scholarly journals 2019 EULAR points to consider for the assessment of competences in rheumatology specialty training

2020 ◽  
Vol 80 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Francisca Sivera ◽  
Alessia Alunno ◽  
Aurélie Najm ◽  
Tadej Avcin ◽  
Xenofon Baraliakos ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Training Programme ◽  
Assessment Practices ◽  
Specialty Training ◽  
Sufficient Time ◽  
Effective Implementation ◽  
European League Against Rheumatism ◽  
Training Programmes ◽  
Level Of Agreement

Background and aimStriving for harmonisation of specialty training and excellence of care in rheumatology, the European League Against Rheumatism (EULAR) established a task force to develop points to consider (PtCs) for the assessment of competences during rheumatology specialty training.MethodsA systematic literature review on the performance of methods for the assessment of competences in rheumatology specialty training was conducted. This was followed by focus groups in five selected countries to gather information on assessment practices and priorities. Combining the collected evidence with expert opinion, the PtCs were formulated by the multidisciplinary task force, including rheumatologists, medical educationalists, and people with rheumatic and musculoskeletal diseases. The level of agreement (LoA) for each PtC was anonymously voted online.ResultsFour overarching principles and 10 PtCs were formulated. The overarching principles highlighted the importance of assessments being closely linked to the rheumatology training programme and protecting sufficient time and resources to ensure effective implementation. In the PtCs, two were related to overall assessment strategy (PtCs 1 and 5); three focused on formative assessment and portfolio (PtCs 2–4); three focused on the assessment of knowledge, skills or professionalism (PtCs 6–8); one focused on trainees at risk of failure (PtC 9); and one focused on training the trainers (PtC 10). The LoA (0–10) ranged from 8.75 to 9.9.ConclusionThese EULAR PtCs provide European guidance on assessment methods throughout rheumatology training programmes. These can be used to benchmark current practices and to develop future strategies, thereby fostering continuous improvement in rheumatology learning and, ultimately, in patient care.

Differences and similarities in rheumatology specialty training programmes across European countries

2015 ◽  
Vol 74 (6) ◽  
pp. 1183-1187 ◽  
Author(s):  
Francisca Sivera ◽  
Sofia Ramiro ◽  
Nada Cikes ◽  
Maxime Dougados ◽  
Laure Gossec ◽  
...  
Keyword(s):  
National Curriculum ◽  
Training Programme ◽  
Steering Committee ◽  
European Countries ◽  
Standards Of Care ◽  
Specialty Training ◽  
Internal Medicine Training ◽  
General Internal ◽  
European League Against Rheumatism ◽  
Training Programmes

ObjectivesTo analyse the similarities and discrepancies between the official rheumatology specialty training programmes across Europe.MethodsA steering committee defined the main aspects of training to be assessed. In 2013, the rheumatology official training programmes were reviewed for each of the European League Against Rheumatism (EULAR) countries and two local physicians independently extracted data on the structure of training, included competencies and assessments performed. Analyses were descriptive.Results41 of the 45 EULAR countries currently provide specialist training in rheumatology; in the remaining four rheumatologists are trained abroad. 36 (88%) had a single national curriculum, one country had two national curricula and four had only local or university-specific curricula. The mean length of training programmes in rheumatology was 45 (SD 19) months, ranging between 3 and 72 months. General internal medicine training was mandatory in 40 (98%) countries, and was performed prior to and/or during the rheumatology training programme (mean length: 33 (19) months). 33 (80%) countries had a formal final examination.ConclusionsMost European countries provide training in rheumatology, but the length, structure, contents and assessments of these training programmes are quite heterogeneous. In order to promote excellence in standards of care and to support physicians’ mobility, a certain degree of harmonisation should be encouraged.

scholarly journals The 2017 EULAR standardised procedures for ultrasound imaging in rheumatology

