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肌骨超声医学教育在物理医学与康复中的共识:一项针对住院医师主任的全国调查。

Toward a Consensus for Musculoskeletal Ultrasonography Education in Physical Medicine and Rehabilitation: A National Poll of Residency Directors.

机构信息

From the Department of Physical Medicine & Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, Ohio (MAB, RDT, SCC); Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio (DPW, DPB); Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts (IJS, JL, JB-S, KO); Regenerative Orthopedics and Sports Medicine (ROSM), Washington, DC (IJS); Department of Orthopedics, Tufts University School of Medicine, St. Elizabeth's Medical Center, Boston, Massachusetts (JL); and Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (MJK).

出版信息

Am J Phys Med Rehabil. 2019 Aug;98(8):715-724. doi: 10.1097/PHM.0000000000001195.

Abstract

OBJECTIVES

The aims of the study were to evaluate integration of musculoskeletal ultrasonography education in physical medicine and rehabilitation training programs in 2014-2015, when the American Academy of Physical Medicine & Rehabilitation and Accreditation Council for Graduate Medical Education Residency Review Committee both recognized it as a fundamental component of physiatric practice, to identify common musculoskeletal ultrasonography components of physical medicine and rehabilitation residency curricula, and to identify common barriers to integration.

DESIGN

Survey of 78 Accreditation Council for Graduate Medical Education-accredited physical medicine and rehabilitation residency programs was conducted.

RESULTS

The 2015 survey response rate was more than 50%, and respondents were representative of programs across the United States. Most programs (80%) reported teaching musculoskeletal ultrasonography, whereas a minority (20%) required mastery of ultrasonography skills for graduation. Ultrasonography curricula varied, although most programs agreed that the scope of resident training in physical medicine and rehabilitation should include diagnostic and interventional musculoskeletal ultrasonography, especially for key joints (shoulder, elbow, knee, wrist, hip, and ankle) and nerves (median, ulnar, fibular, tibial, radial, and sciatic). Barriers to teaching included insufficient expertise of instructors, poor access to equipment, and lack of a structured curriculum.

CONCLUSIONS

Musculoskeletal ultrasonography has become a required component of physical medicine and rehabilitation residency training. Based on survey responses and expert recommendations, we propose a structure for musculoskeletal ultrasonography curricular standards and milestones for trainee competency.

摘要

目的

本研究旨在评估在 2014-2015 年期间,将肌肉骨骼超声检查教育纳入物理医学与康复培训计划的情况,当时美国物理医学与康复学院和研究生医学教育认证委员会都将其认可为物理医学实践的基本组成部分,确定物理医学与康复住院医师课程中常见的肌肉骨骼超声检查内容,并确定整合的常见障碍。

设计

对 78 个经研究生医学教育认证委员会认可的物理医学与康复住院医师培训计划进行了调查。

结果

2015 年的调查回复率超过 50%,且受访者代表了全美各地的项目。大多数项目(80%)报告了肌肉骨骼超声检查的教学情况,而只有少数(20%)要求毕业生必须掌握超声检查技能。超声检查课程有所不同,尽管大多数项目都认为物理医学与康复住院医师培训的范围应包括诊断和介入性肌肉骨骼超声检查,特别是针对关键关节(肩、肘、膝、腕、髋和踝)和神经(正中、尺、腓、胫、桡和坐骨)。教学的障碍包括讲师的专业知识不足、设备使用不便以及缺乏结构化课程。

结论

肌肉骨骼超声检查已成为物理医学与康复住院医师培训的必修内容。根据调查结果和专家建议,我们提出了肌肉骨骼超声检查课程标准和学员能力的里程碑结构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d19d/6635046/9cc65bab76e5/phm-98-715-g002.jpg

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