Using ultrasound imaging to assess novice physiotherapy students' ability to locate musculoskeletal structures with palpation

Physiotherapy. 2021 Dec:113:53-60. doi: 10.1016/j.physio.2021.05.006. Epub 2021 May 26.

Abstract

Objective: Use ultrasound imaging to assess success rates of novice physiotherapy students attempting to locate two tendons and two joint spaces using palpation.

Design: Cross-sectional study.

Setting: Master of physiotherapy program at an academic institution.

Participants: Twenty-two end of first-year physiotherapy students.

Methods: Participants were asked to palpate and locate the long head of the biceps (LHBT) and tibialis posterior (PTT) tendons as well as the acromioclavicular joint (ACJ) and medial tibiofemoral joint (TFJ) spaces on two human models. A truncated needle was taped onto the skin, parallel to the palpated structure. Ultrasound imaging was used to assess the position of the needle relative to the structures.

Main outcome measures: Success or failure was determined based on a judgment call on the needle position relative to the targeted structure on the ultrasound images. Inter-evaluator agreement for judgment criteria was investigated using Cohen's kappa tests and success rates subsequently calculated.

Results: Kappa coefficients were 1.00 for all structures collectively, 1.00 for LHBT and PTT tendons, 1.006 for ACJ, and 0.79 for TFJ. Palpation success rates were: 9% for LHBT, 64% for PTT, 23% for ACJ, and 31% for medial TFJ.

Conclusion: These results highlight the fact that there is room for improvement in anatomy and palpation skill teaching methods and ultrasound imaging is valuable tool to assess this important skill.

Keywords: Education; Palpation; Physiotherapy; Ultrasound.

MeSH terms

  • Clinical Competence*
  • Cross-Sectional Studies
  • Humans
  • Palpation* / methods
  • Physical Therapy Modalities
  • Students
  • Ultrasonography / methods