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Emergency Radiology Elective Improves Second-Year Medical Students' Perceived Confidence and Knowledge of Appropriate Imaging Utilization

      Rationale and Objectives

      Given recent advances in and wider availability of complex imaging, physicians are expected to understand imaging appropriateness. We introduced second-year medical students to the American College of Radiology Appropriateness Criteria (ACR-AC) in an interactive case-based elective to demonstrate their use in imaging for common emergency department clinical complaints.

      Materials and Methods

      Prospective pre- and post-test design assessed second-year medical students' performance on case-based knowledge applications and self-assessed confidence related to ACR-AC guidelines compared to second-year students participating in a different concurrent radiology elective. Students participated in a 3-day elective covering the ACR-AC, comparative effective imaging, and risks associated with imaging radiation exposure, with outcomes of perceived confidence using a 5-point Likert scale and knowledge of ACR-AC using case-based multiple choice questions. Analysis included computing mean scores and assessing effect sizes for changes in knowledge.

      Results

      Before the elective, 24 students scored an average of 3.45 questions correct of 8 (43.1%). On course completion, students scored an average of 5.3 questions correct of the same questions (66.3%) (P < .001; effect size [Cohen's d] = 1.3940. In the comparison group, 12 students scored an average of 3.08 questions (38.5%) correctly pretest and 3.09 questions (38.6%) correctly post-test (P > .85; effect size = 0.008). Students' confidence in ordering appropriate imaging improved nearly 2-fold from a range of 1.9 to 3.2 (on a scale of 1.0 to 5.0) to a range of 3.7 to 4.5.

      Conclusions

      Following a short radiology elective, second-year medical students improved their knowledge of appropriate image utilization and perceived awareness of the indications, contraindications, and effects of radiation exposure related to medical imaging.

      Key Words

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      References

        • Hendee W.R.
        • Becker G.J.
        • Borgstede J.P.
        • et al.
        Addressing overutilization in medical imaging.
        Radiology. 2010; 257: 240-245
        • Dunnick N.R.
        • Applegate K.E.
        • Arenson R.L.
        The inappropriate use of imaging studies: a report of the 2004 Intersociety Conference.
        J Am Coll Radiol. 2005; 2: 401-406
        • Branstetter BFt
        • Humphrey A.L.
        • Schumann J.B.
        The long-term impact of preclinical education on medical students' opinions about radiology.
        Acad Radiol. 2008; 15: 1331-1339
        • Poot J.D.
        • Hartman M.S.
        • Daffner R.H.
        Understanding the US medical school requirements and medical students' attitudes about radiology rotations.
        Acad Radiol. 2012; 19: 369-373
        • Gunderman R.B.
        • Hill D.V.
        Student concerns and misconceptions about a career in radiology.
        Acad Radiol. 2012; 19: 366-368
        • Del Mar C.
        • Glasziou P.
        • Mayer D.
        Teaching evidence based medicine.
        BMJ. 2004; 329: 989-990
        • Erturk S.M.
        • Ondategui-Parra S.
        • Otero H.
        • et al.
        Evidence-based radiology.
        J Am Coll Radiol. 2006; 3: 513-519
        • Marshall N.L.
        • Spooner M.
        • Galvin P.L.
        • et al.
        Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.
        Radiographics. 2011; 31: 1463-1474
        • Thurley P.
        • Dennick R.
        Problem-based learning and radiology.
        Clin Radiol. 2008; 63: 623-628
        • Subramaniam R.M.
        Problem-based learning: concept, theories, effectiveness and application to radiology teaching.
        Australas Radiol. 2006; 50: 339-341
        • Cascade P.N.
        Setting appropriateness guidelines for radiology.
        Radiology. 1994; 192: 50A-54A
        • Chiunda A.B.
        • Mohammed T.L.
        Knowledge of ACR thoracic imaging Appropriateness Criteria® among trainees: one institution's experience.
        Acad Radiol. 2012; 19: 635-639
        • Nadgir R.
        • Slanetz P.J.
        Integrating evidence-based imaging into the radiology core clerkship: a proposed teaching tool of imaging strategies.
        J Am Coll Radiol. 2010; 7: 517-521
        • Dillon J.E.
        • Slanetz P.J.
        Teaching evidence-based imaging in the radiology clerkship using the ACR appropriateness criteria.
        Acad Radiol. 2010; 17: 912-916
        • Koontz N.A.
        • Gunderman R.B.
        Radiation safety and medical education: development and integration of a dedicated educational module into a radiology clerkship, outcomes assessment, and survey of medical students' perceptions.
        Acad Radiol. 2012; 19: 491-497
        • Branstetter B.F.
        • Faix L.E.
        • Humphrey A.L.
        • et al.
        Preclinical medical student training in radiology: the effect of early exposure.
        AJR Am J Roentgenol. 2007; 188: W9-14
        • Lynch D.C.
        • Whitley T.W.
        • Willis S.E.
        A rationale for using synthetic designs in medical education research.
        Adv Health Sci Educ Theory Pract. 2000; 5: 93-103
        • Hojat M.
        • Xu G.
        A visitor's guide to effect sizes: statistical significance versus practical (clinical) importance of research findings.
        Adv Health Sci Educ Theory Pract. 2004; 9: 241-249