Expert learning in musculoskeletal ultrasound - an international observational study.

To examine the effect of discovery learning on musculoskeletal ultrasound (MSUS) performance and to explore how expert learners engage in a collaborative learning environment.Experts in MSUS participated in a discovery learning session where they were divided into groups. Each participant had one attempt to solve the same MSUS case and could seek assistance from other group members or learning resources. The video-recorded sessions were analyzed using both quantitative and qualitative methods. Performance was assessed using the validated Objective Structured Assessment of Ultrasound Skills (OSAUS) tool (1-5 points per item), and an outcome score was calculated based on the number of correct MSUS images (0-4). Participants' comfort and perception of discovery learning were evaluated using a 5-point Likert scale questionnaire.28 MSUS experts from 13 different countries completed the study. The mean OSAUS score (standard deviation) was 3.96 (0.5), and the mean outcome score was 1.89 (0.9). Using Pearson's correlation coefficient, we found a significant correlation between the OSAUS score and the outcome score (0.72, p < .001). The qualitative analysis revealed that the experts used actions associated with adaptive expertise and that social hierarchy persisted in the collaborative learning environment. Finally, we found high comfort with and acceptance of the discovery learning approach.Discovery learning may be an effective teaching strategy for future advanced MSUS courses, including international Teach-the-Teachers courses. Since social hierarchy was present, a facilitator is necessary during collaborative training.