We have developed a self-taught course by which rheumatologists in training can learn how to conduct capillaroscopy examinations using a computerized videomicroscopy system. We assessed the effectiveness of this course by following the learning curve of one specialist trainee with no experience in capillaroscopy.
The student's training consisted of 10 practical sessions held on three consecutive days. The perceived difficulty in completing each session was graded from 0 (least difficult) to 10 (most difficult). All the images obtained were stored and the time spent by both the trainee and the tutor during the sessions was recorded. Each image was blindly judged by both the novice and the tutor for quality, assigning a score from 0 (lowest quality) to 10 (highest quality). The minimum acceptable score for standard clinical practice was considered to be >5.
The student spent a total of approximately 5 non-consecutive hours engaged in 'direct' capillaroscopy and recorded a total of 172 images. The mean time required to produce each image varied from approximately 1.0 to 2.0 minutes. The perceived difficulty in completing a session decreased from the first to the last session. A quality score > 5 was assigned by the novice and tutor, respectively, to 16/49 images for the first group of sessions, 26/45 for the second group of sessions, and 56/78 for the third group of sessions. The overall agreement between the novice and tutor was good (K=0.617, SE=0.021).
The monitoring of one rheumatologist in training indicates that novices can quickly learn, through an intensive self-teaching programme under the supervision of an expert, how to use computerized videomicroscopy to conduct capillaroscopy studies.