Dr. Kissin receives royalties from Gulfcoast Ultrasound for the wrist ultrasound video.
Special Theme Article: Clinical Imaging and the Rheumatic Diseases
Musculoskeletal Ultrasound Objective Structured Clinical Examination: An Assessment of the Test†
Article first published online: 24 DEC 2013
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 1, pages 2–6, January 2014
How to Cite
Kissin, E. Y., Grayson, P. C., Cannella, A. C., DeMarco, P. J., Evangelisto, A., Goyal, J., al Haj, R., Higgs, J., Malone, D. G., Nishio, M. J., Tabechian, D. and Kaeley, G. S. (2014), Musculoskeletal Ultrasound Objective Structured Clinical Examination: An Assessment of the Test. Arthritis Care Res, 66: 2–6. doi: 10.1002/acr.22105
The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the U.S. Air Force, the Department of Defense, or the U.S. Government.
- Issue published online: 24 DEC 2013
- Article first published online: 24 DEC 2013
- Accepted manuscript online: 7 AUG 2013 01:24PM EST
- Manuscript Accepted: 31 JUL 2013
- Manuscript Received: 13 MAR 2013
- Clinician Scholar Educator Award from the Rheumatology Research Foundation
To determine the reliability and validity of an objective structured clinical examination (OSCE) for musculoskeletal ultrasound (MSUS).
A 9-station OSCE was administered to 35 rheumatology fellows trained in MSUS and to 3 expert faculty (controls). Participants were unaware of joint health (5 diseased/4 healthy). Faculty assessors (n = 9) graded image quality with predefined checklists and a 0–5 global rating, blinded to who performed the study. Interrater reliability, correlation between a written multiple choice question examination (MCQ) and OSCE performance, and comparison of fellow OSCE results with those of the faculty were measured to determine OSCE reliability, concurrent validity, and construct validity.
Assessors' interrater reliability was good (intraclass correlation coefficient [ICC] 0.7). Score reliability was good in the normal wrist and ankle stations (ICC 0.7) and moderate in the abnormal wrist and ankle stations (ICC 0.4). MCQ grades significantly correlated with OSCE grades (r = 0.52, P < 0.01). The fellows in the bottom quartile of the MCQ scored 3.07 on the OSCE, significantly worse than the top quartile fellows (3.32) and the faculty (3.29; P < 0.01). Scores also significantly discriminated bottom quartile fellows from faculty in the normal wrist and ankle stations (3.38 versus 3.78; P < 0.01), but not in the abnormal stations (3.37 versus 3.49; P = 0.08).
MSUS OSCE is a reliable and valid method for evaluation of MSUS skill. Normal joint assessment stations are more reliable than abnormal joint assessment stations and better discriminate poorly performing fellows from faculty. Therefore, MSUS OSCE with normal joints can be used for the assessment of MSUS skill competency.