108 - Case Based Spine Workshop for a PM&R Residency: A Resident led Initiative

Objectives: To advance our residency program's education on spinal pathologies, a group of PM&R residents developed an interactive, hands-on workshop. This initiative aimed to deepen residents' understanding of complex spine conditions, enhance their ability to distinguish between similarly presenting diagnoses, and improve clinical decision-making through key history and physical exam findings. Additional objectives included the analysis of characteristic imaging for various pathologies and discussions of treatment strategies. The workshop also aimed to increase residents' proficiency and comfort with interventional spine procedures.

Design:  
The two-part spine workshop was facilitated by the authors and three fellowship-trained pain and spine specialists. A pre- and post-workshop assessment measured both self-reported understanding and objective competency.
The first part featured six resident-created case scenarios covering conditions such as cervical and lumbar radiculopathy, lumbar axial pain, vertebrogenic pain, sacroiliac pain, and persistent post-surgical pain. Each scenario identified common symptoms, key physical findings, and differential diagnoses. Residents reviewed relevant imaging before engaging in discussions on evidence-based treatment options and procedural considerations.
The second part of the workshop provided hands-on training with a lumbar spine model and fluoroscopic C-arm. Participants practiced procedures, including lumbar interlaminar and transforaminal epidural steroid injections, lumbar medial branch blocks, and sacroiliac joint injections, under expert supervision. This session allowed for practical experience with C-arm maneuvering to optimize needle placement and target visualization.








 












Results: Seventeen trainees, medical students through PGY-4 level participated. There was an average 28% improvement in assessment scores. The medical student showed the greatest improvement (42%), followed by PGY-4 (33%), PGY-3 (27%), and PGY-2 residents (24%).
 

Conclusions: This resident-led workshop provided an engaging, comprehensive exploration of spine pathologies. It demonstrated improved understanding and procedural competence, with the greatest gains in participants less familiar with the material. This model could be applied to other programs to enhance training in spinal pathology and interventional techniques.