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

Abstract

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.

Chest X‐ray evaluation training: impact of normal and abnormal image ratio and instructional sequence

“…The interpretation of medical images, such as electrocardiograms, pathology slices or radiographs, is an important part of everyday medical practice . Research on medical image interpretation has primarily focused on characteristics of visual expertise . In such research, novices and experts in image interpretation are compared and the experts’ performance is superior to that of novices.…”

A new mobile learning module using smartphone wallpapers in identification of medical fungi for medical students and residents

“…Educators have attempted to design different instructional materials to aid medical image interpretation, from lecture‐based, teacher‐centered education to active, student‐centered learning . With modern technology, almost every medical student or resident uses a smartphone in their daily lives.…”

Radiology education: a radiology curriculum for all medical students?

“…Most importantly, however, if students have to learn to interpret radiological images, image interpretation needs to be part of the curriculum, and radiology should not be taught in lectures only: practicing with a substantial number of realworld cases promotes learning [24]. E-learning modules are widely used in radiology because they provide great opportunities for practicing interpretation skills with (immediate) feedback [25][26][27]. They allow for practicing the whole task of image perception, interpretation and decision [28] and provide scaffolding of the task.…”

“…Importantly, teaching files should include not only abnormal radiographs but also normal images of different image quality. Detailed recommendations for designing effective and efficient instruction in radiology can be found elsewhere [25].…”