Premium
Musculoskeletal Ultrasound Objective Structured Clinical Examination: An Assessment of the Test
Author(s) -
Kissin Eugene Y.,
Grayson Peter C.,
Cannella Amy C.,
DeMarco Paul J.,
Evangelisto Amy,
Goyal Janak,
al Haj Rany,
Higgs Jay,
Malone Daniel G.,
Nishio Midori J.,
Tabechian Darren,
Kaeley Gurjit S.
Publication year - 2014
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22105
Subject(s) - medicine , intraclass correlation , objective structured clinical examination , inter rater reliability , quartile , physical therapy , construct validity , ankle , reliability (semiconductor) , test (biology) , wrist , physical examination , psychometrics , rating scale , surgery , psychology , medical education , confidence interval , clinical psychology , developmental psychology , power (physics) , physics , paleontology , quantum mechanics , biology
Objective To determine the reliability and validity of an objective structured clinical examination (OSCE) for musculoskeletal ultrasound (MSUS). Methods 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. Results 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). Conclusion 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.