Integration of capillary microscopy and dermoscopy into the rheumatology fellow curriculum

This study evaluates a novel, three-part nailfold capillaroscopy training curriculum for adult and paediatric rheumatology fellows.

All rheumatology fellows training at an academic medical centre took part in the three-part nailfold capillaroscopy curriculum. Tests of fellows' usage, interest, confidence, and ability in nailfold capillaroscopy were taken at multiple time-points throughout the curriculum.

Fellows self-reported high levels of interest, increased confidence in delineating normal and abnormal nailfold capillaries (p=0.03) and increased usage of nailfold capillaroscopy (p=0.09). The ability of fellows to identify normal nailfold capillaries (p=0.03) and systemic sclerosis-specific nailfold capillary changes, such as neoangiogenesis (p<0.001), also increased.

The curriculum was feasible and led to improved ability of learners to distinguish normal from abnormal and to recognise and describe systemic sclerosis-specific nailfold capillary changes. This curriculum also led to improved confidence in examining nailfold capillaries and increased usage of this skill in rheumatologic consultation.