急诊放射选修课程提高了二年级医学生对适当影像学应用的感知信心和知识。

Emergency radiology elective improves second-year medical students' perceived confidence and knowledge of appropriate imaging utilization.

机构信息

Department of Radiology, University of Michigan Hospital System, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.

出版信息

Acad Radiol. 2013 Sep;20(9):1168-76. doi: 10.1016/j.acra.2013.05.011.

DOI:10.1016/j.acra.2013.05.011

PMID:23931432

Abstract

RATIONALE AND OBJECTIVES

Given recent advances in and wider availability of complex imaging, physicians are expected to understand imaging appropriateness. We introduced second-year medical students to the American College of Radiology Appropriateness Criteria (ACR-AC) in an interactive case-based elective to demonstrate their use in imaging for common emergency department clinical complaints.

MATERIALS AND METHODS

Prospective pre- and post-test design assessed second-year medical students' performance on case-based knowledge applications and self-assessed confidence related to ACR-AC guidelines compared to second-year students participating in a different concurrent radiology elective. Students participated in a 3-day elective covering the ACR-AC, comparative effective imaging, and risks associated with imaging radiation exposure, with outcomes of perceived confidence using a 5-point Likert scale and knowledge of ACR-AC using case-based multiple choice questions. Analysis included computing mean scores and assessing effect sizes for changes in knowledge.

RESULTS

Before the elective, 24 students scored an average of 3.45 questions correct of 8 (43.1%). On course completion, students scored an average of 5.3 questions correct of the same questions (66.3%) (P < .001; effect size [Cohen's d] = 1.3940. In the comparison group, 12 students scored an average of 3.08 questions (38.5%) correctly pretest and 3.09 questions (38.6%) correctly post-test (P > .85; effect size = 0.008). Students' confidence in ordering appropriate imaging improved nearly 2-fold from a range of 1.9 to 3.2 (on a scale of 1.0 to 5.0) to a range of 3.7 to 4.5.

CONCLUSIONS

Following a short radiology elective, second-year medical students improved their knowledge of appropriate image utilization and perceived awareness of the indications, contraindications, and effects of radiation exposure related to medical imaging.

摘要

背景与目的

鉴于复杂成像技术的最新进展和更广泛的应用，医生应了解成像的适宜性。我们在一个互动的基于案例的选修课程中向二年级医学生介绍了美国放射学院适宜性标准（ACR-AC），以展示其在常见急诊科临床投诉的成像中的应用。

材料与方法

前瞻性的预测试和后测试设计评估了二年级医学生在基于案例的知识应用方面的表现，以及与参加另一门同期放射学选修课程的二年级学生相比，他们对 ACR-AC 指南的自我评估信心。学生参加了为期 3 天的选修课程，涵盖 ACR-AC、比较有效的成像以及与成像辐射暴露相关的风险，使用 5 分李克特量表评估感知信心，使用基于案例的多项选择题评估对 ACR-AC 的了解。分析包括计算平均分和评估知识变化的效应大小。

结果

在选修课程之前，24 名学生平均答对了 8 个问题中的 3.45 个（43.1%）。在课程结束时，学生平均答对了相同问题中的 5.3 个（66.3%）（P<0.001；效应大小[Cohen's d] = 1.3940。在对照组中，12 名学生在预测试中平均答对了 3.08 个问题（38.5%），在后测试中平均答对了 3.09 个问题（38.6%）（P>0.85；效应大小=0.008）。学生对适当成像的订购信心从 1.0 到 5.0 的范围从 1.9 提高到 3.2，从 3.7 到 4.5 的范围提高了近 2 倍。