Neck Pain OSCE: A 65-Year-Old Patient Presents to the Emergency Department With Neck Pain

Abstract

Abstract Introduction Neck pain affects 10% of the United States population each year. The American Academy of Family Physicians (AAFP) and American Academy of Neurology (AAN) guidelines require that medical students and residents have the applicable knowledge and training to recognize, evaluate, and manage acute conditions such as spinal cord compression. Methods This 15-minute OSCE requires that the examinee take a detailed neck pain history from a standardized patient, generate an initial differential diagnosis, request and interpret a diagnostic evaluation, and defend the final diagnosis. The objectives of this OSCE are aligned with the following curriculum guidelines: the neurology clerkship core curriculum guidelines endorsed by the AAN, the core curriculum for a first-year neurology resident endorsed by the AAN, and the recommended curriculum guidelines for family medicine residents endorsed by the AAFP. Results Seventy-three medical students completed this assessment. Ninety percent of students passed the OSCE. Five percent of students required remediation because they did not order an imaging study of the cervical spine (CT or MRI). After writing an essay on indications for imaging of the cervical spinal cord, these students received a score of 80. Four percent of students failed the OSCE because they misdiagnosed the patient. After writing an essay comparing and contrasting the erroneous diagnosis with the correct diagnosis, failing students received a score of 75. Overall scores ranged from 75%-99%, with a mean of 94%. Normative data for each section are detailed within. Discussion Neck pain affects 10% of the United States population each year. This resource provides medical students with exposure to acute conditions such as spinal cord compression in an approach aligned with the AAFP and AAN.

Keywords

• OSCE
• Objective Structured Clinical Examination
• Neck Pain
• Cervical Myelopathy