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Am J Phys Med Rehabil. 2018 Mar 15. doi: 10.1097/PHM.0000000000000924. [Epub ahead of print]

Long-term Retention of Musculoskeletal Ultrasound Training During Residency.

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Dr. Irwin is Professor and Interim Chairman, Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine; Jeffrey Smith is a fourth-year medical student at the University of Miami Miller School of Medicine; Dr. Issenberg is Professor of Medicine, Senior Associate Dean for Research in Medical Education and Director of the Michael S. Gordon Center for Research in Medical Education, University of Miami Miller School of Medicine.


The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Physical Medicine and Rehabilitation (ABPMR) developed milestones for evaluation of resident physicians that include proper musculoskeletal ultrasound (MSUS) examination of major joints. To date, there have been no published data demonstrating acquisition and retention of these skills and correlation with the milestone evaluation. The investigators developed and implemented a curriculum in musculoskeletal ultrasound examination for Physical Medicine and Rehabilitation (PM&R) residents at a large academic medical center. The investigators chose six joints for training and evaluation: ankle, elbow, hip, knee, shoulder and wrist/hand. The program included: 1) didactic lectures on anatomy and ultrasound technique; 2) peer-led demonstrations of the procedure on a standardized patient (SP); 3) individual practice on SPs; 4) faculty observation and feedback; 5) review sessions and additional practice; and, 6) assessment of skills in an objective structured clinical examination (OSCE). From 2013-2017, 30 PM&R residents were trained and evaluated. The results, based on OSCE scores, showed that the majority of residents achieved the appropriate level of competency for their year. A blended, standardized curriculum in MSUS instruction with assessment by an OSCE, can be used to evaluate MSUS skills, and can help align this education with residency milestones.

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