LITERATURE HIGHLIGHTS

Abstract

Resident Case Volume Correlates with Clinical Performance: Finding the Sweet Spot

Vikas Agarwal MD, Gregory M. Bump MD, Matthew T. Heller MD, Ling-Wan Chen MS, PhD, Barton F. Branstetter MD, Nikhil B. Amesur MD and Marion A. Hughes MD

Academic Radiology, 2019-01-01, Volume 26, Issue 1, Pages 136-140, Copyright © 2018 The Association of University Radiologists

Rationale and Objectives

To determine whether the total number of studies interpreted during radiology residency correlates with clinical performance as measured by objective criteria.

Materials and Methods

We performed a retrospective cohort study of three graduating classes of radiology residents from a single residency program between the years 2015–2017. The total number of studies interpreted by each resident during residency was tracked. Clinical performance was determined by tracking an individual resident's major discordance rate. A major discordance was recorded when there was a difference between the preliminary resident interpretation and final attending interpretation that could immediately impact patient care. Accreditation council for graduate medical education milestones at the completion of residency, Diagnostic radiology in-training scores in the third year, and score from the American board of radiology core exam were also tabulated. Pearson correlation coefficients and polynomial regression analysis were used to identify correlations between the total number of interpreted films and clinical, test, and milestone performance.

Results

Thirty-seven residents interpreted a mean of 12,709 studies (range 8898–19,818; standard deviation [SD] 2351.9) in residency with a mean major discordance rate of 1.1% (range 0.34%–2.54%; stand dev 0.49%). There was a nonlinear correlation between total number of interpreted films and performance. As the number of interpreted films increased to approximately 16,000, clinical performance ( p = 0.004) and test performance ( p = 0.01) improved, but volumes over 16,000 correlated with worse performance.

Conclusion

The total number of studies interpreted during radiology training correlates with performance. Residencies should endeavor to find the “sweet spot”: the amount of work that maximizes clinical exposure and knowledge without overburdening trainees.

Trainee radiologist reports as a source of confirmation bias in radiology 

A. Nanapragasam, P. Bhatnagar and D. Birchall

Clinical Radiology, 2018-12-01, Volume 73, Issue 12, Pages 1052-1055, Copyright © 2018 The Royal College of Radiologists

Aim

To assess and quantify the relationship between trainee reporting and radiology errors.

Materials and methods

A retrospective analysis of the 100 most recent cases reviewed by a discrepancy forum in a tertiary neuroradiology service was performed. Data on the time of the scan and the presence of a trainee report were collected, with comparison being made between the cohort of erroneous reports and the overall service.