Dunne Kevin, Madden Caoimhe, Byrne Dara, McCarthy Peter, O'Connor Paul, Lydon Sinéad
Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Galway, Ireland; Department of Radiology, University Hospital Galway, Galway, Ireland.
Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Galway, Ireland.
Eur J Radiol. 2022 Jun;151:110296. doi: 10.1016/j.ejrad.2022.110296. Epub 2022 Apr 6.
Junior doctors find chest radiograph (CXR) interpretation challenging, and commonly make diagnostic errors. The aim of this study was to evaluate the effectiveness of SAFMEDS in teaching undergraduate medical students to identify important chest abnormalities in radiology imaging.
A pragmatic randomized controlled trial design was utilized. Third-year medical students were randomly assigned to an intervention group (n = 20), who received the SAFMEDS intervention, or a control group (n = 20), who did not receive the intervention. Three participants (one intervention, two control) withdrew from participation. Percentage accuracy in CXR interpretation was assessed at three timepoints (baseline, post-test, and retention). A series of one-way between-subjects' analyses of covariance, with percentage accuracy at the pre-test timepoint entered as the covariate, were conducted.
Large effect sizes of the SAFMEDS intervention were observed at post-test and retention (η = 0.67, η = 0.58 respectively), with the intervention group demonstrating significantly higher percentage accuracy in CXR interpretation as compared to the control group at both timepoints. Intervention group performance decreased by 5.26% (SD = 9.80) from post-test to retention. Twelve intervention group participants (63.2%) met the fluency criteria. Despite large effect sizes, there were no significant differences in post-test or retention performance between fluent and non-fluent participants (η = 0.17 and η = 0.2 respectively).
SAFMEDS offers an effective adjunct to usual teaching. Future research could focus on examining the effect of fluency with a larger sample, in addition the expansion of the SAFMEDS approach, and its' application to other health profession populations.
初级医生发现胸部X光片（CXR）解读具有挑战性，且常犯诊断错误。本研究的目的是评估速示卡片教学法（SAFMEDS）在教导本科医学生识别放射影像中重要胸部异常方面的有效性。
采用实用随机对照试验设计。三年级医学生被随机分配到干预组（n = 20），接受SAFMEDS干预，或对照组（n = 20），不接受干预。三名参与者（一名干预组，两名对照组）退出研究。在三个时间点（基线、测试后和留存期）评估CXR解读的准确率。进行了一系列单因素组间协方差分析，将测试前时间点的准确率作为协变量纳入。
在测试后和留存期观察到SAFMEDS干预有较大效应量（分别为η = 0.67，η = 0.58），干预组在两个时间点的CXR解读准确率均显著高于对照组。干预组的表现从测试后到留存期下降了5.26%（标准差 = 9.80）。12名干预组参与者（63.2%）达到了流利标准。尽管效应量较大，但流利和不流利参与者在测试后或留存期的表现没有显著差异（分别为η = 0.17和η = 0.2）。
SAFMEDS是常规教学的有效辅助方法。未来的研究可以集中在以更大样本研究流利程度的影响，此外还可以扩展SAFMEDS方法，并将其应用于其他卫生专业人群。
