotation had significantly higher confidence (p= 0.003) and knowledge (p= 0.04) to diagnose and treat osteoporosis. Residents who attended endocrine didactics had significantly higher confidence (p=0.04) but no difference in knowledge (p= 0.1). Senior residents had a positive correlation between confidence and knowledge (rho= 0.4, p=0.02). There was no difference in confidence level between males and females. Senior residents who had completed an endocrinology rotation were more likely to respond that they feel confident to obtain osteoporosis history and perform a physical exam compared to those who had not completed an endocrinology rotation (p=0.04). Female junior residents who attended didactics were more likely to respond that they have a higher confidence level to screen (p=0.02) and diagnose (p=0.007) osteoporosis compared with female junior residents who did not attend didactics. There was a strong positive correlation between confidence and knowledge for osteoporosis screening among senior residents who attended didactics (rho=0.8, p<0.0001) and for female residents overall (rho=0.75, p<0.0001). Confidence and knowledge for management of osteoporosis were highly correlated among junior residents who had completed endocrine rotation (rho=1, p<0.0001).
Conclusion: This pilot study provides important insights into the confidence and knowledge among in-training primary care medical residents in two independent University programs. Curriculum development should focus on practical and measurable modules to improve resident knowledge. Findings from this survey need to be replicated in a larger sample size study.