Musculoskeletal ultrasound training and competency assessment program for rheumatology fellows.
OBJECTIVE
The purpose of this study was to establish standards for musculoskeletal ultrasound competency through knowledge and skills testing using criterion-referenced methods.


METHODS
Two groups of rheumatology fellows trained in musculoskeletal ultrasound through a standardized curriculum, which required submission of ultrasound studies for review over 8 months. Both groups then completed written and practical examinations in musculoskeletal ultrasound. Instructors, advanced users, and intermediate users of musculoskeletal ultrasound served as comparison groups. A passing score (competency) was established for the written examination by the Angoff procedure and for the practical examination by the borderline method.


RESULTS
Thirty-eight fellows (19 in each group) took the final examination. Five fellows failed the written examination, and 1 failed the practical examination, whereas none of the advanced users failed. Written examination scores did not differ between the two fellow groups (74% versus 70%; P > .05), were reliable, and were able to discriminate between the intermediate and advanced groups. Practical and written examination results correlated in both groups (first group, r = 0.70; P = .0008; second group, r = 0.59; P = .009).


CONCLUSIONS
Criterion-referenced methods were used for the first time to determine fellow musculoskeletal ultrasound competency. The examination used to determine competency was reproducible, was reliable, and could differentiate musculoskeletal ultrasound users with different levels of experience. Most rheumatology fellows completing our program passed the written and practical examinations, suggesting achievement of basic musculoskeletal ultrasound competency.
Arthritis Center, Boston University School of Medicine, 72 East Concord St, Evans 506, Boston, MA 02118 USA. eukissin@bu.edu.
Eugene Y
EY
Kissin
Jingbo
J
Niu
Peter
P
Balint
David
D
Bong
Amy
A
Evangelisto
Janak
J
Goyal
Jay
J
Higgs
Daniel
D
Malone
Midori J
MJ
Nishio
Carlos
C
Pineda
Wolfgang A
WA
Schmidt
Ralf G
RG
Thiele
Karina D
KD
Torralba
Gurjit S
GS
Kaeley
D000328:Adult; D003479:Curriculum / Q000592:standards / Q000706:statistics & numerical data; D004521:Educational Measurement / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D017408:Guidelines as Topic; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency / Q000592:standards* / Q000706:statistics & numerical data; D008297:Male; D009141:Musculoskeletal System / Q000000981:diagnostic imaging*; D011361:Professional Competence / Q000592:standards / Q000706:statistics & numerical data; D011871:Radiology / Q000592:standards* / Q000706:statistics & numerical data; D012219:Rheumatology / Q000193:education* / Q000706:statistics & numerical data; D014463:Ultrasonography / Q000592:standards* / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
competency; education; examination; musculoskeletal; ultrasound