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. 2023 Nov 27;8(2):146-152.
doi: 10.24908/pocus.v8i2.16229. eCollection 2023.

Dissemination of a Pediatric Musculoskeletal POCUS Scoring System via Virtual Education: A Proof-of-Concept Study

Ysabella Esteban  1 , Jackeline Rodriguez-Smith  2 , Marie Tominna  3 , Amy Cassedy  4 , Arthur B Meyers  5 , Michael Henrickson  2 , Tracy V Ting  2 , Patricia Vega-Fernandez  2
Affiliations

Dissemination of a Pediatric Musculoskeletal POCUS Scoring System via Virtual Education: A Proof-of-Concept Study

Ysabella Esteban et al. POCUS J. .

Abstract

Point of care pediatric musculoskeletal POCUS scanning and scoring protocols for childhood arthritis have emerged in recent years. However, pediatric musculoskeletal POCUS curricula in rheumatology fellowship programs are limited due to availability of trained faculty and resources. This proof-of-concept study investigated the effectiveness of educational methods for a pediatric musculoskeletal POCUS scoring protocol among fellows and physicians of differing subspecialties. Educational methods assessed included recorded videos and virtual review sessions. Effectiveness was assessed by calculating interrater reliability for the musculoskeletal POCUS scoring systems using the intra-class correlation coefficient (ICC). Following training sessions, participants then underwent scoring exercise(s) until the goal of an excellent ICC ≥ 0.75 was reached. Four participants completed two rounds of virtual education, review, and scoring sessions. Excellent interrater reliability was achieved for most views. This proof-of-concept study demonstrated virtual education covering advanced concepts of pediatric musculoskeletal POCUS provides a knowledge base for physicians from different subspecialties and various experience.

Keywords: arthritis; musculoskeletal ultrasound; paediatric POCUS; point of care ultrasound education.

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Conflict of interest statement

Dr. Vega-Fernandez’s work was supported by the Center for Clinical & Translational Science & Training (CCTST) at the University of Cincinnati funded by the National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) program, grant 2UL1TR001425-05A1 and KL2 (2KL2TR001426-05A). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Figures

Figure 1
Figure 1. Methods. Methodology used for education and scoring exercises. Participants included 3 fellows in training from pediatric rheumatology (2) and pediatric radiology (1), as well as 1 attending from musculoskeletal radiology. Sessions were led by a trained pediatric Musculoskeletal Ultrasound Certification in Rheumatology (RhMSUS) certified sonographer of >10 years. Education materials covered normal sonographic anatomy, pathologic findings related to arthritis, as well as a semiquantitative scoring system., Scoring exercises were comprised of still images using B- and PD-mode, representative of normal and pathologic findings. Assessment used intra-class correlation coefficient (ICC) with goal of 0.75 or greater for the lower confidence interval (CI) for each joint., Education and scoring were repeated if this goal was not achieved per joint and view.
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