Werth Brady, Nguyen Barbara, Ward Jeanette, Reyes Jared, Helmer Stephen D, Nold Joseph, Brewer Nicholas, Haan James
University of Kansas School of Medicine-Wichita, Department of Surgery, Wichita, KS.
Chandler Regional Medical Center, Department of Trauma Services, Chandler, AZ Via Christi Hospital Saint Francis, Wichita, KS.
Kans J Med. 2018 Nov 29;11(4):91-94. eCollection 2018 Nov.
Exposure to radiologic images during clinical rotations may improve students' skill levels. This study aimed to quantify the improvement in radiographic interpretation of life-threatening traumatic injuries gained during third year clinical clerkships (MS-3).
We used a paired-sample prospective study design to compare students' accuracy in reading computed tomography (CT) images at the beginning of their third year clerkships (Phase I) and again after completion of all of their third year clerkships (Phase II). Students were shown life-threatening injuries that included head, chest, abdomen, and pelvic injuries. Overall scores for Phase II were compared with Phase I, as well as sub-scores for each anatomical region: head, chest, abdomen, and pelvis.
Only scores from students participating in both Phase I and Phase II (N = 57) were used in the analysis. After completing their MS3 clerkship, students scored significantly better overall and in every anatomical region. Phase I and Phase II overall mean scores were 1.2 ± 1.1 vs. 4.6 ± 1.8 (p < 0.001). Students improved the most with respect to injuries of the head and chest and the area of least improvement was in interpreting CT scans of the abdomen. Although improvements in reading radiographic images were noted after the clerkship year, students accurately diagnosed only 46% of life-threatening images on CT scan in the trauma setting.
These results indicated that enhanced education is needed for medical students to interpret CT scans.
在临床轮转期间接触放射影像可能会提高学生的技能水平。本研究旨在量化三年级临床实习（MS-3）期间在解读危及生命的创伤性损伤的影像学方面取得的进步。
我们采用配对样本前瞻性研究设计，比较学生在三年级实习开始时（第一阶段）和完成所有三年级实习后（第二阶段）阅读计算机断层扫描（CT）图像的准确性。向学生展示包括头部、胸部、腹部和骨盆损伤在内的危及生命的损伤。将第二阶段的总体得分与第一阶段进行比较，以及每个解剖区域的子得分：头部、胸部、腹部和骨盆。
分析中仅使用了参与第一阶段和第二阶段的学生（N = 57）的分数。完成MS3实习后，学生在总体和每个解剖区域的得分均显著提高。第一阶段和第二阶段的总体平均得分分别为1.2±1.1和4.6±1.8（p < 0.001）。学生在头部和胸部损伤方面进步最大，而在解读腹部CT扫描方面进步最小。尽管在实习年后阅读放射影像有进步，但在创伤环境中，学生在CT扫描上仅准确诊断出46%的危及生命的影像。
这些结果表明医学生需要加强CT扫描解读方面的教育。
