The Musculoskeletal 30-question multiple choice questionnaire (MSK-30): a new assessing tool of musculoskeletal competence in a sample of Italian physiotherapists

Giovannico et al. BMC Musculoskeletal Disorders (2024) 25:265 https://doi.org/10.1186/s12891-024-07400-6 BMC Musculoskeletal Disorders Open Access RESEARCH The Musculoskeletal 30‑question multiple choice questionnaire (MSK‑30): a new assessing tool of musculoskeletal competence in a sample of Italian physiotherapists Giuseppe Giovannico1 , Marco Pappaccogli1, Matteo Cioeta2* , Leonardo Pellicciari3 , Saad Youssef1 , Domenico Angilecchia1,4 , Gabriele Giannotta5   and Fabrizio Brindisino1    Abstract Background The prevalence and cost of musculoskeletal diseases increased dramatically over the past few decades. Therefore, several institutions have begun to re-evaluate the quality of their musculoskeletal educational paths. However, current standardized questionnaires inadequately assess musculoskeletal knowledge, and other musculoskeletal-specific exams have limitations in implementation. The musculoskeletal 30-question multiple choice questionnaire (MSK-30) was proposed as a new tool for assessing basic musculoskeletal knowledge. Aim To analyse basic musculoskeletal knowledge in a sample of Italian physiotherapists by administering the MSK-30 questionnaire. Methods After a transcultural adaptation process, the MSK-30 was developed and administered to Italian physiotherapists to assess their musculoskeletal knowledge. Participants were invited to participate in the survey via the SurveyMonkey link. Mann-Whitney test and the Kruskal-Wallis test with Bonferroni correction were used to observe the differences between groups in the MSK-30 scores. Results Four hundred-fourteen (n=414) physiotherapists participated in the survey. The median MSK-30 value was higher in physiotherapists who attended the International Federation of Orthopaedic Manipulative Physical Therapists postgraduate certification than in those who attended unstructured postgraduate training in musculoskeletal condition or in those who had not completed any postgraduate training in this field (p<0.001). Conclusions This work demonstrates significant differences in the management of musculoskeletal disorders between those with specific postgraduate university education and those without. The findings can contribute to the advancement of the physiotherapy profession in Italy. Authors recommend further research with more robust methodologies to deeper understand this topic. Musculoskeletal conditions will continue to represent a significant portion of primary care visits, and future generations of physiotherapists must be prepared to address this challenge. Keywords Surveys and questionnaires, Musculoskeletal diseases, Physical therapists, Professional competence, Consultation and referral *Correspondence: Matteo Cioeta Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Giovannico et al. BMC Musculoskeletal Disorders (2024) 25:265 Introduction Musculoskeletal Conditions (MsC) are a significant contributor to global disability [1]. These disorders have a high prevalence throughout all ages, with at least one person out of five (children included) complaining of musculoskeletal pain, as seenable based on previous articles [2–4]. MsC contains more than 150 diagnoses affecting the musculoskeletal system [3]. The impact of these conditions is expected to increase with the global aging of the population, driven by age-related risk factors [4]. This trend will result in a rise in healthcare costs, which are already heavily influenced by MsC [5]. Taking into account all these factors, many institutions re-evaluated the significance of developing specific clinical competencies on this topic [6]. To establish if medical students were adequately experienced to face this rising problem, members of the University of Pennsylvania Orthopaedic Surgery Department developed a base competence questionnaire that could objectively evaluate the musculoskeletal knowledge of the health professional [7]. Usually known as the "Basic Competency Examination in Musculoskeletal Medicine" (BCEMM), this questionnaire has been repeatedly used in several American and European Universities to appreciate the adequacy of Medical didactic programs [8–10]. In 2019, the musculoskeletal 30-question multiple-choice questionnaire (MSK-30) was presented by Cummings et al. [11]. It is a helpful, multiple-choice questionnaire about the musculoskeletal competence evaluating the musculoskeletal competence of the healthcare professionals working in primary-care process. This questionnaire aimes instead to identify common and critical MsC, to choose appropriate initial management, and to know when to refer the patient to a professionalist. Furthermore, the exam format reduces the likelihood of misinterpretation compared to the short-answer format used in the BCEMM, thus allowing for more accurate statistical analysis [11]. By assessing individual musculoskeletal knowledge, this clinical evaluation tool identify weaknesses and address knowledge gaps. The accompanying answer explanation guide and included references further support this process. Nowadays, direct access to physiotherapy care is a largely used method for managing musculoskeletal pain in many patients [12–14]. This trend needs advanced skills developed by the physiotherapists working in direct access to allow the best management of the patient’s condition, including his referral, if necessary [15]. For these reasons, the aims of this study were to adapt the MSK-30 questionnaire into Italian language and to evaluate the basic musculoskeletal knowledge in a sample of Italian physiotherapists by administrating the Italian version of the MSK-30 questionnaire. The secondary aim Page 2 of 9 of this work is to spark a deeper analysis on the necessity of carving university physiotherapy programs corporating these key topics. Methods Study design and ethical approval This research project is an observational (...truncated)