Background/Purpose: While point-of care ultrasound (POCUS) training is increasingly introduced during rheumatology fellowship, limited exposure may not provide the depth or continuity needed to build clinical readiness. Structured, mentored experiential learning, grounded in hands-on skill building and real-time feedback, may help bridge this gap by fostering both technical proficiency and learner confidence.

Methods: Survey data were collected from participants in the 2024 and 2025 Ultrasound School of North American Rheumatologists (USSONAR) Fundamentals Musculoskeletal Ultrasound (MSKUS) workshops, part of a national hands-on training program in rheumatology-focused ultrasound. Participants included fellows and post-fellowship clinicians in academic and private practice settings. Demographic characteristics were comparable across cohorts, supporting the validity of pooled confidence analysis. Retrospective pre-post surveys (administered post-course) assessed perceived knowledge, confidence in scanning and interpretation, and clinical application. Due to a split survey format in 2024, knowledge and application responses could not be individually paired, limiting analysis to confidence data only. 2025 survey data included all survey domains. Confidence scores from both years were pooled for aggregate analysis. Knowledge and clinical application scores were converted to a 0-10 scale to align with the confidence variable. Responses were analyzed using paired t-tests and Spearman correlations.

Results: Among the 2025 cohort (n = 69), perceived knowledge increased by a mean of 2.25 points (SD = 1.7, p < 0.0001), with a post-course mean of 8.33 (SD = 1.4). Post-course confidence in scanning and interpretation, available from both 2024 and 2025 cohorts, averaged 7.34 across the combined group (SD= 1.38, n = 116), suggesting moderate-to-high technical assurance. Correlation analyses, conducted using 2025 data, showed post-course knowledge was positively associated with confidence in MSKUS scanning and interpretation (Spearman's ρ= 0.48, p < 0.0001). Confidence in scanning also correlated with perceived ability to apply ultrasound skills in clinical practice (ρ = 0.38, p < 0.0001). A one-point increase in confidence was associated with a 0.5-point increase in perceived knowledge. There was no significant difference in post-course confidence scores between fellows and post-fellowship clinicians (p= 0.30), suggesting a reproducible and equitable impact across training levels.

Conclusion: These findings suggest that structured, mentored hands-on training increases learner confidence and technical proficiency, and supports clinical utilization of POCUS in clinical practice. The results support a confidence-driven development model in which experiential learning contributes to clinical readiness. Consistent confidence scores across cohorts support the reproducibility of this model and highlight reliable learning patterns. As POCUS becomes more integrated into rheumatology practice, these findings underscore the need to expand structured training and promote curriculum alignment with competency benchmarks, as reflected in the RhMSUS certification pathway.

TABLE.1 Demographic Characteristics of Workshop Participants in 2024 and 2025

Figure1: Relationship between perceived knowledge and confidence in scanning

Figure2: Relationship between perceived ability to apply MSKUS into clinical practice and confidence in scanning

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/bridging-the-musculoskeletal-ultrasound-training-gap-analysis-of-confidence-competency-and-clinical-readiness/