Musculoskeletal (MSK) conditions account for up to one-third of general practice consultations and over one-fifth of emergency department attendances in the UK. Postpandemic, the elective orthopaedic surgery backlog remains one of the most substantial across surgical specialties. Despite this burden, undergraduate exposure to trauma and orthopaedics (T&O) remains limited and inconsistent. Most UK medical students receive only 2–3 weeks of T&O teaching, with up to 40% of foundation doctors feeling underprepared to manage MSK conditions. The Evaluation of Trauma and Orthopaedic Teaching in Medical Schools Nationally (TENDON Study) aims to evaluate the current state of undergraduate T&O education in UK medical schools from both student and educator perspectives.

This national, prospective, cross-sectional survey will be conducted between 25 July and 27 October 2025. A dual-instrument electronic survey was developed through Qualtrics, informed by the British Orthopaedic Association (BOA) Undergraduate Curriculum and UK Medical Licensing Assessment content map. Participants will include medical students (Years 1–6), foundation doctors and orthopaedic educators recruited through British Orthopaedic Medical Students Association and BOA networks, and designated school representatives. Survey domains include curriculum coverage, teaching methods, clinical exposure and self-reported competence. Quantitative data will be analysed using descriptive and inferential statistics; qualitative data will undergo thematic analysis. Reporting will follow the Checklist for Reporting Of Survey Studies framework, with relevant elements drawn from the Checklist for Reporting Results of Internet E-Surveys checklist.

Ethical approval was obtained from the Human Biology Research Ethics Committee, University of Cambridge. Findings will be disseminated via peer-reviewed publication, conference presentations and summary reports to curriculum leads and relevant educational bodies.

Three-dimensional high-resolution anorectal manometry (3D HRAM) is a minimally invasive test allowing the assessment of lower gastrointestinal tract function. Nowadays, it is performed in left lateral or supine position (non-physiological) in accordance with the London Protocol. 3D HRAM can disclose pathological defecation model such as dyssynergic defecation (DD) that might be a cause of constipation in a significant percentage of patients.

3D HRAM in healthy adults in lying position shows up to 67%–87% abnormal results during the bear-down manoeuvre; it may result from the non-physiological position taken during the examination.

The aim of this study is to assess the influence of body position on parameters of the bear-down manoeuvre during 3D HRAM in children with constipation and healthy volunteers.

This is a prospective, case-control study. Study participants of 5–18 years old will be recruited and divided into two groups: (I) patients with functional constipation and non-retentive faecal incontinence diagnosed according to the Rome IV criteria and (II) healthy controls. Tests will be performed both in supine and sitting positions, successively using 3D HRAM. The order in which the examination will be performed will be in accordance with the randomisation list generated by computer.

The primary endpoint of the study is the difference in the number of patients with DD detected in the sitting and supine positions.

The study was approved by the Ethics Committee of the Medical University of Warsaw, Poland (KB/178/2019). The results of this study will be submitted to a peer-reviewed journal no later than 1 year after data collection. The abstract will be presented at relevant national and international conferences.

NCT06924957.