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Introduction: This needs assessment evaluated residents’ and medical students’ knowledge of Competence by Design (CBD), perceived benefits of and challenges or barriers to the transition to CBD for residents, and perceived overall preparedness for the transition to CBD in diagnostic radiology. Materials and Methods: All diagnostic radiology residents and medical students in Canada were eligible to participate in this national cross-sectional, questionnaire-based needs assessment. Knowledge of CBD was evaluated through participants’ self-reported rating of their knowledge of CBD on a 5-point Likert scale. Perceived benefits of and challenges or barriers to the transition to CBD for residents were rank ordered. Participants’ overall self-reported preparedness for the transition to CBD was assessed on a 5-point Likert scale. Data were summarized by descriptive statistics and bivariate analyses were conducted as appropriate. Results: Ninety-four residents ( n = 77) and medical students ( n = 17) participated in this needs assessment. Participants’ mean ± standard deviation self-reported rating of their overall knowledge of CBD was 2.86 ± .94. Provision of meaningful feedback to learners and learners’ ability to identify their own educational needs were among the highest ranked perceived benefits of the transition to CBD, while demands on time and increased frequency of evaluation were among the highest ranked perceived challenges or barriers to the transition to CBD. Few participants reported being either “prepared” (4.7%) or “somewhat prepared” (14.0%) for the transition to CBD. Conclusion: Preparedness for the transition to CBD in diagnostic radiology may be improved. Targeted interventions to augment the preparedness of residents and medical students should be considered.

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Ten humeri and ten femora were radiographed in nine positions of longitudinal rotation. In each position total, medullary and cortical widths of the diaphyses (TW, MW, CW) were measured to assess the effect of rotation on these dimensions. The results were expressed as differences from the values in the neutral position (delta TW, delta MW, delta CW). In the humerus, medial rotation produced greater changes than lateral rotation. Though rotation in either direction increased CW, the systematic error due to medial rotation to only 5 degrees (approximately +0.0058 cm per degree) was more than double that due to lateral rotation. In the femur, lateral rotation had the greater effect, producing a marked decrease in CW (approximately -0.0072 cm per degree). Medial rotation produced only a slight increase in CW. The ratios CW/TW ("cortical index") and CA/TA ("area ratio") were calculated and expressed as differences from the values in the neutral position (delta CW/TW, delta CA/TA). Rotation affected these variables much less than the linear dimensions. Furthermore, through the variance of delta TW, delta MW and delta CA/TA increased only slightly or not at all. These results suggest that if radiographic morphometry is to be applied to the humerus and femur, these ratios rather than transverse dimensions should be used. Sequential changes in CW may be totally obscured by small rotational errors.

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