Extreme musculo-skeletal ultrasound: Training of non-physicians in the Arctic Circle

Objective: The purpose of this study was to compare if non-physician, inexperienced ultrasound subjects can take quality diagnostic images after watching a brief educational video and using reference cue cards (autonomous group) versus taking ultrasound images with expert guidance using a satellite connection. Methods: Six non-medical, inexperienced ultrasound subjects from a rural area (Arctic Circle) obtained ultrasound images of target anatomic regions using a portable ultrasound device after receiving expert-guided training or autonomous training (educational video and cue cards). Real-time expert guidance was provided using an audiovisual tele-ultrasound connection with direct ultrasound video compression which was relayed to a remote expert via a secure satellite connection. The resultant images from all studies were blindly reviewed by imaging experts for determination of diagnostic adequacy. Results: All of the examinations were completed in <15 min. The blinded expert identified 85.1% of autonomously acquired images and 86.2% of the images obtained by expert guidance to be of diagnostic quality; there was no statistical difference between the two groups (P = 0.6653). Conclusion: Non-physician, inexperienced subjects can quickly educate themselves to retrieve diagnostic quality ultrasound images whether they are being expert-guided or trained autonomously. © 2011 Springer-Verlag.