Neuromuscular ultrasound competency assessment: Consensus‐based survey

Abstract

Neuromuscular ultrasound is a rapidly evolving specialty with direct application for patient care. Competency assessment is an essential standard needed to ensure quality for practitioners, particularly for those newly acquiring skills with the technique. Our aim was to survey experts' opinions regarding physician competency assessment of neuromuscular ultrasound and to identify minimal competency of knowledge and skills. The opinions of 18 experts were obtained through the Delphi method using two consecutive electronic surveys. A high degree of consensus was achieved on items regarding framework and the conduct of neuromuscular ultrasound assessment and the knowledge and skills that a candidate needs to attain minimal competency in neuromuscular ultrasound. In this study, a group of neuromuscular ultrasound experts developed a general framework for neuromuscular ultrasound competency assessment and recommended testable areas of knowledge and skills suitable for establishing minimal competency.

Developing a framework for neuromuscular ultrasound training and accreditation

“…In this way, even relatively small groups of experts can generate a consensus on a topic where equal weight is given to the opinions of each member of the panel, thereby preventing a dominant opinion from determining the outcome 12 . The recommendations for competency assessment of NMUS presented by Tawfik and colleagues 7 are largely in line with the structures proposed for cardiac MRI which speaks to the universality of health education goals as well as the success of the Delphi process.…”

“…5 Further the current AMA position is that: In this issue of Muscle & Nerve, a panel of 18 NMUS experts used the Delphi method to form a consensus on how to assess the minimal competency required to perform NMUS studies. 7 The core recommendations included that certifying examinations should establish a minimum standard (rather than a knowledge of all details of NMUS).…”

“…12 For example, groups of experts who share common educational and geographic backgrounds may be more likely to agree with each other, and this may be particularly relevant to a nascent subspecialty like NMUS, where a founder effect from the early adopters is likely. With respect to this expert cohort, 7 the majority of the experts were from North America and Europe, with only one expert each from the Middle East, Asia, and Australia. Although As the popularity of NMUS increases, there is a greater need for suitable training and credentialing.…”

“…Therefore, it is now important for those clinicians who want to incorporate ultrasound into their clinical practice to be assessed against a common standard to ensure the adequacy of their skill and training, and a supply of future mentors with sufficient experience and expertise to train the next crop of practitioners. This is why the development of standard training and assessment criteria in NMUS should be approached with some urgency, hence the importance of the report by Tawfik et al 7 Identifying an adequate number of appropriate supervisors is likely to be the greatest challenge. Experienced NMUS practitioners are relatively sparsely distributed throughout the world and are substantially outweighed by the number of trainees with an interest in learning the technique.…”

“…For example, groups of experts who share common educational and geographic backgrounds may be more likely to agree with each other, and this may be particularly relevant to a nascent subspecialty like NMUS, where a founder effect from the early adopters is likely. With respect to this expert cohort, 7 the majority of the experts were from North America and Europe, with only one expert each from the Middle East, Asia, and Australia. Although this somewhat reflects the distribution of research activity in NMUS the recommendations may not accommodate the specific requirements of training in countries not represented in the group, despite the consensus statement concluding that competency assessment should be developed as an international process.…”