Musculoskeletal ultrasound training and competency assessment program for rheumatology fellows

Eugene Y. Kissin, Jingbo Niu, Peter Balint, David Bong, Amy Evangelisto, Janak Goyal, Jay Higgs, Daniel Malone, Midori J. Nishio, Carlos Pineda, Wolfgang A. Schmidt, Ralf G. Thiele, Karina D. Torralba, Gurjit S. Kaeley

Research output: Contribution to journalArticle

18 Citations (Scopus)


Objectives-The purpose of this study was to establish standards for musculoskeletal ultrasound competency through knowledge and skills testing using criterion-referenced methods. Methods-Two groups of rheumatology fellows trained in musculoskeletal ultrasound through a standardized curriculum, which required submission of ultrasound studies for review over 8 months. Both groups then completed written and practical examinations in musculoskeletal ultrasound. Instructors, advanced users, and intermediate users of musculoskeletal ultrasound served as comparison groups. A passing score (competency) was established for the written examination by the Angoff procedure and for the practical examination by the borderline method. Results-Thirty-eight fellows (19 in each group) took the final examination. Five fellows failed the written examination, and 1 failed the practical examination, whereas none of the advanced users failed. Written examination scores did not differ between the two fellow groups (74% versus 70%; P > .05), were reliable, and were able to discriminate between the intermediate and advanced groups. Practical and written examination results correlated in both groups (first group, r = 0.70; P = .0008; second group, r = 0.59; P = .009). Conclusions-Criterion-referenced methods were used for the first time to determine fellow musculoskeletal ultrasound competency. The examination used to determine competency was reproducible, was reliable, and could differentiate musculoskeletal ultrasound users with different levels of experience. Most rheumatology fellows completing our program passed the written and practical examinations, suggesting achievement of basic musculoskeletal ultrasound competency.

Original languageEnglish
Pages (from-to)1735-1743
Number of pages9
JournalJournal of Ultrasound in Medicine
Issue number10
Publication statusPublished - Oct 1 2013


  • Competency
  • Education
  • Examination
  • Musculoskeletal
  • Ultrasound

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Kissin, E. Y., Niu, J., Balint, P., Bong, D., Evangelisto, A., Goyal, J., Higgs, J., Malone, D., Nishio, M. J., Pineda, C., Schmidt, W. A., Thiele, R. G., Torralba, K. D., & Kaeley, G. S. (2013). Musculoskeletal ultrasound training and competency assessment program for rheumatology fellows. Journal of Ultrasound in Medicine, 32(10), 1735-1743.