Rheumatology training experience across Europe: analysis of core competences.
The aim of this project was to analyze and compare the educational experience in rheumatology specialty training programs across European countries, with a focus on self-reported ability.



An electronic survey was designed to assess the training experience in terms of self-reported ability, existence of formal education, number of patients managed and assessments performed during rheumatology training in 21 core competences including managing specific diseases, generic competences and procedures. The target population consisted of rheumatology trainees and recently certified rheumatologists across Europe. The relationship between the country of training and the self-reported ability or training methods for each competence was analyzed through linear or logistic regression, as appropriate.



In total 1079 questionnaires from 41 countries were gathered. Self-reported ability was high for most competences, range 7.5-9.4 (0-10 scale) for clinical competences, 5.8-9.0 for technical procedures and 7.8-8.9 for generic competences. Competences with lower self-reported ability included managing patients with vasculitis, identifying crystals and performing an ultrasound. Between 53 and 91 % of the trainees received formal education and between 7 and 61 % of the trainees reported limited practical experience (managing ≤10 patients) in each competence. Evaluation of each competence was reported by 29-60 % of the respondents. In adjusted multivariable analysis, the country of training was associated with significant differences in self-reported ability for all individual competences.



Even though self-reported ability is generally high, there are significant differences amongst European countries, including differences in the learning structure and assessment of competences. This suggests that educational outcomes may also differ. Efforts to promote European harmonization in rheumatology training should be encouraged and supported.
Department Reumatologia, Hospital General Universitario de Elda, ctra Sax s/n, Elda, Alicante, 03600, Spain. fransimas@yahoo.es.
Francisca
0000-0002-3414-1667
F
Sivera
Leiden University Medical Center, Leiden, The Netherlands.
Sofia
S
Ramiro
University of Zagreb School of Medicine, University Hospital Centre, Zagreb, Croatia.
Nada
N
Cikes
Research Laboratories and Academic Division of Clinical Rheumatology, Postgraduate School on Rheumatology, Department of Internal Medicine University of Genova, Genova, Italy.
Maurizio
M
Cutolo
Université Paris Descartes University, Department of Rheumatology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris; INSERM (U1153): Epidemiologie Clinique et Biostatistiques, PRES Sorbonne Paris-Cité, Paris, France.
Maxime
M
Dougados
Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'Epidémiologie et de Santé Publique; AP-HP, Pitié Salpêtrière Hospital, Department of rheumatology, F-75013, Paris, France.
Laure
L
Gossec
Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
Tore K
TK
Kvien
Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Sweden.|Karolinska Institutet, Stockholm, Sweden.
Ingrid E
IE
Lundberg
University of Vienna, Vienna, Austria.
Peter
P
Mandl
University Hospitals of Leicester, Leicester, UK.
Arumugam
A
Moorthy
University Hospitals of Leicester NHS Trust, Leicester, UK.
Sonia
S
Panchal
Centro Hospitalar e Universitário de Coimbra, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal.
José A P
JA
da Silva
University Medical Center Utrecht, Utrecht, The Netherlands.
Johannes W
JW
Bijlsma
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000592:standards*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D012219:Rheumatology / Q000193:education*; D011795:Surveys and Questionnaires
Assessment; Competence; Education; Europe; Rheumatology; Training; UEMS
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