2017 ◽  
Vol 76 (12) ◽  
pp. 1974-1979 ◽  
Author(s):  
Ingrid Möller ◽  
Iustina Janta ◽  
Marina Backhaus ◽  
Sarah Ohrndorf ◽  
David A Bong ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Anatomic Structure ◽  
Scanning Method ◽  
European League Against Rheumatism ◽  
The Us ◽  
Technological Developments ◽  
Probe Placement

BackgroundIn 2001, the European League Against Rheumatism developed and disseminated the first guidelines for musculoskeletal (MS) ultrasound (US) in rheumatology. Fifteen years later, the dramatic expansion of new data on MSUS in the literature coupled with technological developments in US imaging has necessitated an update of these guidelines.ObjectivesTo update the existing MSUS guidelines in rheumatology as well as to extend their scope to other anatomic structures relevant for rheumatology.MethodsThe project consisted of the following steps: (1) a systematic literature review of MSUS evaluable structures; (2) a Delphi survey among rheumatologist and radiologist experts in MSUS to select MS and non-MS anatomic structures evaluable by US that are relevant to rheumatology, to select abnormalities evaluable by US and to prioritise these pathologies for rheumatology and (3) a nominal group technique to achieve consensus on the US scanning procedures and to produce an electronic illustrated manual (ie, App of these procedures).ResultsStructures from nine MS and non-MS areas (ie, shoulder, elbow, wrist and hand, hip, knee, ankle and foot, peripheral nerves, salivary glands and vessels) were selected for MSUS in rheumatic and musculoskeletal diseases (RMD) and their detailed scanning procedures (ie, patient position, probe placement, scanning method and bony/other landmarks) were used to produce the App. In addition, US evaluable abnormalities present in RMD for each anatomic structure and their relevance for rheumatology were agreed on by the MSUS experts.ConclusionsThis task force has produced a consensus-based comprehensive and practical framework on standardised procedures for MSUS imaging in rheumatology.

scholarly journals Effect of sex on specialty training application outcomes: a longitudinal administrative data study of UK medical graduates

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025004
Author(s):  
Katherine Woolf ◽  
Hirosha Jayaweera ◽  
Emily Unwin ◽  
Karim Keshwani ◽  
Christopher Valerio ◽  
...  
Keyword(s):  
Sex Differences ◽  
Medical School ◽  
Administrative Data ◽  
Training Programme ◽  
Primary Outcome Measure ◽  
Academic Attainment ◽  
Specialty Training ◽  
Medical Specialties ◽  
Medical Graduates ◽  
Training Programmes

ObjectivesTo examine sex differences in the specialty training recruitment outcomes of UK medical graduates; and whether sex differences were explained by prior academic attainment and previous fitness to practise (FtP) declarations.DesignRetrospective longitudinal cohort study.SettingAdministrative data on entrants to all UK medical schools from the UK Medical Education Database.Participants10 559 doctors (6 155; 58% female) who entered a UK medical school in 2007 or 2008 and were eligible to apply for specialty training by 2015.Primary outcome measureOdds of application, offer and acceptance to any specialty training programme, and on to each of the nine largest training programmes, adjusting for sex, other demographics, prior academic attainment, FtP declaration and medical school.ResultsAcross all specialties, there were no sex differences in applications for specialty training, but women had increased odds of getting an offer (OR=1.40; 95% CI=1.25 to 1.57; p<0.001) and accepting one (OR=1.43; 95% CI=1.19 to 1.71; p<0.001). Seven of the nine largest specialties showed significant sex differences in applications, which remained after adjusting for other factors. In the adjusted models, Paediatrics (OR=1.57; 95% CI=1.01 to 2.46; p=0.046) and general practice (GP) (OR=1.23; 95% CI=1.03 to 1.46; p=0.017) were the only specialties to show sex differences in offers, both favouring women. GP alone showed sex differences in acceptances, with women being more likely to accept (OR=1.34; 95% CI=1.03 to 1.76; p=0.03). Doctors with an FtP declaration were slightly less likely to apply to specialty training overall (OR=0.84; 95% CI=0.71 to 1.00; p=0.048) and less likely to accept an offer to any programme (OR=0.71; 95% CI=0.52 to 0.98; p=0.036), after adjusting for confounders.ConclusionsSex segregation between medical specialties is due to differential application, although research is needed to understand why men are less likely to be offered a place on to GP and Paediatrics training, and if offered GP are less likely to accept.

