Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation

Abstract

Objectives To evaluate ESR eGUIDE—the European Society of Radiology (ESR) e-Learning tool for appropriate use of diagnostic imaging modalities—for learning purposes in different clinical scenarios. Methods This anonymized evaluation was performed after approval of ESR Education on Demand leadership. Forty clinical scenarios were developed in which at least one imaging modality was clinically most appropriate, and the scenarios were divided into sets 1 and 2. These sets were provided to medical students randomly assigned to group A or B to select the most appropriate imaging test for each scenario. Statistical comparisons were made within and across groups. Results Overall, 40 medical students participated, and 31 medical students (78%) answered both sets. The number of correctly chosen imaging methods per set in these 31 paired samples was significantly higher when answered with versus without use of ESR eGUIDE (13.7 ± 2.6 questions vs. 12.1 ± 3.2, p = 0.012). Among the students in group A, who first answered set 1 without ESR eGUIDE (11.1 ± 3.2), there was significant improvement when set 2 was answered with ESR eGUIDE (14.3 ± 2.5, p = 0.013). The number of correct answers in group B did not drop when set 2 was answered without ESR eGUIDE (12.4 ± 2.6) after having answered set 1 first with ESR eGUIDE (13.0 ± 2.7, p = 0.66). Conclusion The clinical decision support tool ESR eGUIDE is suitable for training medical students in choosing the best radiological imaging modality in typical scenarios, and its use in teaching radiology can thus be recommended. Key Points • ESR eGUIDE improved the number of appropriately selected imaging modalities among medical students. • This improvement was also seen in the group of students which first selected imaging tests without ESR eGUIDE. • In the student group which used ESR eGUIDE first, appropriate selection remained stable even without the teaching tool.

Advances in e-learning in undergraduate clinical medicine: a systematic review

“…This finding is consistent with conclusions from a review by Kim et al, describing how most of the existing literature on e-learning interventions have little quantitative data, evaluate a limited range of outcomes and have significant gaps in study designs [72]. Additionally, only 13 (31%) randomized control trials (RCTs) were included in the review [26,[43][44][45][46][47][48][49][50][51][52][53][54]. Amongst these studies, five reported pre and post test scores [45,48,[52][53][54], three of which report long term follow up [45,52,54].…”

“…More than half of the studies were conducted in the European Union (21 studies). Several research designs were described, including 17 observational studies [25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42], 13 randomised control trials [26,[43][44][45][46][47][48][49][50][51][52][53][54], three non-randomised control trials [55][56][57], eight qualitative studies [58][59][60][61][62][63][64][65], and one mixed methods study [66]. Thirteen of the total studies included data collection both pre-and post-intervention [25,27,31,34,36,38,…”

“…The interventions ranged in duration from a single session to a complete academic year. Thirteen of the interventions were synchronous, where users log on at a given time [8,26,27,31,33,34,37,43,47,51,52,58,66], and the remaining 29 used an asynchronous platform (users logging on independently in their own time). Seven were accessible in a classroom setting only [26,27,36,47,52,58,66] while the others could be accessed from home (Fig.…”

“…Twenty-nine (69%) of the 42 studies described an impact matching a Kirkpatrick level 2, where evaluation of whether learning took place was assessed through post intervention scores [25, 27, 31, 36, 38, 39, 47, 48, 50, 52-54, 56, 57, 61], final exam results [26,29,45,66], direct observation [28,31,33,43,46,51,55] and student survey [25, 26, 30, 37-42, 45, 48, 49, 53, 54, 56, 65, 66]. Among these studies, two studies had included both pre-and post-intervention evaluations but neither had a control group nor longer term follow-up [25,27].…”

A context-based chatbot surpasses trained radiologists and generic ChatGPT in following the ACR appropriateness guidelines

“…(https://www.changehealthcare.com/clinical-decision-support/careselect/imaging)) 10,13 . These tools have proven valuable in improving the diagnostic management of patients with various clinical conditions, resulting in lower rates of inappropriate examinations 3,14,15 .…”