Background/Purpose: There is increasing interest in procedural training at all levels of medical education. While point of care ultrasound (POCUS) and joint injection are not specific requirements of Internal Medicine (IM) training curricula, they are at times included. The aim of this study was to assess the feasibility of an integrated approach to delivering musculoskeletal (MSK) POCUS and joint injection education to Internal Medicine trainees.

Methods: A pilot workshop for IM trainees was created. The workshop consisted of pre-session materials (videos and step-by-step guides to both ultrasound of the knee and knee aspiration and injection), a pre- and post-session knowledge check consisting of two identical multi-sectional cases involving the use of POCUS and joint aspiration/injection in a clinical context and three, 30-minute hands-on small groups sessions on 1: knee ultrasound, 2: knee aspiration and injection and 3: data interpretation/clinical context. Paired t-test was used to compare the pre- and post-session knowledge check scores with a value p< 0.05 deemed significant. In addition, post-workshop, feedback in the form of a five-point Likert scale (1 = not at all, 5 = extremely) on each component of the workshop and free text comments were solicitated from participants.

Results: Sixteen IM trainees participated in the pilot workshop (7 Post-Graduate Year (PGY)-1, 4 PGY-2, 4 PGY-3, 1 PGY-4). Eleven subjects had improvement in their test scores after the workshop, three scored the same pre- and post-workshop and one had a lower score post-workshop (Figure 1). The mean test score increased from 5.5 pre-workshop to 7.3 post-workshop (p=0.001). Feedback from the group was overall positive with the majority rating each distinct aspect of the workshop either extremely or very useful (Table 1). The three most common feedback comments included 1: obtaining models for different joints in addition to the knee 2: more time to practice MSK POCUS and 3: more examples of pathological states.

Conclusion: An integrated workshop combining ultrasound, aspiration and injection of the knee joint in combination with education around the clinical use and context of these procedures was feasible. In addition, participants found the workshop valuable, leading to increased knowledge post-workshop. Future work is planned to expand this workshop to an entire IM residency program.

Figure 1. Scores for pre-test cases and post-test cases.

Table 1. Post-workshop feedback (%).

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/introduction-of-a-joint-injection-and-ultrasound-workshop-for-internal-medicine-trainees/