scholarly journals EULAR points to consider for the development, evaluation and implementation of mobile health applications aiding self-management in people living with rheumatic and musculoskeletal diseases

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001014 ◽  
Author(s):  
Aurélie Najm ◽  
Elena Nikiphorou ◽  
Marie Kostine ◽  
Christophe Richez ◽  
John D Pauling ◽  
...  
Keyword(s):  
Mobile Health ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
Cost Benefit ◽  
Self Management ◽  
Mobile Health Applications ◽  
Development Evaluation ◽  
Level Of Agreement ◽  
Health Applications

BackgroundMobile health applications (apps) are available to enable people with rheumatic and musculoskeletal diseases (RMDs) to better self-manage their health. However, guidance on the development and evaluation of such apps is lacking.ObjectivesThe objective of this EULAR task force was to establish points to consider (PtC) for the development, evaluation and implementation of apps for self-management of RMDs.MethodsA systematic literature review of app content and development strategies was conducted, followed by patient focus group and an online survey. Based on this information and along with task force expert opinion, PtC were formulated in a face-to-face meeting by a multidisciplinary task force panel of experts, including two patient research partners. The level of agreement among the panel in regard to each PtC was established by anonymous online voting.ResultsThree overarching principles and 10 PtC were formulated. Three PtC are related to patient safety, considered as a critical issue by the panel. Three are related to relevance of the content and functionalities. The requirement for transparency around app development and funding sources, along with involvement of relevant health professionals, were also raised. Ease of app access across ages and abilities was highlighted, in addition to considering the cost benefit of apps from the outset. The level of agreement was from 8.8 to 9.9 out of 10.ConclusionThese EULAR PtC provide guidance on important aspects that should be considered for the development, evaluation and implementation of existing and new apps.

scholarly journals 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis

2018 ◽  
Vol 77 (9) ◽  
pp. 1251-1260 ◽  
Author(s):  
Anne-Kathrin Rausch Osthoff ◽  
Karin Niedermann ◽  
Jürgen Braun ◽  
Jo Adams ◽  
Nina Brodin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Inflammatory Arthritis ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
The Public ◽  
Knee Oa ◽  
Eular Recommendations ◽  
Patient Representatives ◽  
Research And Education ◽  
Level Of Agreement

Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.

scholarly journals EULAR points to consider for the use of big data in rheumatic and musculoskeletal diseases

2019 ◽  
Vol 79 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Laure Gossec ◽  
Joanna Kedra ◽  
Hervé Servy ◽  
Aridaman Pandit ◽  
Simon Stones ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Big Data ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
Data Interpretation ◽  
Current Status ◽  
Privacy By Design ◽  
Design Data ◽  
European League Against Rheumatism ◽  
International Experts

BackgroundTremendous opportunities for health research have been unlocked by the recent expansion of big data and artificial intelligence. However, this is an emergent area where recommendations for optimal use and implementation are needed. The objective of these European League Against Rheumatism (EULAR) points to consider is to guide the collection, analysis and use of big data in rheumatic and musculoskeletal disorders (RMDs).MethodsA multidisciplinary task force of 14 international experts was assembled with expertise from a range of disciplines including computer science and artificial intelligence. Based on a literature review of the current status of big data in RMDs and in other fields of medicine, points to consider were formulated. Levels of evidence and strengths of recommendations were allocated and mean levels of agreement of the task force members were calculated.ResultsThree overarching principles and 10 points to consider were formulated. The overarching principles address ethical and general principles for dealing with big data in RMDs. The points to consider cover aspects of data sources and data collection, privacy by design, data platforms, data sharing and data analyses, in particular through artificial intelligence and machine learning. Furthermore, the points to consider state that big data is a moving field in need of adequate reporting of methods and benchmarking, careful data interpretation and implementation in clinical practice.ConclusionThese EULAR points to consider discuss essential issues and provide a framework for the use of big data in RMDs.

