Fall 2022 (Volume 32, Number 3)
RheumTutor: An Invaluable Learning Resource
By Raj Carmona, MBBS, FRCPC
I had the great benefit of doing medical school in a resource-limited setting (University of the West Indies, Trinidad). Our ears became ECHOs, our eyes X-rays, and our fingertips ultrasounds. This deep appreciation for the value of clinical skills followed me into internal medicine and rheumatology training at McMaster. Dr. Sam Pillersdorf showed me my first four-finger joint examination technique, and Dr. Tulio Scocchia’s weekly sessions sharpened our musculoskeletal (MSK) examination skills. Dr. Nader Khalidi taught me my first joint injections. It was during fellowship that Dr. Alf Cividino, who was the Medical Foundation 5 Director at the time, invited me to become involved in teaching within the MD program. The entire Division of Rheumatology had become heavily invested in undergraduate training, a strategy that provided early student exposure to rheumatology, and one that continues to pay dividends today. While our faculty were awesome teachers, I recognized the need for reliable audiovisual resources for MSK clinical skills teaching at both undergraduate and postgraduate levels.
With the acting prowess of fellows/residents at the time (Kim Legault, Arthur Lau, Brendan Flowers, and Andrew Duncan), the McMaster MSK Examination video series was created (2011-2012). This includes videos on examination of the hand/wrist, elbow, shoulder, back, hip, knee and ankle/foot. The benefit of these videos was immediately recognized, as students arrived at teaching sessions with a greater degree of preparedness. While these became part of the MD program curriculum, they were also quickly absorbed at various levels of training across a number of programs at McMaster. To provide open online access to the videos beyond McMaster, RheumTutor.com was launched in 2012. The response was humbling, with commendations from multiple faculty nationally and internationally, and formal requests from several institutions worldwide to use the videos and accompanying manual as part of their training programs.
Following the examination videos, multiple videos (23 and counting) teaching MSK injection techniques were created. Many of these are step-by-step instructional simulations, but several are actual procedures shot (pun intended) in clinic. To aid understanding, I drew surface anatomy illustrations for both examination and injection videos. The feedback on this artwork suggests that it is highly valued, maybe even legendary (oh humility, wherefore art thou?).
Back in 2012 (life is a blink!), YouTube could not handle larger file sizes. The videos were therefore hosted via Vimeo, with viewership recorded across more than 110 countries. Viewership exponentially increased with the more recent launch of the RheumTutor Channel on YouTube. To date, there have been over 2.9M views on YouTube, with over 14,500 subscribers and overwhelmingly positive feedback.
The hope for RheumTutor is to continue creating and providing high-yield resources. While it does not replace the teaching expertise of faculty and clinicians across the country, the hope is that it will continue to serve as an aid in teaching and learning, with the ultimate aim of improving patient care. I thank all those who have contributed and encouraged this endeavor along the way. Cheers from McMaster!
Raj Carmona, MBBS, FRCPC
Associate Clinical Professor
Director, Medical Foundation 4, MD Program
MSK Clinical Skill Coordinator, MD Program