Non-disclosure of symptoms in primary care: an observational study.

Background: Symptoms form a major component of patient agendas, with the need for an explanation of symptoms being a prominent reason for consultation.

Objectives: To estimate the prevalence of different symptoms pre-consultation, to investigate whether intention to mention a symptom in the consultation varied between patients and across symptoms, and to determine how patients' intended agendas for mentioning symptoms compared with what was discussed.

Method: We videorecorded consultations of an unselected sample of people aged 45 and over consulting their GP in seven different practices in UK primary care.

Getting back to the dissecting room: An evaluation of an innovative course in musculoskeletal anatomy for UK-based rheumatology training.

Background: The rheumatologist relies heavily on clinical skills to diagnose diverse conditions, something that is correlated with one's knowledge of clinical anatomy. More recently, rheumatology has offered further career flexibility with opportunities to develop skills such as joint injection and musculoskeletal (MSK) ultrasound, both of which require a sound understanding of anatomy. Currently, there are no formal strategies to support competency-based anatomy learning in rheumatology in the UK.

Evidence regarding the utility of multiple mini-interview (MMI) for selection to undergraduate health programs: A BEME systematic review: BEME Guide No. 37.

Background: In the 11 years since its development at McMaster University Medical School, the multiple mini-interview (MMI) has become a popular selection tool. We aimed to systematically explore, analyze and synthesize the evidence regarding MMIs for selection to undergraduate health programs.

Methods: The review protocol was peer-reviewed and prospectively registered with the Best Evidence Medical Education (BEME) collaboration.

The Identity Crisis of Osteoarthritis in General Practice: A Qualitative Study Using Video-Stimulated Recall.

Purpose: Patients and doctors report marked disenchantment with primary care consultation experiences relating to osteoarthritis. This study aimed to observe and analyze interactions between general practitioners (GPs) and patients presenting with osteoarthritis (OA) to identify how to improve care for OA.

Methods: We conducted an observational study in general practices in the United Kingdom using video-recorded real-life consultations of unselected patients and their GPs.

Getting under the skin of the primary care consultation using video stimulated recall: a systematic review.

Background: Video stimulated recall (VSR) is a method of enhancing participants' accounts of the consultation using a video recording of the event to encourage and prompt recall in a post consultation interview. VSR is used in education and education research, and to a lesser extent in medical and nursing research. Little is known about the sort of research questions that lend themselves best to the use of VSR or the impact of the specific VSR procedure on study quality.

Comparison of patient experiences of the osteoarthritis consultation with GP attitudes and beliefs to OA: a narrative review.

Background: Osteoarthritis (OA) is a common cause of disability and consultation with a GP. However, little is known about what currently happens when patients with OA consult their GP. This review aims to compare existing literature reporting patient experiences of consultations in which OA is discussed with GP attitudes and beliefs regarding OA, in order to identify any consultation events that may be targeted for intervention.

What influences patients with osteoarthritis to consult their GP about their symptoms? A narrative review.

Background: Osteoarthritis (OA) is a common cause of disability and consultation with a GP. However research suggests the majority of sufferers choose not to consult their GP regarding their symptoms. Understanding the reasons for consulting is central to optimising patient outcomes.

Musculoskeletal health professional use of internet resources for personal and patient education: results from an online national survey.

Objectives: To study the current practice of computer use in musculoskeletal health professionals for their education and that of their patients.

Methods: A survey questionnaire, designed by a working group including representatives from Arthritis Research UK and the British Society for Rheumatology, was made available on surveymonkey.com and the link distributed by email.

Effect of psychological distress on continuation of anti-tumor necrosis factor therapy in patients with rheumatoid arthritis.

Objective: To investigate the relationship of psychological distress and associated factors with continuation of tumor necrosis factor (TNF) antagonist therapy in patients with rheumatoid arthritis (RA).

Methods: Patients about to start therapy with TNF antagonists (n = 166) were assessed for psychological distress using the Hospital Anxiety and Depression Scale (HADS). A core set of demographic and clinical variables, including comorbidities from medical records and cigarette smoking history by questionnaire, were recorded at baseline and regular intervals thereafter.

Attitudes and perceptions of rheumatologists regarding consultation skills training for specialist trainees: a qualitative study.

Within rheumatology specialty training, direct observation and formal assessment of consultation skills rarely occur. This study explored the attitudes and perceptions of rheumatology specialist registrars (SpRs) and consultants regarding consultation skills training and potential barriers to its successful implementation in the context of specialist training. Semi-structured interviews with rheumatology consultants and focus groups with rheumatology SpRs were conducted in four UK deanery regions.

Assessment of clinical nurse specialists in rheumatology using an OSCE.

