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Study: Musculoskeletal ultrasound is increasingly taught in US rheumatology fellowships
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A significantly greater number of rheumatology fellowships in the United States teach musculoskeletal ultrasound, according to recent findings.
Researchers acquired a list of 113 rheumatology fellowship directors from FREIDA online and sent surveys pertaining to musculoskeletal ultrasound (MSUS). The first survey (S1) was a 12-item needs assessment survey to evaluate the needs of rheumatology fellowships for the implementation of MSUS. This survey included questions about program size, faculty training, acquisition of equipment, barriers to incorporating a program and formal curricular inclusion. Researchers defined a formal curriculum as a written curriculum, either separate from or assimilated into the existing standardized curriculum established by the ACR and the American Board of Internal Medicine.
A curriculum survey (S2) was sent to lead faculty. The 25-item curriculum survey was used to determine the state of MSUS teaching among fellowship programs that already taught MSUS. This survey assessed areas of curriculum content, instructional methods, competency assessments and current influences of barriers.
Of the 113 fellowship directors who were sent the S1, 96% responded. Some form of MSUS curriculum was taught in 94% of the programs. A comparable proportion of small programs (92%) and large programs (97%) were identified among those offering MSUS. A total of 103 program directors (95.3%) favored the incorporation of MSUS into the fellowship curriculum. Sixty-six percent wanted MSUS to be optional, while 30% noted it should be required as part of the standard curriculum. Five programs did not want MSUS to be part of the curriculum. Barriers to teaching MSUS were lack of faculty or fellow interest, lack of faculty ability to teach MSUS, lack of time for MSUS teaching, lack of division support, and lack of ultrasound machine and storage space.
Of the 101 programs that taught MSUS and received S2, 73% of the lead faculty responded. A total of 30 programs (41%) cited having a formal curriculum, while 44 (59%) had none. Programs with a formal curriculum utilized multiple teaching strategies, and the content was similar between these programs.
No significant difference was identified in the number of programs with or without a formal curriculum according to program size. Of the 30 programs that offered a formal curriculum, 24 (80%) expressed a willingness to share their curriculum with other programs. Access to ultrasound outside of dedicated teaching and clinical time was available in about 96% of programs with a formal curriculum; such access was provided by 79% of programs without a formal curriculum.
There was a high prevalence of use of external courses. Although the researchers found fewer barriers to the teaching of MSUS among S2 respondents, these programs also observed inadequate time, funding and number of trained faculty. In programs without a formal curriculum, the researchers observed a lack of institutional interest and lack of fellow interest.
“Our specialty has seen a dramatic increase in the use of point-of-care MSUS among rheumatologists, as evidenced by delineation of MSUS standards of use, inclusion of MSUS into disease classification systems, increased attendance by rheumatologists at training courses, provision of the RhMSUS certification and the almost universal desire among fellowship training programs to integrate MSUS education into the curriculum,” the researchers wrote. “Educators in other specialties and levels of medical training are adapting ultrasound as a teaching and point-of-care assessment strategy.”
Disclosure s : The researchers report no relevant disclosures.