Family medicine residents’ skill levels in emergency chest X-ray interpretation

Shammari, Malak Al; Hassan, Ali; AlShamlan, Nouf A; Alotaibi, Sarah; Bamashmoos, Manar; Hakami, Amani M; Althunyan, Abdullatif K; Basager, Shymaa A; Motabgani, Sameerah; Alsaif, Hind S.

doi:10.1186/s12875-021-01390-3

Cited by 4 publications

(6 citation statements)

References 29 publications

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“…On the other hand, other comparable study showed 83.8% of the participants detect the normal CXR. [8] This might be because of the quality of training and multiple exposure of such a case.…”

Section: Discussionmentioning

confidence: 99%

“…This survey sought to assess the competency level of medical interns in interpreting common X-ray abnormalities and to explore the barriers and enablers that contribute to the development of adequate X-ray interpretation skills. The study questionnaire was developed by reviewing recent literature and questionnaire used in previous study [8]. The survey's distribution was facilitated with the support of 18 data collectors from different universities, a measure taken to ensure the presence of a sufficiently large participant cohort that effectively represents the target population.…”

Section: Methodsmentioning

confidence: 99%

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Medical Interns' Skill Levels in Emergency Chest X-ray Interpretation

Alburayh,

AlSubaie,

Almuhanna

et al. 2023

SaudiRad

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Objectives: The research aims to evaluate the proficiency of medical interns in identifying critical findings on chest X-rays, such as pneumothorax, pleural effusion, pulmonary edema, pneumonia, and other urgent conditions. It also seeks to determine the interns' capability to differentiate between normal and abnormal findings, as well as their ability to prioritize and communicate these findings to senior medical staff promptly. Materials and Methods: A cross-sectional online questionnaire-based form was used to collect data from medical interns across different medical schools around Saudi Arabia. Pearson correlation was carried out to see the relationship between x-ray interpretation scores and degree of confidence. A Fischer exact test was conducted to find an association between the demographic characteristics and diagnostic accuracy of X-rays. Results: A total of 545 medical interns from different universities participated in this study. The lowest diagnosis accuracy (27%) was when identifying a case of left lower lobe pneumonia. On the other hand, the most identified case (60.9%) was COVID-19 pneumonia. In cases of life-threatening conditions, only 13.1% of them have high confidence in their diagnosis of pneumoperitoneum, and 23.8% have high confidence in their diagnosis of pneumothorax. Normal CXR was answered incorrectly by 47.7% of the participants. The performance among recently started interns for some conditions is better than that of recently finished interns. Moreover, there are no significant differences in performance between those who are interested in radiology and those who are not. More than half of the participants advise doing extracurricular courses, practical case-based training in college, and volunteer work in radiology to improve their CXR interpretation skills. Conclusion: The competence of medical interns in interpreting chest X-rays varied across different medical conditions. Only 27.0% of interns correctly identified left lower lobe pneumonia, while 60.9% of them were able to identify COVID-19 pneumonia. Medical interns' competencies have limitations across different medical conditions; therefore, increasing exposure to radiological cases during internships and adequate training in college are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Medical Interns' Skill Levels in Emergency Chest X-ray Interpretation

Alburayh,

AlSubaie,

Almuhanna

et al. 2023

SaudiRad

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“…The COVID-19 pandemic may have also contributed to the increased number of chest radiographs performed during the study. 26 …”

Section: Discussionmentioning

confidence: 99%

“…The Covid-19 pandemic may have also contributed to the increased number of chest radiographs performed during the study. 26 General practitioners reported strong performance in consultation and communication skills, although communication skills are challenging to define and self-assess. 27 Indirect observation of the GPs' consultations in a previous study carried out at these facilities, showed that consultations were brief, bio-medical and lacked a person-centred approach.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Clinical skills of general practitioners in Nairobi, Kenya: a cross-sectional study

Mohamoud

Mash

2022

BJGP Open

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BackgroundQuality service delivery in primary care requires motivated and competent health professionals. In the Kenyan private sector, general practitioners (GP), with no post-graduate training in family medicine, offer primary care. There is a paucity of evidence on the ability of primary care providers to deliver comprehensive care and no such evidence is available for GPs practising in the private sector in Kenya.AimTo evaluate GPs’ training and experience in the skills required for comprehensive primary care.Design and settingA cross-sectional descriptive survey in 13 primary care clinics in the private sector of Nairobi, KenyaMethodA questionnaire, originally designed for a national survey of primary care doctors in South Africa, was adapted. The study collected self-reported data on performance of clinical skills by 25 GPs. Data were analysed in the Statistical Package for Social Sciences.ResultsGPs were mostly under 40 years, with less than 10 years of experience and an equal gender distribution. GPs reported moderate performance with adult health, communication and consultation, and clinical administration; and weak performance with emergencies, child health, surgery, ear-nose-and-throat, eyes, women’s health and orthopaedics. The GPs lacked training in specific skills such as proctoscopy, contraceptive devices, skin procedures, intra-articular injections, red reflex test and use of a genogram.ConclusionGeneral practitioners lacked training and performed poorly in some of the essential skills required in primary care. Continuing professional development, training in Family Medicine and deployment of family physicians to the clinics could improve the comprehensiveness of care.

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“…4,11–13 Although systems are often in place for the correction of errors made at the bedside, the final report by a radiologist may not be available in a timely manner to influence immediate decision-making, and in resource limited settings, there may be no radiologist over-read of the pCXR at all. 1,9,14–16…”

mentioning

confidence: 99%

A Performance-Based Competency Assessment of Pediatric Chest Radiograph Interpretation Among Practicing Physicians

Bregman

Thau

Pusic

et al. 2022

J Contin Educ Health Prof

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Introduction: There is limited knowledge on pediatric chest radiograph (pCXR) interpretation skill among practicing physicians. We systematically determined baseline interpretation skill, the number of pCXR cases physicians required complete to achieve a performance benchmark, and which diagnoses posed the greatest diagnostic challenge. Methods: Physicians interpreted 434 pCXR cases via a web-based platform until they achieved a performance benchmark of 85% accuracy, sensitivity, and specificity. Interpretation difficulty scores for each case were derived by applying one-parameter item response theory to participant data. We compared interpretation difficulty scores across diagnostic categories and described the diagnoses of the 30% most difficult-to-interpret cases.Results: 240 physicians who practice in one of three geographic areas interpreted cases, yielding 56,833 pCXR case interpretations. The initial diagnostic performance (first 50 cases) of our participants demonstrated an accuracy of 68.9%, sensitivity of 69.4%, and a specificity of 68.4%. The median number of cases completed to achieve the performance benchmark was 102 (interquartile range 69, 176; min, max, 54, 431). Among the 30% most difficult-to-interpret cases, 39.2% were normal pCXR and 32.3% were cases of lobar pneumonia. Cases with a single trauma-related imaging finding, cardiac, hilar, and diaphragmatic pathologies were also among the most challenging. Discussion: At baseline, practicing physicians misdiagnosed about one-third of pCXR and there was up to an eight-fold difference between participants in number of cases completed to achieve the standardized performance benchmark. We also identified the diagnoses with the greatest potential for educational intervention.

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Family medicine residents’ skill levels in emergency chest X-ray interpretation

Cited by 4 publications

References 29 publications

Medical Interns' Skill Levels in Emergency Chest X-ray Interpretation

Medical Interns' Skill Levels in Emergency Chest X-ray Interpretation

Clinical skills of general practitioners in Nairobi, Kenya: a cross-sectional study

A Performance-Based Competency Assessment of Pediatric Chest Radiograph Interpretation Among Practicing Physicians

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