Measurement of breast ultrasound skill: A systematic review of the literature

To expand access to diagnostic breast ultrasound, experts recommend training non-radiologist clinicians. Robust strategies to assess trainee competence are needed to ensure ultrasound quality. This review sought to answer the question, “What strategies have been used to assess breast ultrasound skill?,” describe skill domains assessed, and determine whether tools’ measurement validity has been established. Following PRISMA guidelines, we searched Medline, Embase, Scopus, and Web of Science. Of 3,422 records, 21 studies were included; 61.9% were from high-income countries. Skill assessment strategies included comparison to a gold standard (n=8) and review of images with known findings (n=6). Lesion detection and characterization and BI-RADS were the most common skills assessed. No study systematically validated a tool. Existing methods for evaluating breast ultrasound skill are varied and unvalidated. Validated tools could help optimize breast ultrasound training and quality globally.