Orthopaedic residents demonstrate retention of point of care ultrasound knowledge after a brief educational session: a quasi experimental study

Samuel Larrivée; Robyn Rodger; Patricia Larouche; Jeff Leiter; Tomislav Jelic; Peter MacDonald

doi:10.1186/s12909-019-1916-0

Orthopaedic residents demonstrate retention of point of care ultrasound knowledge after a brief educational session: a quasi experimental study

BMC Med Educ. 2019 Dec 30;19(1):474. doi: 10.1186/s12909-019-1916-0.

Authors

Samuel Larrivée¹, Robyn Rodger², Patricia Larouche³, Jeff Leiter³, Tomislav Jelic², Peter MacDonald³

Affiliations

¹ Department of Surgery, Section of Orthopaedic Surgery, Rady Faculty of Health Sciences, University of Manitoba, AD4 - 820 Sherbrook St, Winnipeg, Manitoba, R3A 1R9, Canada. larrives@myumanitoba.ca.
² Department of Emergency Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
³ Department of Surgery, Section of Orthopaedic Surgery, Rady Faculty of Health Sciences, University of Manitoba, AD4 - 820 Sherbrook St, Winnipeg, Manitoba, R3A 1R9, Canada.

Abstract

Background: Musculoskeletal point of care ultrasound (MSK POCUS) has many uses for orthopaedic surgeons, but orthopaedic trainees are rarely exposed to this modality. The purpose of this project was to assess the usefulness in clinical education of a newly implemented MSK POCUS course in an orthopaedic surgery program.

Methods: An MSK POCUS course for orthopaedic surgery residents was developed by an interdisciplinary team. Online videos were created to be viewed by residents prior to a half-day long practical course. An online survey covering the level of training of the resident and their previous use of ultrasound (total hours) was completed by the participants prior to the course. Resident's knowledge acquisition was measured with written pre-course, same-day post-course and six-month follow-up tests. Residents were also scored on a practical shoulder examination immediately after the course and at six-month follow-up. Changes in test scores between time points were evaluated using Wilcoxon signed-rank tests.

Results: Ten orthopaedic surgery residents underwent the MSK POCUS curriculum. Pre-course interest in MSK-POCUS was moderate (65%) and prior exposure was low (1.5 h mean total experience). Written test scores improved significantly from 50.7 ± 17.0% before to 84.0 ± 10.7% immediately after the course (p < 0.001) and suffered no significant drop at 6 months (score 75.0 ± 8.7%; p = 0.303). Average post-course practical exam score was 78.8 ± 3.1% and decreased to 66.2 ± 11.3% at 6 months (p = 0.012). Residents significantly improved their subjective comfort level with all aspects of ultrasound use at 6 months (p = 0.007-0.018) but did not significantly increase clinical usage frequency.

Conclusion: An MSK POCUS curriculum was successfully developed and implemented using an interdisciplinary approach. The course succeeded in improving the residents' knowledge, skills, and comfort with MSK POCUS. This improvement was maintained at 6 months on the written test but did not result in higher frequency of use by the residents.

Keywords: Musculoskeletal ultrasound; Online curriculum; Orthopaedic surgery; Point of care ultrasound; Resident education; Sonography.

MeSH terms

Clinical Competence*
Curriculum
Education, Medical, Graduate*
Humans
Internship and Residency*
Orthopedics / education*
Point-of-Care Systems
Retention, Psychology*
Surveys and Questionnaires
Ultrasonography*