Most radiologists have moved toward peer learning, but many want more standardization

Most practicing radiologists have made the move toward peer learning, but there are still discrepancies in the process causing dissatisfaction among large ranks of imaging professionals, according to a new survey.

Peer review systems are designed to assess radiologists’ competency and help maintain their ability to deliver high-quality care. Some current approaches, however, do the opposite, Cindy S. Lee, with NYU School of Medicine, and colleagues argued Jan. 15 in the American Journal of Roentgenology.

“Existing peer review systems have multiple problems and unintended consequences,” they noted. “Participants find that the process of scoring peers and being graded is awkward, anxiety-provoking, damaging to personal relationships, threatening to job security, time-consuming and potentially biased.”

Because of this, radiologists have been clamoring to transition toward a peer-learning model, emphasizing positive culture, anonymous cases and growth. But few studies have been able to gauge the current status of peer review, Lee et al. noted.

The team emailed a 21-question, multiple-choice questionnaire to more than 17,000 members of the American Roentgen Ray Society. Of that total, 547 board-certified radiologist responses were available for inclusion in the study.

Overall, a majority of respondents said they are evaluated through a peer-learning, rather than peer-review system. Approximately 45% of radiologists remain “dissatisfied” with their peer review program; nearly all of those experts cited “insufficient learning” as a source of unhappiness, with 75% also reporting problems with how their performance improvement is represented.  

This isn’t surprising, the authors wrote, given that peer learning results in “improved clinical practice, better patient outcomes and greater radiologist satisfaction.”

There are areas where both peer review and peer learning can be improved, Lee and co-authors wrote.

Determining the minimum number of required monthly cases for peer review and how discrepancies in interpretations are communicated to radiologists are two areas that need standardization, they wrote. Uniform metrics for reporting peer learning could also be benchmarked on a national level to help address radiologists’ displeasure.