A randomized controlled educational study to evaluate an e-learning module to teach the physical examination of the temporomandibular joint in juvenile idiopathic arthritis.
Arthritis
Education
Juvenile
Medical
Temporomandibular joint
Journal
Pediatric rheumatology online journal
ISSN: 1546-0096
Titre abrégé: Pediatr Rheumatol Online J
Pays: England
ID NLM: 101248897
Informations de publication
Date de publication:
19 Oct 2024
19 Oct 2024
Historique:
received:
03
06
2024
accepted:
01
10
2024
medline:
19
10
2024
pubmed:
19
10
2024
entrez:
18
10
2024
Statut:
epublish
Résumé
The aim of the study was to evaluate the effectiveness of a novel e-learning module in teaching the physical exam of the temporomandibular joint (TMJ) in Juvenile idiopathic arthritis (JIA.). An e-learning module was developed to convey the TMJ physical examination maneuvers that are considered to be best practice in JIA. Pediatric rheumatology fellows were randomized to two groups. One group received an article describing the physical examination skills while the second group received both the article and module. All participants completed a written pre-test, an in-person objective structured clinical examination (OSCE), a written post-test, and a follow-up survey. Twenty-two pediatric rheumatology fellows enrolled, with 11 per group. Written test: The two groups improved equally, although there was a trend toward improved defining of maximal incisal opening (MIO) in the module group. OSCE: The mean OSCE score was 11.1 (SD 3.3) in the article group and 13.5 (SD 1.9) in the module group (p = 0.06); significant differences were seen in measuring MIO (p = 0.01), calculating maximal unassisted mouth opening (MUMO; p = 0.01), and assessment of facial symmetry (p = 0.03), all favoring the module. Enjoyment scores in the module group were higher than in the article group (mean 7.7/10 vs. 5.9/10, p = 0.02). The two groups self-reported performing TMJ examinations at comparable rates three months following the intervention. The study demonstrated that a formalized educational program improved knowledge of the physical exam of the TMJ in JIA. Learners viewing the module were more adept at obtaining quantitative TMJ measurements.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of the study was to evaluate the effectiveness of a novel e-learning module in teaching the physical exam of the temporomandibular joint (TMJ) in Juvenile idiopathic arthritis (JIA.).
METHODS
METHODS
An e-learning module was developed to convey the TMJ physical examination maneuvers that are considered to be best practice in JIA. Pediatric rheumatology fellows were randomized to two groups. One group received an article describing the physical examination skills while the second group received both the article and module. All participants completed a written pre-test, an in-person objective structured clinical examination (OSCE), a written post-test, and a follow-up survey.
RESULTS
RESULTS
Twenty-two pediatric rheumatology fellows enrolled, with 11 per group. Written test: The two groups improved equally, although there was a trend toward improved defining of maximal incisal opening (MIO) in the module group. OSCE: The mean OSCE score was 11.1 (SD 3.3) in the article group and 13.5 (SD 1.9) in the module group (p = 0.06); significant differences were seen in measuring MIO (p = 0.01), calculating maximal unassisted mouth opening (MUMO; p = 0.01), and assessment of facial symmetry (p = 0.03), all favoring the module. Enjoyment scores in the module group were higher than in the article group (mean 7.7/10 vs. 5.9/10, p = 0.02). The two groups self-reported performing TMJ examinations at comparable rates three months following the intervention.
CONCLUSIONS
CONCLUSIONS
The study demonstrated that a formalized educational program improved knowledge of the physical exam of the TMJ in JIA. Learners viewing the module were more adept at obtaining quantitative TMJ measurements.
Identifiants
pubmed: 39425085
doi: 10.1186/s12969-024-01026-7
pii: 10.1186/s12969-024-01026-7
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
91Subventions
Organisme : Childhood Arthritis and Rheumatology Research Alliance
ID : Childhood Arthritis and Rheumatology Research Alliance
Investigateurs
Alex Bryant
(A)
Holly Bloom
(H)
Kurt Sidenstick
(K)
Informations de copyright
© 2024. The Author(s).
Références
Stoustrup P, Glerup M, Bilgrau AE, Küseler A, Verna C, Christensen AE, et al. Cumulative incidence of orofacial manifestations in early juvenile idiopathic arthritis: a regional, three-year cohort study. Arthritis Care Res. 2020;72:907–16.
doi: 10.1002/acr.23899
Stoll ML, Kau CH, Waite PD, Cron RQ. Temporomandibular joint arthritis in juvenile idiopathic arthritis, now what? Pediatr Rheumatol Online J. 2018;16:32.
doi: 10.1186/s12969-018-0244-y
pubmed: 29695255
pmcid: 5918758
Arabshahi B, Cron RQ. Temporomandibular joint arthritis in juvenile idiopathic arthritis: the forgotten joint. Curr Opin Rheumatol. 2006;18:490–5.
doi: 10.1097/01.bor.0000240360.24465.4c
pubmed: 16896288
Hügle B, Spiegel L, Hotte J, Wiens S, Herlin T, Cron RQ, et al. Isolated arthritis of the Temporomandibular Joint as the initial manifestation of Juvenile Idiopathic Arthritis. J Rheumatol. 2017;44:1632–5.
doi: 10.3899/jrheum.170263
pubmed: 28864647
Klenke D, Quast A, Prelog M, Holl-Wieden A, Riekert M, Stellzig-Eisenhauer A, et al. TMJ pathomorphology in patients with JIA-radiographic parameters for early diagnosis. Head Face Med. 2018;14:15.
doi: 10.1186/s13005-018-0173-5
pubmed: 30223858
pmcid: 6142390
Resnick CM, Dang R, Henderson LA, Zander DA, Daniels KM, Nigrovic PA, et al. Frequency and morbidity of Temporomandibular Joint involvement in adult patients with a history of Juvenile Idiopathic Arthritis. J Oral Maxillofac Surg off J Am Assoc Oral Maxillofac Surg. 2017;75:1191–200.
