Rheumatology Advance Access originally published online on January 30, 2007
Rheumatology 2007 46(3):391-397; doi:10.1093/rheumatology/kel415
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The development of an evidence-based educational framework to facilitate the training of competent rheumatologist ultrasonographers
Academic Unit of Musculoskeletal Disease, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK, 1Medical Education Unit, School of Medicine, University of Leeds, Leeds LS2 9NL, UK and 2Department of Radiology, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK.
Correspondence to: Dr Andrew K. Brown, Lecturer in Rheumatology, Academic Unit of Musculoskeletal Disease, University of Leeds, Chapel Allerton Hospital, Leeds LS7 4SA, UK. E-mail: andrewkbrown{at}ukonline.co.uk
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Abstract |
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Objectives. Musculoskeletal ultrasonography (MSKUS) has been described by some rheumatologists as the ‘stethoscope of the joint’. Such enthusiasm is supported by evidence confirming validity and clinical utility in evaluation of musculoskeletal diseases. But if rheumatologist-performed MSKUS is to emulate the impact of cardiologist-performed echocardiography, a number of educational challenges need be addressed. Evaluation of current training reveals the absence of a unified educational structure, ad hoc teaching and assessment and published data are insufficient to make practice and training recommendations specific to rheumatology.
Methods. Informed by developments in adult-learning theory, we have utilized a competency-based approach to develop an educational programme for rheumatologist ultrasonographers. Fundamental to this process has been accurate functional analysis of the role of the rheumatologist ultrasonographer and precise translation of these data into educational outcomes. This involved a thorough, transparent, iterative, curriculum-defining approach, employing quantitative and qualitative research techniques including interview, questionnaire, Delphi and standard setting methodologies. All relevant stakeholders were engaged, including international US experts and clinical rheumatologists.
Results. Outcomes include clarification of the role of a rheumatologist ultrasonographer; definition of appropriate knowledge and skills; establishment of competency standards; a balanced, clearly defined, clinically relevant educational outcome blueprint. Teaching and assessment approaches have been piloted as part of an accessible modular curriculum strategy. Thorough validation and evaluation confirms effectiveness, efficiency and suitability.
Conclusions. A comprehensive evidence-based, expert consensus-defined educational framework is proposed that provides a template for teaching and learning and standards for competency assessment. This should facilitate common principles of training, uniform professional practice and a justifiable governance structure.
Submitted 26 July 2006;
revised version accepted 7 November 2006.
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