key: cord-0697398-vpbj5raz authors: Pelosi, Luciana; Simon, Neil G. title: Neuromuscular ultrasound training courses in the post COVID‐19 era: Is virtual training here to stay, and should the pre‐pandemic training design be revised? date: 2021-11-08 journal: Muscle Nerve DOI: 10.1002/mus.27441 sha: e1512d5d171287b17e602b57832d699eb52a2184 doc_id: 697398 cord_uid: vpbj5raz nan The acquisition of fundamental skills in neuromuscular ultrasound (NMUS) is rapidly becoming a necessity for clinical neurophysiologists. Experts in NMUS are providing guidance on education and competency assessment, 1-4 but proficiency remains confined to a relatively small number of clinicians who are mainly concentrated in a few countries. "Previous attendance at neuromuscular ultrasound training courses/workshops" is a consensus expert criterion for competency evaluation. 2 A number of NMUS courses are available, often linked with professional neurology or subspecialty society meetings, but there are barriers imposed by in-person attendance and costs associated with registration that may have prevented many potential trainees from participating. Furthermore, the design of these courses, requiring supervised hands-on sessions, allows for only a limited number of registrants. During the coronavirus disease 2019 (COVID-19) pandemic, mandatory social distancing and travel restrictions have impacted on traditional training models in healthcare, especially those relying on in-person learning, which were either stopped altogether or modified. [5] [6] [7] However, as in any "crisis," the search for alternatives and remedies has also created opportunities to explore new ways of conducting training that may ultimately lead to more inclusive, effective and sustainable practice. supervised training is essential to learn diagnostic ultrasound" illustrates the pre-COVID pandemic assumption that in-person supervision is a sine-qua-non of neuromuscular ultrasound courses. As a result of the COVID-19 pandemic, all scheduled hands-on courses had to be suspended. Accordingly, the Egyptian Neuromuscular Ultrasound Society converted their pre-scheduled in-person NMUS courses into virtual courses. Tawfik et al. 8 Despite its limitations, the study by Tawfik et al. 8 has an important timely message, which is that NMUS virtual courses can be both feasible and well received. The authors concluded that virtual courses can be proposed as "useful alternatives to in-person training when inperson interaction is restricted." This study also shows several significant advantages of a virtual course over in-person attendance: 1. The opportunity to participate is extended to a much larger number of participants. This is crucial when both teachers and learning opportunities are scarce. to appropriate technology, which may not be available in some settings. Remote hands-on learning may also be achieved by the use of virtual reality simulators, which may obviate the need for local supervision although require specialized equipment. Virtual reality simulators have been shown to be superior to static resources in the development of ultrasound anatomy knowledge. 12 Simulators have been integrated into ultrasound training for the study of other body regions 13 but have not yet been developed for NMUS. In summary, the need for continuing education during the COVID-19 pandemic has revealed that some of the barriers and negative consequences related to in-person attendance can be overcome with approaches that take advantage of existing resources in telemedicine and are more inclusive and sustainable for current and future generations. Potentially, much more can be achieved by exploring this path further, particularly given rapid technological advances in the remote education sphere, and a greater consideration of the financial and environmental costs of global education. 9 We confirm that we have read the Journalʼs position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. Guidelines for neuromuscular ultrasound training Neuromuscular ultrasound competency assessment: consensus-based survey Developing a framework for neuromuscular ultrasound training and accreditation Expert consensus on the combined investigation of ulnar neuropathy at the elbow using electrodiagnostic tests and nerve ultrasound A virtual point-of-care ultrasound course during the COVID-19 pandemic Sports ultrasound training during a pandemic: developing a "hands-on" skill through distance learning Online liver imaging course; pivoting to transform radiology education during the SARS-CoV-2 pandemic Virtual neuromuscular ultrasound courses during COVID-19 pandemic: leveraging technology to enhance learning opportunities Academic conferences urgently need environmental policies Moving academic conferences online: aids and barriers to delegate participation A year without conferences? How the coronavirus pandemic could change research Impact of virtual reality anatomy training on ultrasound competency development: a randomized controlled trial The integration of transabdominal ultrasound simulators into an ultrasound curriculum. Ultrasound Nature carbon footprint. Virtual science conference tries to recreate social buzz How the ecology and evolution of the COVID-19 pandemic changed learning