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Eldeiry L, Katz SJ. A rheumatology practice profile: Implications for subspeciality training in the era of advanced therapies. Musculoskeletal Care 2023; 21:249-252. [PMID: 36082878 DOI: 10.1002/msc.1696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/08/2022]
Affiliation(s)
| | - Steven J Katz
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Villaseñor-Ovies P, Navarro-Zarza JE, Saavedra MÁ, Hernández-Díaz C, Canoso JJ, Biundo JJ, Kalish RA, de Toro Santos FJ, McGonagle D, Carette S, Alvarez-Nemegyei J. A survey of anatomical items relevant to the practice of rheumatology: upper extremity, head, neck, spine, and general concepts. Clin Rheumatol 2016; 35:3025-3030. [PMID: 27539219 DOI: 10.1007/s10067-016-3378-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Accepted: 08/06/2016] [Indexed: 11/25/2022]
Abstract
This study aimed to identify the anatomical items of the upper extremity and spine that are potentially relevant to the practice of rheumatology. Ten rheumatologists interested in clinical anatomy who published, taught, and/or participated as active members of Clinical Anatomy Interest groups (six seniors, four juniors), participated in a one-round relevance Delphi exercise. An initial, 560-item list that included 45 (8.0 %) general concepts items; 138 (24.8 %) hand items; 100 (17.8 %) forearm and elbow items; 147 (26.2 %) shoulder items; and 130 (23.2 %) head, neck, and spine items was compiled by 5 of the participants. Each item was graded for importance with a Likert scale from 1 (not important) to 5 (very important). Thus, scores could range from 10 (1 × 10) to 50 (5 × 10). An item score of ≥40 was considered most relevant to competent practice as a rheumatologist. Mean item Likert scores ranged from 2.2 ± 0.5 to 4.6 ± 0.7. A total of 115 (20.5 %) of the 560 initial items reached relevance. Broken down by categories, this final relevant item list was composed by 7 (6.1 %) general concepts items; 32 (27.8 %) hand items; 20 (17.4 %) forearm and elbow items; 33 (28.7 %) shoulder items; and 23 (17.6 %) head, neck, and spine items. In this Delphi exercise, a group of practicing academic rheumatologists with an interest in clinical anatomy compiled a list of anatomical items that were deemed important to the practice of rheumatology. We suggest these items be considered curricular priorities when training rheumatology fellows in clinical anatomy skills and in programs of continuing rheumatology education.
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Affiliation(s)
- Pablo Villaseñor-Ovies
- Hospital Ángeles de Tijuana, Tijuana, BC, Mexico
- Universidad Autónoma de Baja California, Mexicali, Mexico
| | - José Eduardo Navarro-Zarza
- Hospital General de Chilpancingo Raymundo Abarca Alarcón, Chilpancingo, Gro, Mexico
- Universidad Autónoma de Guerrero, Acapulco, Gro, Mexico
| | - Miguel Ángel Saavedra
- Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
| | - Cristina Hernández-Díaz
- Laboratorio de Ultrasonido Musculoesquelético y Articular, Instituto Nacional de Rehabilitación, México, DF, Mexico
| | - Juan J Canoso
- Centro Médico ABC, México, DF, Mexico
- Tufts Medical School, Boston, MA, USA
| | | | - Robert A Kalish
- Tufts Medical School, Boston, MA, USA
- Tufts Medical Center, Boston, MA, USA
| | - Francisco Javier de Toro Santos
- Servicio de Reumatología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complejo Hospitalario Universitario A Coruña (CHUAC), Sergas, Universidad La Coruña (UDC), Coruña, Spain
| | - Dennis McGonagle
- UK National Institute for Health Research Leeds Musculoskeletal Biomedical Research Unit, Chapel Allerton Hospital, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Simon Carette
- Division of Rheumatology, University Health Network, Mount Sinai Hospital, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
| | - José Alvarez-Nemegyei
- Unidad de Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Yucatán, Mexico
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Navarro-Zarza JE, Hernández-Díaz C, Saavedra MA, Alvarez-Nemegyei J, Kalish RA, Canoso JJ, Villaseñor-Ovies P. Preworkshop knowledge of musculoskeletal anatomy of rheumatology fellows and rheumatologists of seven North, Central, and South American countries. Arthritis Care Res (Hoboken) 2014; 66:270-6. [PMID: 23983095 DOI: 10.1002/acr.22114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 08/07/2013] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To report the baseline knowledge of clinical anatomy of rheumatology fellows and rheumatologists from Argentina, Chile, Ecuador, El Salvador, Mexico, the US, and Uruguay. METHODS The invitation to attend a workshop in clinical anatomy was an open call by national rheumatology societies in 4 countries or by invitation from teaching program directors in 3 countries. Prior to the workshop, a practical test of anatomic structures commonly involved in rheumatic diseases was administered. The test consisted of the demonstration of these structures or their function in the participant's or instructor's body. At one site, a postworkshop practical test was administered immediately after the workshop. RESULTS There were 170 participants (84 rheumatology fellows, 61 rheumatologists, and 25 nonrheumatologists). The overall mean ± SD number of correct answers was 46.6% ± 19.9% and ranged from 32.5-67.0% by country. Rheumatology fellows scored significantly higher than nonrheumatologists. Questions related to anatomy of the hand scored the lowest of the regions surveyed. CONCLUSION Rheumatology fellows and rheumatologists showed a deficit in knowledge of musculoskeletal anatomy that is of central importance in rheumatologic assessment and diagnosis. This gap may hinder accurate and cost-effective rheumatologic diagnosis, particularly in the area of regional pain syndromes. Presently, widespread use of musculoskeletal ultrasound (MSUS) by rheumatologists may be premature, since a key component of expert-level MSUS is the integration of an accurate knowledge of anatomy with the views obtained with the ultrasound probe.
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Affiliation(s)
- José E Navarro-Zarza
- Hospital General de Chilpancingo Dr. Raymundo Abarca Alarcón, Chilpancingo, Guerrero, Mexico
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