Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus Box 8131, Saint Louis, MO, 63110, USA.
Abdom Radiol (NY). 2022 Jul;47(7):2509-2519. doi: 10.1007/s00261-022-03523-3. Epub 2022 Apr 28.
The purpose of this study was to transition from a traditional score-based peer-review system to an education-oriented peer-learning program in our academic abdominal radiology practice.
This retrospective study compared our experience with a score-based peer-review model used prior to September 2020 and a peer-learning model implemented and used exclusively beginning in October of 2020. In peer review, a web-based peer-review tool randomly generated a list of cases, which were blindly reviewed in consensus. Comparison of the consensus interpretation with the original report was used to categorize each reviewed case and to calculate the rates of significant and minor discrepancies. Only cases with a discrepancy were considered to represent a learning opportunity. In peer learning, faculty prospectively identified and submitted cases for review in several categories, including case interpretations with a discrepancy from subsequent opinion or result, interpretations considered to represent a great call, and interesting or challenging cases meriting further discussion. The peer-learning coordinator showed each case to the group in a manner which blinded the group to both submitting and interpreting radiologist and invited discussion during various stages of the case.
During peer review, a total of 172 cases were reviewed over 16 sessions occurring between April 2016 and September 2020. Only 3 cases (1.8%) yielded significant discrepancies whereas 13 (7.6%) yielded minor discrepancies, representing a total of 16 learning opportunities (3.6 per year). In peer learning, 64 cases were submitted and 52 reviewed over 7 sessions occurring between October 2020 and October 2021. 29 (56%) were submitted as an interesting or challenging case meriting further discussion, 18 (35%) were submitted for a discrepancy, and 5 (10%) were submitted for a great call. All 52 presented cases represented learning opportunities (48 per year).
An education-focused peer-learning program provided a platform for continuous quality improvement and yielded substantially more learning opportunities compared to score-based peer review.
本研究旨在将我们学术腹部放射学实践中的传统基于评分的同行评议系统转变为以教育为导向的同伴学习计划。
本回顾性研究比较了我们在 2020 年 9 月之前使用基于评分的同行评议模型的经验和 2020 年 10 月开始专门使用的同伴学习模型。在同行评议中,使用基于网络的同行评议工具随机生成一份病例列表,这些病例以共识方式进行盲法审查。将共识解释与原始报告进行比较,以对每个审查病例进行分类,并计算重大和次要差异的发生率。只有出现差异的病例才被认为是学习机会。在同伴学习中,教师前瞻性地确定并提交了几类病例进行审查,包括与后续意见或结果存在差异的病例解释、被认为是伟大呼叫的解释,以及值得进一步讨论的有趣或具有挑战性的病例。同伴学习协调员以一种使小组对提交和解释放射科医生都视而不见的方式向小组展示每个病例,并在病例的各个阶段邀请讨论。
在同行评议中,在 2016 年 4 月至 2020 年 9 月期间的 16 次会议中,共审查了 172 例病例。只有 3 例(1.8%)出现重大差异,13 例(7.6%)出现次要差异,共代表 16 个学习机会(每年 3.6 个)。在同伴学习中,在 2020 年 10 月至 2021 年 10 月期间的 7 次会议中,共提交了 64 例病例,其中 52 例被审查。29 例(56%)提交的是一个有趣或具有挑战性的病例,值得进一步讨论,18 例(35%)提交的是有差异的病例,5 例(10%)提交的是一个伟大的呼叫。所有 52 个呈现的病例都代表了学习机会(每年 48 个)。
以教育为重点的同伴学习计划为持续质量改进提供了一个平台,与基于评分的同行评议相比,产生了更多的学习机会。