105 - Implementation of a Musculoskeletal Ultrasound Knee Workshop in a Physical Medicine and Rehabilitation Residency: A Quality Improvement Study

Musculoskeletal ultrasound (MSK US) is an increasingly important diagnostic and interventional tool in physical medicine and rehabilitation (PM&R). Despite its clinical relevance, formalized MSK US training during residency remains variable. This project aimed to implement and evaluate a structured ultrasound workshop focused on the knee, with the objective of improving resident knowledge of anatomy, physical exam correlation, and sonographic interpretation, while also exploring trends across training levels.


Design:

This quality improvement study utilized a pre- and post-test design. Twelve residents participated in a single-session knee ultrasound workshop. Prior to the session, residents completed a 10-question knowledge assessment covering knee physical exam maneuvers and MSK US principles, including image-based anatomy identification. Sports medicine-trained faculty led a didactic and hands-on scanning workshop, after which residents repeated the same knowledge test. Average scores were compared descriptively, and an independent samples t-test was applied, as individual responses could not be linked across assessments.


Results:

Twelve residents completed both assessments. The average pre-test score was 68.3%, while the post-test average increased to 75.0%, reflecting a 6.7 percentage point absolute improvement (9.8% relative improvement). When analyzed as independent groups, this difference was not statistically significant (p = 0.35), likely reflecting small sample size and inability to pair responses. The greatest descriptive gains were observed in identifying suprapatellar bursitis (+25%) and Gerdy’s tubercle (+25%). By PGY level, modest improvements were observed among PGY-2s (+5.0%) and PGY-3s (+2.5%), while PGY-4s demonstrated the greatest gains (+12.5%).


Conclusions:

A single-session knee ultrasound workshop led to measurable descriptive improvements in resident knowledge, particularly in applied diagnostic interpretation and anatomical identification. Although statistical significance was not reached, this limitation was expected given the study design. The findings suggest educational benefit, with senior residents deriving the most value. Future iterations should incorporate anonymous identifiers to allow paired analyses, along with longitudinal reinforcement and PGY-specific tailoring.