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OBJECTIVES - To assess the efficacy of dual film reading in screening mammography with a suitably trained radiographer as the second reader and to determine a suitable decision model for radiographer/radiologist double reading. SETTING - Three breast screening centres in South Thames (West) region. METHODS - Seven radiographers with prior film reading training double read 17 202 screening mammograms with a radiologist. Screening performance of radiographers and radiologists was assessed taking into account interval cancers. The efficacy of radiographer/radiologist double reading was assessed in terms of changes in sensitivity and specificity compared with radiologist single reading. RESULTS - Radiographers yielded equivalent sensitivity but lower specificity than radiologist film readers. The effect of double reading between radiographer/radiologist pairs was an increase in sensitivity of 6-4%, which was achieved at the cost of a 0-6% decrease in specificity. This was reached by a decision system involving radiologists' review of radiographer queries and recall classifications. If all radiographer queries were recalled a large increase in sensitivity would be counterbalanced by an equally large decrease in specificity. CONCLUSIONS - Radiographer/radiologist double reading resulted in similar increases in sensitivity as those previously reported in radiologist double reading studies. Radiologist review of radiographer reported abnormalities is a suitable means by which to limit excess recall.

Problem-based learning (PBL) is an internationally recognised pedagogical approach that is implemented within a number of disciplines. The relevance and uptake of PBL in psychology has to date, however, received very limited attention. The aim of this paper is therefore to review published accounts on how PBL is being used to deliver psychology curricula in higher education and to highlight psychological research that offers practical strategies for PBL theory and practice. The paper is divided into three sections. In the first, we discuss the principles of PBL and provide examples of how it can be used within psychology curricula alongside a consideration of its advantages and disadvantages. In the second section, we outline the results of a systematic literature review of published examples of PBL used within psychology undergraduate and postgraduate courses. Finally, in the third section, we examine some of the ways in which psychological research can provide practical guidance for PBL teaching practice. We conclude this paper with some recommendations for future research across all these areas, and call for the further development of PBL curricula in psychology higher education course provision. IntroductionProblem-based learning (PBL) is more than a pedagogical method (sometimes referred to as a didactic approach). It is an orientation to teaching and learning falling under the broad umbrella of student-centred, enquiry-based or active learning approaches (Barrett, 2005;Hmelo-Silver, 2004). PBL was pioneered in the 1960s in the Medical School at McMaster University, Canada (Barrows & Tamblyn, 1980) and has since then been developed at Aalborg University (Denmark), Maastricht University (Netherlands) and Newcastle University (Australia), as well as being implemented in a number of disciplines and universities worldwide. The fundamental principle of PBL is to equip students with an investigative approach and to develop a greater sense of responsibility for their learning. As the main processes of PBL are rooted in problem-solving, self-directed learning and group interaction, this places psychology very much at the centre of how PBL works and how it may be understood as a teaching and learning approach. Despite this, there is relatively little reporting of how PBL is used in psychology and how psychology informs PBL in published work (see for example, Dunsmuir & Frederickson, 2014;Kiernan, Murrell & Relf, 2008;Norman & Schmidt, 1992). In view of this, a main objective of this paper is to provide a systematic review of published accounts of the ways in which PBL is being used to deliver psychology curricula in higher education, with a second main objective to illustrate the ways in which psychological research can provide a range of principles and strategies that inform PBL practice. In so doing, our overall aim is to summarise the current developments in each of these areas and to stimulate a more robust engagement with PBL in psychology teaching and learning, and in psychological research. We will be...