scholarly journals EULAR Points to Consider for the use of imaging to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs)

2021 ◽  
pp. annrheumdis-2021-221261
Author(s):  
Christian Dejaco ◽  
Pedro M Machado ◽  
Francesco Carubbi ◽  
Philipp Bosch ◽  
Lene Terslev ◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Healthcare Professionals ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
Fusion Imaging ◽  
Imaging Modalities ◽  
Imaging Method ◽  
Sacroiliac Joints ◽  
Level Of Agreement

ObjectivesTo develop evidence-based Points to Consider (PtC) for the use of imaging modalities to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs).MethodsEuropean Alliance of Associations for Rheumatology (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound (US), fluoroscopy, MRI, CT and fusion imaging to guide interventional procedures. Based on evidence and expert opinion, the task force (25 participants consisting of physicians, healthcare professionals and patients from 11 countries) developed PtC, with consensus obtained through voting. The final level of agreement was provided anonymously.ResultsA total of three overarching principles and six specific PtC were formulated. The task force recommends preference of imaging over palpation to guide targeted interventional procedures at peripheral joints, periarticular musculoskeletal structures, nerves and the spine. While US is the favoured imaging technique for peripheral joints and nerves, the choice of the imaging method for the spine and sacroiliac joints has to be individualised according to the target, procedure, expertise, availability and radiation exposure. All imaging guided interventions should be performed by a trained specialist using appropriate operational procedures, settings and assistance by technical personnel.ConclusionThese are the first EULAR PtC to provide guidance on the role of imaging to guide interventional procedures in patients with RMDs.

scholarly journals 2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice

2020 ◽  
pp. annrheumdis-2020-218986
Author(s):  
Valentin Ritschl ◽  
Tanja A Stamm ◽  
Daniel Aletaha ◽  
Johannes W J Bijlsma ◽  
Peter Böhm ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Treatment Plan ◽  
Healthcare Providers ◽  
Structural Barriers ◽  
Adherence To Treatment ◽  
Patient Representatives ◽  
Screening Assessment ◽  
Free Environment ◽  
Level Of Agreement

BackgroundNon-adherence to treatment could preclude reaching an optimal outcome. Thirty to 80% of patients with rheumatic and musculoskeletal diseases (RMDs) do not adhere to the agreed treatment.ObjectivesThe objective was to establish points to consider (PtCs) for the prevention, screening, assessment and management of non-adherence to (non-)pharmacological treatments in people with RMDs.MethodsAn EULAR task force (TF) was established, and the EULAR standardised operating procedures for the development of PtCs were followed. The TF included healthcare providers (HCPs), comprising rheumatologists, nurses, pharmacists, psychologists, physiotherapists, occupational therapists and patient-representatives from 12 European countries. A review of systematic reviews was conducted in advance to support the TF in formulating the PtCs. The level of agreement among the TF was established by anonymous online voting.ResultsFour overarching principles and nine PtCs were formulated. The PtCs reflect the phases of action on non-adherence. HCPs should assess and discuss adherence with patients on a regular basis and support patients to treatment adherence. As adherence is an agreed behaviour, the treatment has to be tailored to the patients’ needs. The level of agreement ranged from 9.5 to 9.9 out of 10.ConclusionsThese PtCs can help HCPs to support people with RMDs to be more adherent to the agreed treatment plan. The basic scheme being prevent non-adherence by bonding with the patient and building trust, overcoming structural barriers, assessing in a blame-free environment and tailoring the solution to the problem.

