Carstensen Stine M D, Velander Marie Juul, Konge Lars, Østergaard Mikkel, Pfeiffer Jensen Mogens, Just Søren Andreas, Terslev Lene
Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet Glostrup, Glostrup.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen.
Rheumatology (Oxford). 2022 Oct 6;61(10):3889-3901. doi: 10.1093/rheumatology/keac119.
To examine how residents are trained and assessed in musculoskeletal US (MSUS), MSUS-guided and landmark-guided joint aspiration and injection. Additionally, to present the available assessment tools and examine their supporting validity evidence.
A systematic search of PubMed, Cochrane Library and Embase was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and studies published from 1 January 2000 to 31 May 2021 were included. Two independent reviewers performed the search and data extraction. The studies were evaluated using the Medical Education Research Quality Instrument (MERSQI).
A total of 9884 articles were screened, and 43 were included; 3 were randomized studies, 21 pre- and post-test studies, 16 descriptive studies and 3 studies developing assessment tools. The studies used various theoretical training modalities, e.g. lectures, anatomical quizzes and e-learning. The practical training models varied from mannequins and cadavers to healthy volunteers and patients. The majority of studies used subjective 'comfort level' as assessment, others used practical examination and/or theoretical examination. All training programs increased trainees' self-confidence, theoretical knowledge, and/or practical performance, however few used validated assessment tools to measure the effect. Only one study met the MERSQI high methodical quality cut-off score of 14.
The included studies were heterogeneous, and most were of poor methodological quality and not based on contemporary educational theories. This review highlights the need for educational studies using validated theoretical and practical assessment tools to ensure optimal MSUS training and assessment in rheumatology.
探讨住院医师在肌肉骨骼超声（MSUS）、MSUS引导和体表标志引导下的关节穿刺及注射方面是如何接受培训和评估的。此外，介绍现有的评估工具并审查其支持有效性的证据。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南，对PubMed、Cochrane图书馆和Embase进行系统检索，纳入2000年1月1日至2021年5月31日发表的研究。两名独立 reviewers 进行检索和数据提取。使用医学教育研究质量工具（MERSQI）对研究进行评估。
共筛选出9884篇文章，纳入43篇；3篇为随机研究，21篇为前后测试研究，16篇为描述性研究，3篇为开发评估工具的研究。这些研究使用了各种理论培训方式，如讲座、解剖学测验和电子学习。实践培训模式从人体模型、尸体到健康志愿者和患者各不相同。大多数研究使用主观的“舒适度”作为评估，其他研究使用实践考试和/或理论考试。所有培训项目都提高了学员的自信心、理论知识和/或实践表现，然而很少使用经过验证的评估工具来衡量效果。只有一项研究达到了MERSQI方法学高质量的截止分数14分。
纳入的研究具有异质性，大多数研究的方法学质量较差，且并非基于当代教育理论。本综述强调需要开展使用经过验证的理论和实践评估工具的教育研究，以确保在风湿病学中进行最佳的MSUS培训和评估。
