• Jordan Knox, Stephen M Carek, Rajalakshmi Cheerla, Susan Cochella, Alexei O DeCastro, Jason W Deck, Sherilyn DeStefano, Jennifer Hartmark-Hill, Michael Petrizzi, Dan Sepdham, Irvin Sulapas, James Wilcox, Matthew W Wise, and Velyn Wu.
• Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT.
• Fam Med. 2025 Jan 13; 57 (1): 485448-54.

Background And ObjectivesA recognized gap exists between primary care physicians' training in musculoskeletal (MSK) medicine and the burden of MSK complaints in primary care. Family medicine interns often lack adequate baseline MSK physical exam skills, which prompted a proposal to introduce a fourth-year preceptorship to reinforce MSK education. The aim of this study was to prioritize the most important elements to include in this new clinical rotation.MethodsWe employed a three-round, modified Delphi method to derive consensus. Eleven panelists with experience and expertise in MSK training, medical education, or both generated a list of 118 elements. Each panelist then ranked each element by level of importance, and we reviewed the results. The ranking process was repeated two more times with a goal of achieving consensus.ResultsSeventy-seven curricular elements (topics, skills, experiences) achieved consensus recommendation by being ranked either "fairly important" or "very important" for inclusion in the curriculum. Twenty-eight items were unanimously ranked "very important," 42 received a mix of "very important" and "fairly important" rankings, and seven received unanimous ranking of "fairly important." Three items were unanimously ranked "neither important nor unimportant."ConclusionsLongitudinal repetition of physical exam skills, reinforcement of relevant anatomy, and incorporation of specific frameworks for approaching MSK care are important components. Physical examination of the shoulder, knee, back, and hip are especially meaningful clinically.

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