doi: 10.1016/j.joms.2016.11.013
Glerup M, Stoustrup P, Matzen LH, Rypdal V, Nordal E, Frid P, et al. Longterm outcomes of temporomandibular joints in Juvenile Idiopathic Arthritis: 17 years of followup of a nordic Juvenile Idiopathic Arthritis Cohort. J Rheumatol. 2020;47:730–8.
doi: 10.3899/jrheum.190231
pubmed: 31523047
Giancane G, Muratore V, Marzetti V, Quilis N, Benavente BS, Bagnasco F, et al. Disease activity and damage in juvenile idiopathic arthritis: methotrexate era versus biologic era. Arthritis Res Ther. 2019;21:168.
doi: 10.1186/s13075-019-1950-7
pubmed: 31287015
pmcid: 6615271
Tolend MA, Twilt M, Cron RQ, Tzaribachev N, Guleria S, von Kalle T, et al. Toward establishing a standardized magnetic resonance imaging scoring system for temporomandibular joints in Juvenile Idiopathic Arthritis. Arthritis Care Res. 2018;70:758–67.
doi: 10.1002/acr.23340
Stoustrup P, Twilt M, Spiegel L, Kristensen KD, Koos B, Pedersen TK, et al. Clinical orofacial examination in juvenile idiopathic arthritis: international consensus-based recommendations for monitoring patients in clinical practice and research studies. J Rheumatol. 2017;44:326–33.
doi: 10.3899/jrheum.160796
pubmed: 28089967
Ringold S, Tzaribachev N, Cron RQ. Management of temporomandibular joint arthritis in adult rheumatology practices: a survey of adult rheumatologists. Pediatr Rheumatol Online J. 2012;10:26.
doi: 10.1186/1546-0096-10-26
pubmed: 22906004
pmcid: 3511809
Foeldvari I, Tzaribachev N, Cron RQ. Results of a multinational survey regarding the diagnosis and treatment of temporomandibular joint involvement in juvenile idiopathic arthritis. Pediatr Rheumatol Online J. 2014;12:6.
doi: 10.1186/1546-0096-12-6
pubmed: 24461073
pmcid: 3910235
Stoustrup P, Resnick CM, Pedersen TK, Abramowicz S, Michelotti A, Küseler A, et al. Standardizing terminology and assessment for orofacial conditions in juvenile idiopathic arthritis: international, multidisciplinary Consensus-based recommendations. J Rheumatol. 2019;46:518–22.
doi: 10.3899/jrheum.180785
pubmed: 30647179
Stoustrup P, Herlin T, Spiegel L, Rahimi H, Koos B, Pedersen TK, et al. Standardizing the clinical orofacial examination in juvenile idiopathic arthritis: an interdisciplinary, consensus-based, short screening protocol. J Rheumatol. 2020;47(9):1397–404.
doi: 10.3899/jrheum.190661
pubmed: 31787607
Pan N, Ronis T, Resnick CM, Sadun R, Lerman M, Stoustrup P, et al. Musculoskeletal examination of the temporomandibular joint in Juvenile idiopathic arthritis. Available from: https://childrensmedicaleducation.org/learnmeded/ . Cited 2024 May 10.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf. 2009;42:377–81.
doi: 10.1016/j.jbi.2008.08.010
Onel KB, Horton DB, Lovell DJ, Shenoi S, Cuello CA, Angeles-Han ST, et al. 2021 American College of Rheumatology Guideline for the treatment of juvenile idiopathic arthritis: therapeutic approaches for Oligoarthritis, Temporomandibular Joint Arthritis, and systemic juvenile idiopathic arthritis. Arthritis Rheumatol Hoboken NJ. 2022;74:553–69.
doi: 10.1002/art.42037
Stoustrup P, Resnick CM, Abramowicz S, Pedersen TK, Michelotti A, Küseler A, et al. Management of orofacial manifestations of juvenile idiopathic arthritis: Interdisciplinary consensus-based recommendations. Arthritis Rheumatol Hoboken NJ. 2023;75:4–14.
doi: 10.1002/art.42338
Abramowicz S, Susarla HK, Kim S, Kaban LB. Physical findings associated with active temporomandibular joint inflammation in children with juvenile idiopathic arthritis. J Oral Maxillofac Surg off J Am Assoc Oral Maxillofac Surg. 2013;71:1683–7.
doi: 10.1016/j.joms.2013.04.009
Kristensen KD, Stoustrup P, Küseler A, Pedersen TK, Twilt M, Herlin T. Clinical predictors of temporomandibular joint arthritis in juvenile idiopathic arthritis: a systematic literature review. Semin Arthritis Rheum. 2016;45:717–32.
doi: 10.1016/j.semarthrit.2015.11.006
pubmed: 26708936
Kinard B, Goldberg B, Kau C, Abramowicz S. Clinical trials of temporomandibular joint involvement of juvenile idiopathic arthritis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021;131:617–9.
doi: 10.1016/j.oooo.2021.02.009
pubmed: 33875398
Costello A, Twilt M, Lerman MA, CARRA Registry Investigators. Provider assessment of the temporomandibular joint in juvenile idiopathic arthritis: a retrospective analysis from the CARRA database. Pediatr Rheumatol Online J. 2024;22:41.
doi: 10.1186/s12969-024-00968-2
pubmed: 38589909
pmcid: 11000332
Carraccio C, Englander R. The objective structured clinical examination: a step in the direction of competency-based evaluation. Arch Pediatr Adolesc Med. 2000;154:736–41.
doi: 10.1001/archpedi.154.7.736
pubmed: 10891028