Ganguli Suvranu, Pedrosa Ivan, Yam Chun-Shan, Appignani Barbara, Siewert Bettina, Kressel Herbert Y
Beth Israel Deaconess Medical Center and Harvard Medical School, Department of Radiology, Boston, MA 02215, USA.
Acad Radiol. 2006 Jun;13(6):764-9. doi: 10.1016/j.acra.2006.02.057.
The aim of the study is to evaluate the effectiveness of an Emergency Radiology (ER) Core Curriculum training module and a Digital Imaging and Communications in Medicine (DICOM)-based interactive examination system to prepare first-year (postgraduate year 2 [PGY-2]) radiology residents and assess their readiness for taking overnight radiology call.
Institutional review board approval was obtained, and the study was compliant with Health Insurance Portability and Accountability Act (HIPAA) regulations. A dedicated month-long ER curriculum was designed to prepare new radiology residents for overnight radiology call that includes interpretation of off-hour urgent and emergent studies without immediate direct attending supervision. Lectures of the curriculum, provided by department staff, were based on the American Society of Emergency Radiology core curriculum. The lecture series was implemented after PGY-2 residents had completed formal introductory resident rotations during their first 6 months of training. A DICOM-based interactive computer-based testing module was developed and administered at the end of the lecture series. The module consisted of 19 actual emergency department cases with entire series of images, simulating an on-call setting. Tests were scored by two staff members blinded to resident identifying information. Upper-level residents also were tested, and comparison was made between first-year and upper-level resident test scores to determine the effectiveness of the test in determining first-year resident preparedness for call. Statistical analysis of results was performed by using t-test (P < .05).
All residents in the residency program present during the month (nine PGY-2, six PGY-3, seven PGY-4, seven PGY-5 residents) attended the lecture series and finished the testing module at the end of the lecture series. Of 19 actual emergency cases on the testing module, five cases were neuroradiology, three cases were thoracic imaging, eight cases were body imaging, and three cases were musculoskeletal. PGY-2 residents scored an average of 73.0% (range, 63.2%-81.6%) of total points possible. PGY-3 residents scored an average of 76.8% (range, 68.4%-86.8%); PGY-4 residents scored an average of 77.4% (range, 65.8%-100%), and PGY-5 residents scored an average of 81.2% (range, 68.4%-94.7%). There was no statistically significant difference in scores according to level of training.
First-year radiology residents who underwent 6 months of formal radiology training followed by an intensive ER lecture series before taking overnight call had scores similar to upper-level colleagues on an interactive computer-based ER simulation module.
本研究旨在评估急诊放射学（ER）核心课程培训模块以及基于医学数字成像和通信（DICOM）的交互式考试系统对于培训一年级（研究生二年级[PGY - 2]）放射科住院医师的有效性，并评估他们应对夜间放射科值班的准备情况。
获得了机构审查委员会的批准，且本研究符合《健康保险流通与责任法案》（HIPAA）的规定。设计了一个为期一个月的专门ER课程，为新的放射科住院医师应对夜间放射科值班做准备，该课程包括在没有直接上级监督的情况下解读非工作时间的紧急和急诊检查。由科室工作人员提供的课程讲座基于美国急诊放射学会核心课程。讲座系列在PGY - 2住院医师完成培训的前6个月的正式入门住院医师轮转后实施。在讲座系列结束时开发并实施了一个基于DICOM的交互式计算机测试模块。该模块由19个实际急诊科病例及完整的图像系列组成，模拟值班场景。测试由两名对住院医师识别信息不知情的工作人员评分。高年级住院医师也进行了测试，并比较一年级和高年级住院医师的测试成绩，以确定该测试在评估一年级住院医师值班准备情况方面的有效性。使用t检验（P < 0.05）对结果进行统计分析。
该月期间住院医师培训项目中的所有住院医师（9名PGY - 2、6名PGY - 3、7名PGY - 4、7名PGY - 5住院医师）都参加了讲座系列，并在讲座系列结束时完成了测试模块。测试模块中的19个实际急诊病例中，5个病例为神经放射学，3个病例为胸部成像，8个病例为身体成像，3个病例为肌肉骨骼系统成像。PGY - 2住院医师的平均得分占总分的73.0%（范围为63.2% - 81.6%）。PGY - 3住院医师的平均得分占76.8%（范围为68.4% - 86.8%）；PGY - 4住院医师的平均得分占77.4%（范围为65.8% - 100%），PGY - 5住院医师的平均得分占81.2%（范围为68.4% - 94.7%）。根据培训水平，得分无统计学显著差异。
在进行夜间值班前接受了6个月正式放射学培训并随后参加强化ER讲座系列的一年级放射科住院医师，在基于计算机的交互式ER模拟模块上的得分与高年级同事相似。
