Virtual neuromuscular ultrasound courses during COVID-19 pandemic: Leveraging technology to enhance learning opportunities.

INTRODUCTION/AIMS: Hands-on supervised training is essential for learning diagnostic ultrasound. Unfortunately, the coronavirus disease 2019 (COVID-19) pandemic led to suspension of in-person training courses. As a result, many hands-on training courses were converted into virtual courses during the pandemic. Several reports regarding virtual ultrasound courses exist, but none has addressed virtual neuromuscular ultrasound courses, their design, or participants' views of this form of training. Therefore, the aims of this study were: (1) to determine the feasibility of conducting virtual neuromuscular ultrasound courses during the COVID-19 pandemic; and (2) to report the positive and negative aspects of the courses through the analyses of the responses of post-course surveys. METHODS: Two virtual neuromuscular ultrasound courses, basic and intermediate level, were conducted by the Egyptian Neuromuscular Ultrasound society during August 2020. Post-course, the attendees were directed to an electronic survey that consisted of eight questions. Ninety-three responses (23.8%) were obtained from the survey of the basic course and 156 responses (44.4%) were obtained from the survey of the intermediate course. RESULTS: Ninety-eight percent of the respondents to basic course surveys, and 100% of the respondents to the intermediate course survey found the courses useful or very useful. DISCUSSION: This report demonstrates the utility of virtual neuromuscular ultrasound courses for those participants willing to respond to a survey and describes a proposed design for such courses. Although hands-on supervised ultrasound training is ideal, virtual courses can be useful alternatives to in-person training when in-person interaction is restricted.

Ultrasound guided anterior approach to intra-articular injection of the knee.

In this clinical practice article, we describe a novel, anterior, approach for therapeutic intra-articular injection of the knee under ultrasound guidance. The benefits of this approach are improved accuracy in knees that do not have an effusion, simplified sonoanatomy for learners, and easy localization in patients with enlarged body habitus or altered anatomy. This article describes the positioning, sonographic anatomy, risks, and technical considerations for this anterior approach.

Neuromuscular ultrasound competency assessment: Consensus-based survey.

Neuromuscular ultrasound is a rapidly evolving specialty with direct application for patient care. Competency assessment is an essential standard needed to ensure quality for practitioners, particularly for those newly acquiring skills with the technique. Our aim was to survey experts' opinions regarding physician competency assessment of neuromuscular ultrasound and to identify minimal competency of knowledge and skills. The opinions of 18 experts were obtained through the Delphi method using two consecutive electronic surveys. A high degree of consensus was achieved on items regarding framework and the conduct of neuromuscular ultrasound assessment and the knowledge and skills that a candidate needs to attain minimal competency in neuromuscular ultrasound. In this study, a group of neuromuscular ultrasound experts developed a general framework for neuromuscular ultrasound competency assessment and recommended testable areas of knowledge and skills suitable for establishing minimal competency.

Guidelines for neuromuscular ultrasound training.

Neuromuscular ultrasound has become an essential tool in the diagnostic evaluation of various neuromuscular disorders, and, as such, there is growing interest in neuromuscular ultrasound training. Effective training is critical in mastering this modality. Our aim was to develop consensus-based guidelines for neuromuscular ultrasound training courses. A total of 18 experts participated. Expert opinion was sought through the Delphi method using 4 consecutive electronic surveys. A high degree of consensus was achieved with regard to the general structure of neuromuscular ultrasound training; the categorization of training into basic, intermediate, and advanced levels; the learning objectives; and the curriculum for each level. In this study, a group of neuromuscular ultrasound experts established consensus-based guidelines for neuromuscular ultrasound training. These guidelines can be used in the development of the specialty and the standardization of neuromuscular ultrasound training courses and workshops.

Manual wheelchair skills capacity versus performance.

OBJECTIVES: To test the hypotheses that self-reported manual wheelchair skills capacity and performance are highly correlated and that capacity significantly exceeds performance. DESIGN: Cross-sectional. SETTING: Rehabilitation center. PARTICIPANTS: Manual wheelchair users (N=26) with a variety of diagnoses and an average of 10.8 years of wheelchair experience. INTERVENTIONS: None. MAIN OUTCOME MEASURE: We administered the questionnaire version of the Wheelchair Skills Test version 4.1 (WST-Q), recording the participants' capacity and performance scores on each of 32 skills. RESULTS: The mean total WST-Q capacity and performance scores ± SD were 72.5%±19.2% and 58.1%±21.2%. The Spearman rho correlation coefficient between total WST-Q capacity and performance scores was .853 (P=.000). The mean difference ± SD in total WST-Q scores (capacity minus performance) was 14.4%±9.5% with a median of 10.9% (P=.000 on a Wilcoxon signed-rank test). There were 9 (28%) of the 32 skills for which the participants' mean capacity success rates were ≥20% higher than the mean performance success rates. Of the reasons for not performing individual skills, 66% of the instances were because the participant lacked the capacity. A variety of other reasons were given by participants for not performing skills of which they were capable (eg, the situation was not encountered, it could be avoided, or assistance was usually available). CONCLUSIONS: Manual wheelchair skills capacity and performance are highly correlated but capacity exceeds performance, more so for some skills than others. Although further study is needed, these findings have implications for the assessment and training of wheelchair skills.

Education in the Time of COVID: At-a-Distance Training in Neuromusculoskeletal Ultrasonography.

Point of care ultrasound is important to the specialty of physical medicine and rehabilitation (PM&R) to aid in the diagnosis and treatment of a variety of neuromusculoskeletal conditions commonly seen in practice. However, across Canada, resident education of sonoanatomy skills is variable. There remain no standards in terms of how ultrasound is taught as part of the residency curriculum as set by the Royal College of Physicians and Surgeons of Canada. As such, residents are often required to find their own educational opportunities. This report describes an alternative approach to learning these skills that was inspired by disruption due to coronavirus disease 2019 in first year residency. This report explores how a PM&R resident was able to develop valuable ultrasound skills from home using not only textbooks and videos, but also new and novel teleguidance technology, namely an ultrasound probe that connects to a clinician's own smart devices to display images.