Résumé
BackgroundMusculoskeletal ultrasound (MSUS) is increasingly gaining importance as an imaging tool in rheumatology. Most training programs currently address resident doctors. However, several studies have demonstrated that teaching MSUS to medical students improves their palpation skills and understanding of musculoskeletal anatomy. With the development of portable ultrasound devices, MSUS education is lately getting more flexible and location-independent. In addition, the COVID-19 pandemic raised awareness of telemedicine training as a powerful tool to ensure the teaching of practical skills under pandemic conditions.ObjectivesThe purpose of our study is to establish a telemedical MSUS course for medical students and to compare its effectiveness with a conventional on-campus course as a world-wide pilot study. In doing so, we aim to expand student educational opportunities in MSUS using innovative teaching options while ensuring quality maintenance of teaching.MethodsThirty medical students were randomized to either a virtual group being delivered only telemedicine instructions, or an on-campus cohort receiving the course in a conventional format. Each student was provided with a handheld ultrasound device. Prior to the start of the course, the students' skills were assessed with an Objective Clinical Structured Examination (OSCE). During the course, a DEGUM-III-certified course instructor taught the basic physics of ultrasound and standard sections of the MUDE ultrasound protocol[1]. In order to quantify the students' learning progress, a second OSCE was carried out after completion of the course. [1].ResultsAt the time of this analysis, data collection within the on-campus course has already been completed, whereas the virtual course is still ongoing. While the average score of the students in the PRE-course OSCE was 21,02% (SD ±6,78), the students were able to achieve an average of 90% (SD ±6,81) in the POST-course OSCE after the intervention.ConclusionWith the results obtained so far, it can be shown that an innovative course concept with hand-held ultrasound devices, originally developed for dermatologists to improve the detection of psoriatic arthritis, can be used very well in student teaching without major modifications and leads to a significant increase in MSUS skills among medical students. The TELMUS study thereby offers a successful example of extending an existing course concept to student teaching and thus promoting the next generation of rheumatologists.Reference[1]Grobelski J, Recker F, Wilsmann- Theis D, et al. Etablierung und Validierung eines didaktischen muskuloskelettalen Ultraschallkurses für Dermatologen unter Verwendung eines innovativen Hand-Ultraschallsystems – die MUDE-Studie (Muskuloskelettaler Ultraschall für Dermatologen). J Deutsche Derma Gesell 2021;19:1753–60. doi:10.1111/ddg.14614_gFigure 1.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
Résumé
BackgroundThe use of musculoskeletal ultrasound improves patient care by increasing diagnostic and therapeutic safety. With its growing application and increasing evidence of its value, the demand for standardized training in musculoskeletal ultrasonography (MSUS) rises rapidly.ObjectivesIn this systematic literature review, we aim to provide a general overview of the various aspects of musculoskeletal ultrasound education worldwide, including target groups, teaching staff, didactic methods, and course formats, as well as to reflect on existing problems and future opportunities. No restrictions were made regarding the educational level of the course recipients nor the specialization of the course instructors.MethodsIn our methodological approach, we followed the PRISMA statement for reporting systematic reviews and meta-analyses of studies[1]. In January 2022, the databases Embase, PubMed, and Google Scholar were considered with all publications to date and were filtered for relevant publications using previously defined keywords. Title and were then screened independently by two authors for inclusion using relevant study characteristics determined in advance according to the PICO scheme[1]. Finally relevant information was filtered from the full text version of the sixty-seven included publications.ResultsThe range of training programs has increased greatly in recent years, primarily aiming at residents in rheumatology, radiology and physical medicine and rehabilitation. However, MSUS is also receiving more attention as a training tool for medical students. Due to the COVID pandemic, didactic approaches using distance learning via simulators and handheld devices have gained additional importance. Given the existing lack of sufficient equipment and trained teaching staff, those approaches should continue to be explored post-pandemic. Another still existing problem is the low international comparability of MSUS training and competency assessment. Therefore, several international institutions, including the European League Against Rheumatism (EULAR) and the Pan-American League of Associations for Rheumatology (PANLAR) have proposed guidelines for training curricula to promote standardized ultrasound training.ConclusionThere is a broad consensus that the development of standardized curricula improves training and facilitates the implementation of new training centers. The development of alternative teaching methods incorporating e-learning, peer teaching, and distance learning on mobile ultrasound devices and the determination of international guidelines could facilitate overcoming the remaining major obstacles still to be passed.Reference[1]Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700. doi:10.1136/bmj.b2700Acknowledgements:NIL.Disclosure of InterestsNone Declared.
Résumé
Background: Over the past few decades, technological advances in both ultrasound (US) and the application of telemedicine have been made [1]. Medical education has shifted to online classes during the COVID-19 pandemic, creating challenges in adequate training of US. Objectives: In the context of the current COVID-19 pandemic and the discontinuation of traditional classroom teaching, a tele-didactic US course for undergraduate medical students was developed. This study is examining the educational outcome of a new digital US course of the abdomen, thorax and the thyroid gland with the implementation of a modern portable US system. Methods: A tele-guided US course was established between April 1st and June 20th, 2020, at the University Hospital in Bonn, Germany. Students completed preand post-course surveys and underwent six US organ modules. Each module took place in a flipped-classroom concept including a digital learning platform. An objective structured assessment of US skills (OSAUS) [2] was implemented as final exam. Further, US images of the course and exam were rated by the Brightness Mode Quality Ultrasound Imaging Examination Technique (B-QUIET) [3]. Achieved points in image rating were compared to the OSAUS exam and survey results. Results: A total of 15 medical students were enrolled. There was a significant increase in self-assessed theoretical and practical ability (p < 0.001). Students achieved an average score of 154.5 (SD ± 11.72) out of 175 points (88.29%) in OSAUS, which corresponded to the image rating using B-QUIET and self-assessment data obtained in surveys. Interrater analysis of US images showed a favorable agreement with an ICC (2,1) of 0.895 (95% confidence interval 0.858 < ICC < 0.924). Conclusion: US training via teleguidance should be considered in medical education. Our pilot study demonstrates the feasibility of this concept that can be used in the future to improve US training of medical students even during a pandemic. The digital implementation with an affordable, portable point-of-care-US device could be an incredible opportunity to expedite US training worldwide.