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

Abstract

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.

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

“…Moreover, pre‐recording the videos avoids video lag that commonly occurs when using online video communication platforms. An attractive alternative to hands‐on training is teleguidance which allows distant supervised scanning 1,2,4 . Teleguidance involves simultaneous live streaming of the ultrasound image and/or the scanning technique via a virtual platform or directly through a hand‐held ultrasound device (eg, Butterfly iQ, Butterfly Network, Guilford, CT).…”

“…Either setting allows the faculty to evaluate the displayed image and guide the learner to capture the optimum image. We did not consider teleguidance in our courses because it is more suitable for one‐on‐one training, or at most a very small group of trainees, 1,2,4 while our courses were planned to target a broader audience on a global level.…”

“…An attractive alternative to hands-on training is teleguidance which allows distant supervised scanning. 1,2,4 Teleguidance involves simultaneous live streaming of the ultrasound image and/or the scanning technique via a virtual platform or directly through a hand-held ultrasound device (eg, Butterfly iQ, Butterfly Network, Guilford, CT). Either setting allows the faculty to evaluate the displayed image and guide the learner to capture the optimum image.…”

“…As a result, the Egyptian Neuromuscular Ultrasound Society converted the in‐person neuromuscular courses that were planned to be held in August 2020 into virtual courses. A few reports have documented the effectiveness of virtual education in different ultrasound domains, 1‐3 and one has addressed residents' neuromusculoskeletal education via teleguidance technology, 4 but none has reported the designs or participants' views of virtual neuromuscular ultrasound courses. Therefore, the authors' aims in this report were to: (1) determine the feasibility of conducting virtual neuromuscular ultrasound courses during the COVID‐19 pandemic; and (2) report the positive and the negative aspects of the courses through the analyses of the responses of post‐course surveys.…”

A Hybrid Musculoskeletal Ultrasound Curriculum for Physical Medicine and Rehabilitation Residents—a Multi-center Pilot Program

“…With the emergence of the COVID-19 pandemic, more teleguided technology has been utilized, which can supplement education to increase familiarity and training frequency. To enhance MSKUS residency education, novel approaches are being developed for distance learning with real-time ultrasound (US) visualization and instructor feedback [ 29 , 30 •, 31 •, 32 ]. This facilitates opportunities for more contact hours, didactic learning, and collaboration between programs/specialties.…”