Improving the Quality of Care in the Specialization: The Benefits of “Hands-on” Courses for Learning Neuromuscular Ultrasound
26 April 2017 (online)
Background: The benefits of neuromuscular ultrasound (NMU) for diagnosis and documentation in neuromuscular diseases are well documented. To improve the accuracy of intramuscular injection of botulinum toxin, the method is evolving to be the gold standard. A structured training to learn neuromuscular sono-anatomy is available only to a limited extent.
Method: A prospective cohort analysis was conducted to evaluate the knowledge increase after participation in “Hands-on” NMU courses. In a query, 16 sono-anatomical structures (cross-sectional images of muscles, neurovascular bundles and bones) on upper and lower extremity were presented to the course participants. The query was made at the beginning and end of the course.
Results: In 2016, a total of 56 specialists (neuropediatrics, neuro-orthopaedics, rehabilitation medicine, and radiology) participated in three “Hands-on” NMU courses (EACD, Sweden: n = 19; focus CP, Germany: n = 12; AACPDM, United States: n = 25). In Germany, 83% of respondents indicated prior knowledge with NMU (United States 58%, Sweden 26%). Before the courses, 57% of the structures could be identified correctly. To the end of course, the correct identification increased to 81% (focus CP + 22%, AACPDM + 24%, EACD + 26%). The greatest increase was achieved in mapping the structures on the forearm (30% > 76%). Knowledge increase on the upper arm was lowest (68% > 80%). Hips and thighs showed an improvement from 58 to 90% and the lower leg from 68 to 84%.
Conclusion: “Hands-on” neuromuscular ultrasound courses offer the possibility for a compact but effective transfer of skills to medical specialists with high relevance for the clinical practice. A structured training with focus on neuromuscular ultrasound should be established regularly in the framework program of specialized conferences.