345 - Neuromuscular Ultrasound Training Initiative

Objectives: As for many PM&R residency programs throughout the nation, there is an ongoing need for neuromuscular ultrasound exposure. A common complaint amongst residents is a difficulty in identifying high-yield clinically relevant information. Our aim was to develop a standardized training program for PM&R residents rotating at our local hospital focused on common pathologies for the general physiatrist, create a consistent tool to evaluate both subjective comfort level (resident-graded) and ultrasound competency (faculty-graded), and generate a sustainable model to enhance ultrasound education.

Design: Our first goal was to identify the problem of decreased ultrasound competency/comfort amongst residents. We then created a curriculum that was taught by one of our faculty members to residents. A pre and post intervention survey with Likert scales was developed. Finally, we analyzed the pre- and post-intervention survey data to investigate its validity in improving both comfort and competency. A total of 15 pre/post surveys were completed by 13 unique residents (2 repeats who rotated for multiple blocks). 8 unique residents were analyzed for competency by the attending physician (7 with missing data points excluded). 10 unique residents were analyzed for subjective confidence (5 with missing data points excluded).

Results: There was a significant difference for both subjective scores and competency scores when comparing pre- and post-interventions (p=0.001). The top 3 interventions residents felt most comfortable with after the ultrasound workshops were the suprapatellar recess, glenohumeral joint, and carpal tunnel.

Conclusions: Most residents did not feel confident in their interventional ultrasound skills but showed much improved comfort after completing our curriculum. Limitations of this study included a relatively small sample size, competency assessment grading biases, the subjective nature of a Likert Scale, and observer-expectancy bias. It is vital that residents get more formal training and practice with ultrasound skills to translate it into real practice and improve patient outcomes.