scholarly journals EVALUATION OF IN-SERVICE TRAINING PROGRAMMERS BY PHYSICAL EDUCATION TEACHERS

2021 ◽  
Vol 9 (08) ◽  
pp. 201-207
Author(s):  
Iqbal Dar ◽  
◽  
Sangeeta Gupta ◽  
Keyword(s):  
Physical Education ◽  
Training Programme ◽  
Physical Education Teachers ◽  
Assessment Practices ◽  
Implementation Barriers ◽  
Educational Materials ◽  
Theoretical Concepts ◽  
Service Training ◽  
Training Activities ◽  
Training Programmes

The aim of this study is to examine the opinions of physical education teachers from both Government and private elementary and high schools on their own in-service training programmes. 1000 pyhsical education teachers in Kulgam district of Jammu Kashmir were selected for this study. The questionnaire was developed which include two parts were applied to the participants. Descriptive statistics was used for the data analysis. Analysis was performed by SPSS software. Findings, obtained during research, are as follows: There is an insufficiency in terms of providing the willing participation to the in-service training programmes. Specific attention was directed to the translation of theoretical concepts into practical and applicable tools. There is a fundamental and principal insufficiency about the timing, conditions of the place and educational materials of the inservice training programmes. There are some problems about the trainers proficiency of teaching the subjects and adult education. There is a insufficiency related to evaluation of programme and success in in-service trainings in which physical education teachers participate. As a result there seems to be an insufficient level of in-service training activities for meeting the needs and expectations of physical education teachers. The in-service teacher training programme is a successful first step in improving the expertise of PE teachers to start and develop higher quality and more motivating assessment practices. Nevertheless, in order to generate durable change within daily PE practice, follow-up training sessions or counselling methods (e.g. through communities of practice) are essential to overcome implementation barriers. Development, adjustment and future directions for assessment are discussed.

scholarly journals EULAR ‘points to consider’ for the conduction of workforce requirement studies in rheumatology

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000780 ◽  
Author(s):  
Christian Dejaco ◽  
Polina Putrik ◽  
Julia Unger ◽  
Daniel Aletaha ◽  
Gerolamo Bianchi ◽  
...  
Keyword(s):  
Health Services ◽  
Literature Review ◽  
Task Force ◽  
Direct Patient Care ◽  
Group Discussions ◽  
New Developments ◽  
European League Against Rheumatism ◽  
The Usa ◽  
Level Of Agreement ◽  
European League

ObjectiveCurrent methods used for forecasting workforce requirements in rheumatology are disparate, as are the parameters incorporated into workforce projection studies. The objective of these European League Against Rheumatism (EULAR points to consider (PTC) is to guide future workforce studies in adult rheumatology in order to produce valid and reliable manpower estimates.MethodsThe EULAR Standardised Operating Procedures were followed. A multidisciplinary task force with experts including patients with rheumatic diseases from 11 EULAR countries and the USA was assembled. A systematic literature review (SLR) was conducted to retrieve workforce models in rheumatology and other medical fields. PTC were based on expert opinion informed by the SLR, followed by group discussions with consensus obtained through informal voting. The level of agreement with the PTC was voted anonymously.ResultsA total of 10 PTC were formulated. The task force recommends models integrating supply (=workforce available in rheumatology), demand (=health services requested by the population) and need (=health services that are considered appropriate to serve the population). In general, projections of workforce requirements should consider all factors relevant for current and future workload in rheumatology inside and outside of direct patient care. Forecasts of workforce supply should consider demography and attrition of rheumatologists, as well as the effects of new developments in healthcare. Predictions of future need/demand should take demographic, sociocultural and epidemiological development of the population into account.ConclusionThese EULAR-endorsed PTC will provide guidance on the methodology and the parameters to be applied in future national and international workforce requirement studies in rheumatology.

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