Department of Radiology,, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
Pediatr Radiol. 2020 Mar;50(3):397-400. doi: 10.1007/s00247-019-04559-2. Epub 2020 Feb 17.
Pediatric residents exhibit knowledge gaps in appropriateness of imaging utilization.
This study evaluates the value of radiologist-driven imaging education in a pediatric residency program. The primary goals of this educational program were to provide pediatric residents with resources such as the American College of Radiology Appropriateness Criteria, support optimal resource utilization and patient care, increase resident understanding of radiation risk, and determine the value of integrating radiologists into pediatric education.
A needs assessment was performed in which the chief residents of a large pediatric program were surveyed. The consensus of chief residents was that a four-part lecture series delivered by a pediatric radiology fellow would be beneficial to the pediatric residents. Topics included general radiation risk as well as basic imaging topics in the chest, abdomen, neurological system, extremities and vasculature. Each lecture integrated appropriate ordering, ALARA (As Low As Reasonably Achievable)/Image Gently, and basic image interpretation. Residents were asked, using a Likert scale, to rate their understanding of radiation risk, the ACR Appropriateness Criteria, and other topics of interest before and after each lecture. Pediatric residents were given a 10-item quiz before and after the lecture series to assess their knowledge regarding the best test to order in clinical scenarios.
The average pre-lecture score for knowledge of radiation risk was 3.27 (95% confidence interval [CI]: 3.02-3.51) out of 5, which improved to 4.27 (95% CI: 4.09-4.57) post-lecture. There was an increase in understanding of ACR appropriateness, with pre-lecture rating of knowledge increasing from 1.91 (95% CI 1.54-2.29) out of 5 to 3.61 (95% CI 3.33-3.90) post-lecture. The residents averaged 82.7% (95% CI 77.3%-88.1%) on the appropriateness pre-test and 93.8% (95% CI 90.3%-97.2%) on the post-test. Residents provided positive feedback upon conclusion of the program and reported a beneficial effect on their education.
A radiologist-driven lecture series in a pediatric residency can improve resident understanding of appropriate ordering practices and radiation risk. Radiologist participation in pediatric residency training is well-received.
儿科住院医师在影像学应用的适宜性方面存在知识差距。
本研究评估了放射科医生主导的影像学教育在儿科住院医师培训计划中的价值。该教育计划的主要目标是为儿科住院医师提供资源,如美国放射学院适宜性标准,支持最佳资源利用和患者护理,增加住院医师对辐射风险的理解,并确定将放射科医生纳入儿科教育的价值。
进行了一项需求评估,其中调查了一个大型儿科项目的首席住院医师。首席住院医师的共识是,由一名儿科放射科住院医师讲授四部分讲座系列将对儿科住院医师有益。主题包括一般辐射风险以及胸部、腹部、神经系统、四肢和脉管系统的基本影像学主题。每一次讲座都整合了适当的订单、ALARA(尽可能低的合理可达到)/图像温和以及基本的图像解释。住院医师使用李克特量表在每次讲座前后评估他们对辐射风险、ACR 适宜性标准和其他感兴趣主题的理解。在讲座系列前后,儿科住院医师接受了一项包含 10 个项目的测验,以评估他们在临床情况下最佳测试订单的知识。
在 5 分制中,辐射风险知识的平均课前得分从 3.27(95%置信区间 [CI]:3.02-3.51)提高到课后的 4.27(95% CI:4.09-4.57)。对 ACR 适宜性的理解有所提高,课前对知识的评分从 5 分制中的 1.91(95% CI 1.54-2.29)增加到课后的 3.61(95% CI 3.33-3.90)。住院医师在适宜性前测中平均得分为 82.7%(95% CI 77.3%-88.1%),在后测中得分为 93.8%(95% CI 90.3%-97.2%)。住院医师在课程结束后提供了积极的反馈,并报告说这对他们的教育有有益的影响。
在儿科住院医师培训中,由放射科医生主导的讲座系列可以提高住院医师对适当订购实践和辐射风险的理解。放射科医生参与儿科住院医师培训受到好评。