259. Mobile Mentoring: An Ultrasound Training Initiative

Abstract

Background: Direct supervision of musculoskeletal ultrasound (MSUS) by an expert mentor is recognized as the best method of training. Lack of access to mentors creates a barrier to learning and limits the capacity for individuals to train in MSUS. Methods: The Scottish Rheumatology Ultrasound Group (SRUG) was formed 3 years ago by members of the Scottish Society of Rheumatology with a particular interest in musculoskeletal ultrasound. It aims to encourage and support rheumatologists and allied healthcare professionals who wish to develop their skills in musculoskeletal ultrasound in rheumatology. SRUG has organized a number of initiatives including an annual Teach the Teachers Course, one of whose aims was to identify individuals who might eventually become teachers of MSUS. During these courses, it became clear that a significant barrier to progress, for a number of members, was the lack of access to a local mentor. Accordingly, we developed an initiative whereby a recognized mentor in MSUS (AT) spent a week visiting selected trainees in their own hospitals to conduct mentoring sessions using patients selected by the trainee. Results: Seven rheumatology centres across Scotland expressed an interest in the training initiative and four participated. Trainees had to have a basic knowledge of MSUS and have exclusive access to an ultrasound machine of the requisite quality. Lead clinicians from each centre were asked to prioritize their training needs before the visit and to assemble a selection of interesting patients deemed suitable for scanning. One day was allocated for the visit to each centre. Training consisted of practical scanning sessions (with at least 30 minutes allocated to each patient) and a review of interesting images obtained by both the trainee and the mentor prior to the visit. Didactic lectures did not form part of the training. AT provided a confidential feedback report to the lead clinician in each centre with specific advice on future training goals and local obstacles to learning. Nine trainees from four centres (six rheumatologists and three allied healthcare professionals) participated in the initiative. Written feedback from the trainees was generally very positive and a number of common themes emerged. In particular, it became clear that MSUS skills are best acquired in the setting of a dedicated scanning joint assessment clinic (this often evolves out of a conventional joint injection clinic). Conclusion: A mobile mentoring initiative in MSUS training evolved from a series of Teach the Teachers Courses organized by the SRUG. The initiative involved a visit by the MSUS mentor to the trainees' own unit. The mentorship concentrated on developing practical scanning skills and on identifying local obstacles to progress. We hope to repeat this initiative in 6 months' time.