DOI: 10.1002/acr.80126 ISSN: 2151-464X

Expert Consensus Recommendations for Musculoskeletal Ultrasound Education in Canadian Rheumatology Residency Programs

Maria F Powell, Steven G Thomson, Sahil Koppikar, Susan G Barr, Shirley Lake, Lihi Eder, Michael Stein, Gurjit S Kaeley, Christopher J Penney, Mohammad Bardi, Sibel Z Aydin, Christopher Lyddell, Maggie J Larché, Minna J Kohler, Janeve Desy, Pooneh Akhavan, Samar Aboulenain, Ashley K Yip, Adam Kovacs‐Litman, Dana C Jerome, Kevin J McLaughlin, Irene W Y Ma
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Objective

We aimed to develop expert consensus recommendations for musculoskeletal ultrasound (MSUS) education in Canadian rheumatology residency programs.

Methods

This three‐stage consensus study used an international working group of 13 MSUS experts and 5 non‐expert stakeholders and incorporated cognitive load theory to ensure educational feasibility. In stage one, MSUS experts participated in a modified nominal group technique (NGT) to generate and prioritize items for stage two. In stage two, the working group completed three survey rounds using a modified Delphi technique, with consensus defined as agreement > 70%. In stage three, experts reviewed items from stage two in a structured focus group, rating each for clinical utility, learnability, and feasibility of national implementation.

Results

The NGT generated 30 prioritized anatomical areas and pathologies. The Delphi working group represented 7/12 (58%) Canadian rheumatology programs (English stream) and two U.S. experts. The response rate across all Delphi rounds was 100%. Round one included 83 items, round two included 52, and round three included nine. Consensus was reached on all but five items, yielding 42 core and 38 optional items. In the structured focus group, consensus was reached that all core items are clinically valuable, learnable for rheumatology residents, and feasible for national implementation. Core items were then organized into 33 MSUS competencies, encompassing general ultrasound skills, features of inflammatory arthritis in the hands, wrists, and MTP joints, double contour sign in the MTP joints, and effusion detection in the knee and ankle joints.

Conclusion

These recommendations provide a foundation for standardized MSUS curricula in rheumatology residency programs.

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