Simulation for Teaching and Assessment of Nodule Perception on Chest Radiography in Nonradiology Health Care Trainees

Auffermann, William F.; Henry, Travis S.; Little, Brent P.; Tigges, Stefan; Tridandapani, Srini

doi:10.1016/j.jacr.2015.07.014

Cited by 21 publications

(16 citation statements)

References 22 publications

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“…17,18 Search patterns suggesting specific eye movements have not been adequately emphasized in radiology education to date. 7 The study proctors queried subjects regarding their prior CXR training after completion of the study. All subjects had received prior training in chest radiography and had been given search algorithms that were essentially checklists of structures to evaluate.…”

Section: Discussionmentioning

confidence: 99%

“…The number of students who were trained per radiologist-hour by individual training in our prior study was approximately 1. 7…”

Section: Training Efficiencymentioning

confidence: 99%

“…Prior research has shown that teaching a search pattern for comprehensive evaluation of the lungs to medial trainees on an individual basis improved their ability to identify pulmonary nodules on CXR. 7 After individual search pattern training (SPT) at a simulated radiology workstation (SRW), medical trainees demonstrated an improved ability to identify pulmonary nodules. In addition, trainees felt that the training was more effective when compared with conventional educational methods.…”

Section: Introductionmentioning

confidence: 99%

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Teaching search patterns to medical trainees in an educational laboratory to improve perception of pulmonary nodules

2015

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The goal of this research is to demonstrate that teaching healthcare trainees a formal search or scan pattern for evaluation of the lungs improves their ability to identify pulmonary nodules on chest radiographs (CXRs). A group of physician assistant trainees were randomly assigned to control and experimental groups. Each group was shown two sets of CXRs, each set with a nodule prevalence of approximately 50%. The experimental group received search pattern training between case sets, whereas the control group did not. Both groups were asked to mark nodules when present and indicate their diagnostic confidence. Subject performance at nodule detection was quantified using changes in area under the localization receiver operating characteristic curve ([Formula: see text]). There was no significant improvement in performance between case sets for the control group. There was a significant improvement in subject performance after training for the experimental group, [Formula: see text], [Formula: see text]. These results demonstrate that teaching a search pattern to trainees improves their ability to identify nodules and decreases the number of perceptual errors in nodule identification, and suggest that our knowledge of medical image perception may be used to develop rational tools for the education of healthcare trainees.

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Section: Discussionmentioning

confidence: 99%

“…The number of students who were trained per radiologist-hour by individual training in our prior study was approximately 1. 7…”

Section: Training Efficiencymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Teaching search patterns to medical trainees in an educational laboratory to improve perception of pulmonary nodules

2015

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“…The claim that students should be instructed to diagnose a case first, based on feelings of familiarity (non-analytic reasoning) and only then collect and analyze all information (analytic reasoning) contrasts with the claim that it is crucial to systematically collect all relevant information in a medical image before making a diagnosis, which is the assumption underlying the idea of teaching a search pattern ( Auffermann et al, 2015 , 2016 ). While these studies provide evidence for a benefit of a search pattern training in radiology over no training, the benefit of systematic viewing training over a non-systematic search pattern training could not be established in radiology ( Kok et al, 2016 ) or in ECG interpretation ( Varvaroussis et al, 2014 ).…”

Section: Reviewmentioning

confidence: 99%

What We Do and Do Not Know about Teaching Medical Image Interpretation

et al. 2017

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Educators in medical image interpretation have difficulty finding scientific evidence as to how they should design their instruction. We review and comment on 81 papers that investigated instructional design in medical image interpretation. We distinguish between studies that evaluated complete offline courses and curricula, studies that evaluated e-learning modules, and studies that evaluated specific educational interventions. Twenty-three percent of all studies evaluated the implementation of complete courses or curricula, and 44% of the studies evaluated the implementation of e-learning modules. We argue that these studies have encouraging results but provide little information for educators: too many differences exist between conditions to unambiguously attribute the learning effects to specific instructional techniques. Moreover, concepts are not uniformly defined and methodological weaknesses further limit the usefulness of evidence provided by these studies. Thirty-two percent of the studies evaluated a specific interventional technique. We discuss three theoretical frameworks that informed these studies: diagnostic reasoning, cognitive schemas and study strategies. Research on diagnostic reasoning suggests teaching students to start with non-analytic reasoning and subsequently applying analytic reasoning, but little is known on how to train non-analytic reasoning. Research on cognitive schemas investigated activities that help the development of appropriate cognitive schemas. Finally, research on study strategies supports the effectiveness of practice testing, but more study strategies could be applicable to learning medical image interpretation. Our commentary highlights the value of evaluating specific instructional techniques, but further evidence is required to optimally inform educators in medical image interpretation.

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“…Specifically, medical trainees shown a search pattern for evaluation of the lungs showed improved ability to identify pulmonary nodules on chest radiographs (CXRs). 3,4 This lung search pattern instructs the observer to sweep their eyes over each intercostal space (Fig. 1), thereby ensuring that the entire lungs were evaluated by the observer's central field-of-view.…”

Section: Introductionmentioning

confidence: 99%

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

2018

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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.

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Simulation for Teaching and Assessment of Nodule Perception on Chest Radiography in Nonradiology Health Care Trainees

Cited by 21 publications

References 22 publications

Teaching search patterns to medical trainees in an educational laboratory to improve perception of pulmonary nodules

Teaching search patterns to medical trainees in an educational laboratory to improve perception of pulmonary nodules

What We Do and Do Not Know about Teaching Medical Image Interpretation

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

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