Jimah Bashiru Babatunde, Baffour Appiah Anthony, Sarkodie Benjamin Dabo, Anim Dorothea
Department of Medical Imaging, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana.
Ghana Field Epidemiology and Laboratory Training Programme, University of Ghana, Accra, Ghana.
Radiol Res Pract. 2020 Nov 6;2020:8861206. doi: 10.1155/2020/8861206. eCollection 2020.
Chest radiography (CXR) is a widely used imaging technique for assessing various chest conditions; however, little is known on the medical doctors' and medical students' level of skills to interpret the CXRs. This study assessed the residents, medical officers, house officers, and final year medical students' competency in CXRs interpretation and how the patient's clinical history influences the interpretation.
We conducted a cross-sectional study in the Cape Coast Teaching Hospital in the Central Region of Ghana among 99 nonradiologists, comprising 10 doctors in residency programmes, 18 medical officers, 33 house officers, and 38 final year medical students. The data collection was done with a semistructured questionnaire in two phases. In phase 1, ten CXRs were presented without patient's clinical history. Phase 2 involved the same ten CXRs presented in the same order alongside the patient's clinical history. Participants were given 3 minutes to interpret each image. Median and interquartile ranges were used to describe continuous variables, while frequencies and percentages were used to describe categorical variables. Test of significant difference and association was conducted using a Wilcoxon rank-sum test/Kruskal-Wallis test and chi-square ( ) test, respectively.
The average score for interpreting CXRs was 7.0 (IQR = 5-8) and 4.0 (IQR = 3-4), when CXRs were, respectively, presented with and without clinical history. No significant difference was seen in average scores regarding the levels of formal training. Without clinical history, only 40.0% of residents, 22.2% of medical officers, 24.2% of house officers, and 13.2% of medical students correctly interpreted CXRs, while more than 75% each of all categories correctly interpreted CXRs when presented with clinical history. However, all participants had difficulties in identifying CXR with pneumothorax (27.3% vs. 30.3%), pneumomediastinum or left rib fracture (8.1% vs. 33.3%), and lung collapse (37.4% vs. 37.4%) in both situations, with and without patient clinical history.
The patient's clinical history was found to greatly influence doctors' competence in interpreting CXRs. We found a gap in doctors' and medical students' ability to interpret CXRs; hence, the development of this skill should be improved at all levels of medical training.
胸部X光检查（CXR）是一种广泛用于评估各种胸部疾病的成像技术；然而，对于医生和医学生解读胸部X光片的技能水平了解甚少。本研究评估了住院医师、医务人员、实习医生和医学专业最后一年学生在解读胸部X光片方面的能力，以及患者的临床病史如何影响解读。
我们在加纳中部地区的海岸角教学医院对99名非放射科医生进行了一项横断面研究，其中包括10名住院医师、18名医务人员、33名实习医生和38名医学专业最后一年学生。数据收集分两个阶段通过半结构化问卷进行。在第一阶段，展示了10张没有患者临床病史的胸部X光片。第二阶段涉及以相同顺序展示相同的10张胸部X光片以及患者的临床病史。参与者有3分钟时间解读每张图像。中位数和四分位间距用于描述连续变量，而频率和百分比用于描述分类变量。分别使用Wilcoxon秩和检验/Kruskal-Wallis检验和卡方（）检验进行显著性差异和关联性检验。
当分别展示有和没有临床病史的胸部X光片时，解读胸部X光片的平均得分分别为7.0（四分位间距 = 5 - 8）和4.0（四分位间距 = 3 - 4）。在正式培训水平方面，平均得分没有显著差异。没有临床病史时，只有40.0%的住院医师、22.2%的医务人员、24.2%的实习医生和13.2%的医学专业学生正确解读了胸部X光片，而在展示临床病史时，所有类别中超过75%的人正确解读了胸部X光片。然而，在有和没有患者临床病史这两种情况下，所有参与者在识别气胸（27.3%对30.3%）、纵隔气肿或左侧肋骨骨折（8.1%对33.3%）以及肺不张（37.4%对37.4%）的胸部X光片时都存在困难。
发现患者的临床病史对医生解读胸部X光片的能力有很大影响。我们发现医生和医学生在解读胸部X光片的能力方面存在差距；因此，应在医学培训的各个层面提高这项技能的培养。
