Educational program may help residents’ case interpretation, consistency

Real View Radiology (RVR), an educational system founded on guided MRI case review, may help increase radiology residents’ case interpretation confidence and improve the consistency of search pattern use, according to a study published online May 10 by Academic Radiology.

Case-based learning is at the heart of radiology education, as it is thought to enable imagers to create their own search patterns. “Case review might be considered the ‘gold standard’ for learning in radiology. Case review allows learners to gain exposure to a wide breadth of normal and abnormal cases thereby allowing learners to gradually determine where to focus attention while interpreting each type of study,” wrote lead author Jared H. Bailey, MD, of the Indiana University School of Medicine in Indianapolis, and colleagues.

Although training and repetition have been proven to improve search pattern accuracy, not much is known about the specific internal and external forces that contribute to the search patterns of trainees. The study’s authors created RVR to evaluate its impact on search patterns and interpretative confidence of junior radiology residents.

RVR guides learners through unknown exams by bringing their attention to certain aspects of a case through use of a comprehensive question set. The resident navigates exams using PACS and a built-in teaching and assessment system. The learners are then provided with immediate feedback.

Twelve first-year and 13 second-year residents were enrolled in the study. The junior residents completed a brief evaluation of their level of confidence when interpreting certain joint MRI cases and the frequency of search pattern use. Four half-days were spent interpreting cases using RVR and then evaluations were repeated. Results from the junior residents were compared to third-year residents who had not used RVR.

During the four-week musculoskeletal rotations, the residents completed an average of 29.3 MRI knee and 17.4 shoulder cases with RVR. The overall search pattern scores of the trained cohort significantly increased both from pretraining to posttraining and in comparison to the untrained third-year residents. Additionally, the trained cohort confidence scores significantly increased from pre to post for all joints.

“Given our results and resident feedback, consideration should be given for wider RVR implementation to include other subspecialty areas of radiology. Cases in subspecialty areas that are technically difficult to interpret because of complexity, such as cardiac computed tomography or MRI may prove helpful. In addition, RVR could be used to supplement training and search pattern creation in areas in which residents often do not acquire adequate clinical exposure,” concluded the researchers.