Search pattern training for evaluation of central venous catheter positioning on chest radiographs

Abstract

The goal of this research was to examine whether search pattern training for central line positioning on chest radiographs (CXRs) improves the ability of healthcare trainees and practitioners to identify malpositioned central venous catheters. Two sets of CXRs with central catheters were shown; half of the images contained catheters that were appropriately positioned, half that were malpositioned. Subjects were asked to: mark the tip of the catheter using the simulated radiology workstations, indicate their confidence in tip localization, and state whether the catheter was appropriately positioned or malpositioned. Subjects were also given a survey assessing their thoughts about the usefulness of search pattern training and the simulated radiology workstation. There was a significant improvement in subjects' ability to classify a catheter as malpositioned after training, [Formula: see text]-value = 0.03. There was no significant difference in localization of the catheter tips or in the confidence for tip localization. Subjects' responses to the questionnaire were significantly positive for all statements, indicating that they felt search pattern training using a simulated radiology workstation had a positive impact on their education. These results suggest that our knowledge of medical image perception may be useful for developing rational educational tools for image interpretation, and that simulated radiology workstations may be a helpful means of deploying these tools.

Examining the effects of passive and active strategy use during interactive search for LEGO® bricks.

“…If expertise leads to differences in both the visual and manual components of interactive search, the natural follow-up question to ask is: Which strategies that arise from training and/or experience might be helpful to adopt to increase performance during interactive search? Questions of expertise in visual search have been explored in detail in previous research (Reingold & Sheridan, 2011;Sheridan & Reingold, 2017) but those studies have tended to compare groups of novices to groups of experts 3 who have already acquired skill in strategy use (e.g., radiologists who employ systematic scanpaths while conducting a radiographic examination, see Auffermann et al, 2015Auffermann et al, , 2018; see also van Geel et al, 2017), perceptual identification (e.g., airport security screeners trained to identify improvised explosive devices, Kramer et al, 2019), or the use of search aids (e.g., control over volumetric scanning in three-dimensional radiography). Often in such studies, experts are either not queried about the strategies they adopt, or they are otherwise unable to articulate the details of the strategies they have learned to employ through experience in their profession (e.g., it may be difficult to explicitly define why one thinks that a certain area of tissue is abnormal or problematic during inspection of a chest X-ray, Waite et al, 2019).…”

Specific versus varied practice in perceptual expertise training.

“…Restricting or cuing participants to diagnostic information can improve decision-making accuracy in tasks such as classifying fish (Baruch et al, 2014), identifying aircraft (Dror et al, 2008), and matching unfamiliar faces (Towler et al, 2021). Visual search training can also benefit performance in radiology and baggage screening tasks (Auffermann et al, 2018; Nakashima et al, 2013; Schuster et al, 2013). Developing perceptual skill with fingerprints may similarly rely on attention and visual search.…”

Cognitive processing differences of experts and novices when correlating anatomy and cross-sectional imaging

“…A computer-based simulation system was used to study whether or not this simulated environment can determine preparedness of radiology residents for being on-call [56][57][58] and reading mammograms. 59 Additionally, simulations using radiology workstations have been used to explore perception differences in experts and novices, and explore reasons for missed diagnoses, 60,61 search pattern training to improve nodule detection, 62,63 and central venous line placement 64 on chest x-rays.…”