Objective: To introduce a new method of assessment; an observed structured clinical examination (OSCE) into a postgraduate course for rheumatology clinical nurse specialists.

Method: The OSCE was introduced into a physical assessment module, which focused on the nurses' ability to perform an examination of patients' shoulders, knees and hands. A modified blueprinting exercise was used to ensure adequate sampling of the different components of the syllabus.

Exploring the use of videotaped objective structured clinical examination in the assessment of joint examination skills of medical students.

Objective: Objective structured clinical examination (OSCE) is a key part of medical student assessment. Currently, assessment is performed by medical examiners in situ. Our objective was to determine whether assessment by videotaped OSCE is as reliable as live OSCE assessment.

Validation of MSAT: an instrument to measure medical students' self-assessed confidence in musculoskeletal examination skills.

Context: Self-assessment promotes reflective practice, helps students identify gaps in their learning and is used in curricular evaluations. Currently, there is a dearth of validated self-assessment tools in rheumatology. We present a new musculoskeletal self-assessment tool (MSAT) that allows students to assess their confidence in their skills in and knowledge of knee and shoulder examination.

Impact of a rheumatology expert nurse on the wellbeing of patients attending a drug monitoring clinic.

Aim: This paper reports a study to test the hypothesis that consultation with a clinical nurse specialist in a drug monitor clinic has a measurable impact on the well-being of patients with rheumatoid arthritis.

Method: A single blinded randomized controlled trial was carried out with 71 patients with rheumatoid arthritis who were starting new disease-modifying anti-rheumatic therapy at a district general hospital. Patients were randomized into two groups over a 3-year recruitment period.

Cluster randomized controlled trial of the impact of a computer-assisted learning package on the learning of musculoskeletal examination skills by undergraduate medical students.

Objective: To identify whether there was measurable impact of a specific computer-assisted learning (CAL) package, "Virtual Rheumatology," on the learning of musculoskeletal examination skills by medical students.

Methods: We conducted 2 parallel, cluster-randomized controlled trials using undergraduate curricula at 2 locations: Newcastle and London, UK. Medical students attending a musculoskeletal rotation were allocated to the intervention (Virtual Rheumatology CD) or the control arm of the study by placement group.

Anemia in rheumatoid arthritis: association with polymorphism in the tumor necrosis factor receptor I and II genes.

Objective: To investigate whether polymorphisms in the tumor necrosis factor receptor I (TNFRSF1A) and receptor II (TNFRSF1B) genes are associated with the anemia observed in rheumatoid arthritis (RA).

Methods: We studied a group of Caucasian patients (n = 160) with established RA on whom longitudinal data of hemoglobin (Hb) levels over 5 years were recorded. A second group of patients (n = 102) with early RA was used for a confirmation study.

The evaluation of multimedia learning packages in the education of health professionals: experience of a musculoskeletal examination package.

The last 20 years have seen rapid technological developments within the field of information technology. The internet, sophisticated software packages and increased accessibility to computers have all opened opportunities for educators. Against this background, increasing numbers of multimedia learning packages are available to the health professional.

GPs' perceptions of the role of DEXA scanning: an exploratory study.

Background: Current recommendation are that women with clinical indicators of low bone mineral density should be offered a DEXA (dual energy X-ray absorptiometer) scan to help assess the need for treatment, but little is known about GPs' attitudes towards DEXA scans.

Objective: Our aim was to explore GPs' beliefs about diagnosis and management of osteoporosis, including the role that DEXA scanning can play.

Methods: Semi-structured interviews with five GPs in the North Staffordshire area were used to explore how GPs make decisions about diagnosis and treatment of osteoporosis, including the use of scans and the application of potential clinical risk factors to decisions about screening and treatment.

Osteoporosis: what are the implications of DEXA scanning 'high risk' women in primary care?

Background: Current recommended practice for the use of dual X-ray absorptiometry (DEXA) scans in screening for osteoporosis is to concentrate on women at 'high risk'.

Objective: We have applied such a screening strategy, in a general practice setting, to estimate the number of women requiring scans.

Methods: A two-phase survey was carried out: (i).

"I'd rather go and know": women's understanding and experience of DEXA scanning for osteoporosis.

Objective: To explore women's knowledge and understanding of osteoporosis and of dual energy x-ray absorptiometer (DEXA) scans; the factors influencing their decision to have a scan and their experience of undergoing a DEXA scan.

Design: In-depth interviews (using a topic guide) were carried out with 12 women [before a DEXA scan and after they had discussed the results with their general practitioner (GP)] and with three women who chose not to have a scan.

Setting: Stoke-on-Trent, Staffordshire, UK.