Real View Radiology - impact on Search Patterns and Confidence in Radiology Education

Rationale and Objectives: Search patterns are important for radiologists because they enable systematic case review. Because radiology residents are exposed to so many imaging modalities and anatomic regions, and they rotate on-and-off service so frequently, they may have difficulty establishing effective search patterns. We-developed Real View Radiology (RVR), an educational system founded on guided magnetic resonance imaging (MRI) case review and evaluated its impact on search patterns and interpretative confidence of junior radiology residents. Materials and Methods: RVR guides learners through unknown examinations by sequentially prompting learners to certain aspects of a case via a comprehensive question set and then providing immediate feedback. Junior residents first completed a brief evaluation regarding their level of confidence when interpreting certain joint MRI cases and frequency of search pattern use. They spent four half-days interpreting cases using RVR. Once finished, they repeated the evaluations. The junior resident results were compared to third-year residents who had not used RVR. The data were analyzed for change in confidence, use of search patterns, and number of cases completed. Results: Twelve first-year and thirteen second-year residents (trained cohort) were enrolled in the study. During their 4-week musculoskeletal rotations, they completed on average 29.3 MRI knee (standard deviation [SD], 1.6)and 17.4 shoulder (SD, 1.2) cases using RVR. Overall search pattern scores of the trained cohort increased significantly both from pretraining to posttraining (knee P <.01, shoulder P <.01) and compared to the untrained third-year residents (knee (P <.01, and shoulder P <.01). The trained cohort confidence scores also increased significantly from pre to post for all joints (knee P <.01, shoulder P <.01, pelvis P <.01, and ankle P <.01). Conclusions: Radiology residents can increase their MRI case interpretation confidence and improve the consistency of search pattern use by training with a question-based sequential reveal educational program. RVR could be used to supplement training and assist with search pattern creation in areas in which residents often do not acquire adequate clinical exposure.