Ganguli Suvranu, Camacho Marc, Yam Chun-Shan, Pedrosa Ivan
Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
AJR Am J Roentgenol. 2009 Feb;192(2):539-44. doi: 10.2214/AJR.08.1631.
The objective of our study was to evaluate the preparedness of postgraduate year (PGY)-2 residents for independent call responsibilities and the impact of the radiology residency training program on call preparedness using an objective DICOM-based simulation module over a 5-year period.
A month-long emergency radiology lecture series, conducted over 5 consecutive years, was designed and given to radiology residents at all levels. A DICOM-based, interactive, computer-based testing module with actual emergency department cases was developed and administered at the end of the lecture series. Comparison was made between first-year and upper-level resident test scores using a Student's t test, generalized estimating equations, and individual fixed effects to determine PGY-2 residents' before-call preparedness and the effectiveness of the simulation module to assess call preparedness. Resident scoring on the simulation module was also plotted as a function of progression through their residency program to evaluate the impact of the training program on call preparedness.
Over 5 years, 45 PGY-2, 34 PGY-3, 32 PGY-4, and 35 PGY-5 residents attended the lecture series and completed the computer-based testing module. PGY-2 residents scored an average of 71% +/- 15% (SD), PGY-3 residents scored 79% +/- 11%, PGY-4 residents scored 84% +/- 10%, and PGY-5 residents scored 86% +/- 11% of the total points possible. A statistically significant (p < 0.05) difference in scoring on the simulation module was identified between the PGY-2 residents and each upper-level class over the 5-year period and during 4 of 5 examination years analyzed separately. A trend toward higher average scores for each cohort of residents as they progressed through residency training was identified.
Over a 5-year period, first-year radiology residents scored significantly lower than upper-level colleagues on an emergency radiology simulation module, suggesting a significant improvement in the ability of residents to interpret typical on-call imaging studies after the PGY-2 year.
我们研究的目的是通过一个基于DICOM的客观模拟模块,在5年时间内评估研究生二年级(PGY-2)住院医师承担独立值班职责的准备情况,以及放射科住院医师培训计划对值班准备情况的影响。
连续5年设计并为各级放射科住院医师举办了为期一个月的急诊放射学系列讲座。在讲座系列结束时,开发并实施了一个基于DICOM的、交互式的、基于计算机的测试模块,其中包含实际的急诊科病例。使用学生t检验、广义估计方程和个体固定效应比较一年级和高年级住院医师的测试成绩,以确定PGY-2住院医师值班前的准备情况以及模拟模块评估值班准备情况的有效性。模拟模块上的住院医师评分也作为其住院医师培训进程的函数进行绘制,以评估培训计划对值班准备情况的影响。
在5年时间里,45名PGY-2、34名PGY-3、32名PGY-4和35名PGY-5住院医师参加了讲座系列并完成了基于计算机的测试模块。PGY-2住院医师平均得分占总分的71%±15%(标准差),PGY-3住院医师得分79%±11%,PGY-4住院医师得分84%±10%,PGY-5住院医师得分86%±11%。在5年期间以及分别分析的5个考试年份中的4年,PGY-2住院医师与每个高年级班级在模拟模块上的得分存在统计学显著差异(p<0.05)。随着住院医师在住院医师培训中不断进步,每个队列的平均得分有升高趋势。
在5年时间里,一年级放射科住院医师在急诊放射学模拟模块上的得分显著低于高年级同事,这表明住院医师在PGY-2年后解读典型值班影像研究的能力有显著提高。