Problem‐Solving Model in Radiology for Medical Students

Abstract

Current undergraduate medical education is criticized for not preparing physicians to be independent thinkers. The rapid development of new imaging techniques and the problem of escalating medical costs call for efficient patient management. The development of algorithms in imaging work-up of patient problems is an excellent example of problem solving or medical decision making. The senior elective in radiology at our institution incorporates this type of problem-solving session. Small groups (15-25 students) with faculty guidance discuss 5-6 common patient problems to develop an investigative plan in imaging. Algorithms are thus developed by the group, but not presented for memorization. Small changes are then made in the case history so that the students are forced to make new hypotheses and generate a modified algorithm. Correlative costs are included. Flexibility and initiative in development of patient management algorithms are stressed.

Pedagogical Approaches to Diagnostic Imaging Education: A Narrative Review of the Literature

“…This ability, combined with the use of an adaptable radiographic search pattern, has been shown to correlate with successful interpretation of radiographs. 4 The article “Problem-Solving Model in Radiology for Medical Students” 5 suggests that the use of algorithms will improve students’ ability to develop this skill set. The authors propose that radiology, with its multitude of rapidly developing imaging techniques and associated escalating costs, demands that students become proficient medical decision makers.…”

Factors associated with success or failure in radiological interpretation: diagnostic thinking approaches

“…It is important to note that virtually all of the research into factors determining diagnostic success has compared clinicians with differing levels of clinical experience. 17,18,20,22,28,30 This is also true of the studies evaluating diagnostic accuracy within radiology. 2±4 No studies prior to this one have investigated factors determining differences in radiological diagnostic success within students or clinicians with the same level of experience.…”

“…Their original instrument has been shown to demonstrate both strong reliability and validity for differentiating expert from novice diagnosticians. As radiology has frequently been described as a classic example of clinical problem solving, 7,14,22 it was logical that portions of this questionnaire should also differentiate more expert from less expert radiological diagnosticians.…”

“…history taking and physical examination procedures) information gathering however. As pointed out by Blane et al, 22 experienced medical problem solvers use less available information to generate fewer hypotheses and need fewer tests to con®rm or rule out their hypotheses. However, with gathering the information from a set of radiographs, all studies show that one must be thorough and complete, covering all areas of the X-ray visualized.…”

“…Prior studies using radiology written examinations suggested 10 cases as an adequate number. 22,30 Fifteen cases were used in the written radiology examinations in this study and therefore, the written exam should have been a more accurate re¯ection of actual student ability than the oral ®lm-reading sessions. Thus the three cases used for the observed sessions became more valuable in terms of assessing student processes of evaluation rather than re¯ecting diagnostic accuracy.…”