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Impact of a lung ultrasound course for rheumatology specialists (IMPACT-2)

1, 2, 3, 4, 5

 

  1. Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
  2. Division of Rheumatology, Department of Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
  3. Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Loma Linda University; and Section of Pulmonology and Critical Care, Loma Linda Veterans Affairs Hospital, Loma Linda, CA, USA.
  4. Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
  5. Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, and Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA. vadinh@llu.edu

CER11277
2019 Vol.37, N°3
PI 0380, PF 0384
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PMID: 30183605 [PubMed]

Received: 29/03/2018
Accepted : 18/06/2018
In Press: 29/08/2018
Published: 10/05/2019

Abstract

OBJECTIVES:
Lung ultrasound (LUS) plays an increasing role in diagnosis and monitoring of interstitial lung disease (ILD). Connective tissue disorders (CTD) frequently cause ILD, and often presents symptomatically after irreversible fibrosis has ensued. As point-of-care musculoskeletal ultrasound (US) is commonly utilised by rheumatologists, translating this US expertise towards LUS places the rheumatologist in a position to screen for ILD. However, a standardised curriculum for the rheumatology community is lacking. The aim of this study is to determine the effectiveness of a formalised lung US training course for rheumatologists.
METHODS:
Four rheumatology fellows and four board-certified rheumatologists participated in a 4-hour training session. Pre-course, post-course and 6-month follow-up surveys evaluated perceptions towards previous US experience, training, clinical utility and attitudes toward lung US. Didactics explained the protocols utilised in ILD evaluation. Evaluation of knowledge in US physiology, lung anatomy, artifact and pathology recognition were done through written exams before, after training, and at 6 months and through a practical exam using live models and simulation.
RESULTS:
Temporally there was overall improvement in written test scores. Improvement was noted in overall practical skill score following training course (17.4% vs. 92.9%, p<0.001), in written test scores 49.3% vs. 72.5% p<0.001), and pathology identification (26.5% vs. 79.6%, p<0.001). Six-month follow assessments were similar to post-test results revealing similar written scores (70.6%) and practical scores (89.7%).
CONCLUSIONS:
This formalised lung ultrasound training course was effective in improving skills and knowledge of rheumatology specialists.

Rheumatology Article