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Musculoskeletal and Sports Medicine

(Research Hub Theater) Efficacy of a Musculoskeletal Ultrasound Anatomy and Skills Curriculum for Post Grad Year 2, 3, and 4 Physical Medicine and Rehabilitation Residents

Thursday, November 16, 2023
12:45 PM – 2:15 PM CT

    Primary Author(s)

  • Carly J. Rothman, DO (she/her/hers)

    Assistant Professor
    Joseph M. Sanzari Children's Hospital, Hackensack Meridian Health
    West Caldwell, New Jersey

    • Co-Author(s)

  • Andrew McCoy, MD (he/him/his)

    Pediatric Rehabilitation Attending
    The Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania

  • AK

    Amy S. Kanallakan, MD

    Assistant Professor, Program Director PRM Fellowship and Combined Pediatrics/PM&R Residency Programs
    University of Colorado School of Medicine, Dept of PM&R
    Aurora, Colorado

  • Adele Meron, MD

    Assistant Professor
    University of Colorado Denver School of Medicine PM&R Program
    Aurora, Colorado

Background and/or Objectives: Ultrasound (US) exposure and education is an ACGME requirement for Physical Medicine & Rehabilitation (PM&R) residents, however there is currently minimal structured training and assessment of US knowledge and skills within the University of Colorado PM&R residency program. The main focus of the current curriculum is sports and interventional pain medicine, however US is increasingly used by both neurorehabilitation and neuromuscular physiatrists. Previous methods of teaching musculoskeletal (MSK) and peripheral nerve (PN) anatomy was through cadaver dissection and lectures. Cadaver dissection is costly, time-consuming and there have been limitations on this resource due to the COVID-19 pandemic.

Design: Mixed-methods research design.

Setting: PM&R resident didactics.

Participants: PM&R residents.

Interventions: We developed a new US curriculum for PM&R residents using principles of adult education with defined learning goals and objectives. The new curriculum was expanded to include anatomy previously covered in a cadaver course and neurorehabilitation uses of ultrasound. Facilitator and learner guides were developed to ensure standardization and curricular continuity. PM&R attendings and fellows served as session leaders and content experts.

Main Outcome Measures: Pre- and post-course needs assessment, survey, MSK knowledge quiz and US skills assessment.

Results: Fifteen residents participated, 46.7% were Post Graduate Year (PGY)-2. All residents reported they were “likely” or “very likely” to use musculoskeletal ultrasound in their future practice. Most residents reported dedicated time for ultrasound as a barrier to learning MSK ultrasound during residency and agreed a dedicated MSK US curriculum was important. Nearly all (93.3%) residents reported they would prefer to learn anatomy through ultrasound rather than by cadaver dissection. Using a validated pre-course skills assessment, most residents needed improvement in areas of technique and image optimization.

Conclusions: Cadaver dissection is a costly and outdated method of anatomy education for PM&R residents. Our new curriculum teaches relevant anatomy through ultrasound education, a modality increasingly used by physiatrists.