Curriculum for musculoskeletal radiology

Developing a clinical competency examination in radiology: part I--test structure

BACKGROUND

There is a need for radiology educational outcome measures that evaluate clinical competency. This is the first of two articles introducing a clinical competency examination in radiology. This first article describes the evolution and structure of the examination. The second article presents the results of two administrations of the examination and evaluates possible outcome predictors.

OBJECTIVE

To develop a measure of clinical competency in radiology.

DESIGN

Descriptive.

METHODS

A test was developed to simulate the radiologic interpretive skills needed in clinical chiropractic practice. Students were timed as they responded to questions regarding the localization, categorization, management, and identification of pathologic conditions presented on plain film images of the spine and chest. Twenty-five radiographic cases were displayed at individual viewbox stations, and student responses to the 4 questions were compared with the consensus responses of 2 radiology instructors.

RESULTS

Two versions of the test, using different cases, were given to the same ninth trimester class of 210 chiropractic students in a 10-trimester program. Of the 210 students, 116 (55.2%; 86 men and 30 women) took version 1 of the examination, and 1 month later 181 (86.2%: 138 men and 43 women) took version 2 of the examination. Student comments after each examination were favorable.

CONCLUSION

The test structure uniquely provides information related to the student's ability to localize, categorize, manage, and identify pathologic conditions on imaging studies. At present the examination is instructor time intensive; further refinement is needed before wide implementation can occur.

1996 Joseph E. Whitley, MD, Award. Evaluation of an introductory course in chest radiology

RATIONALE AND OBJECTIVES

The author developed and evaluated the effectiveness of an educational program for teaching the fundamentals of chest radiology to radiology residents.

METHODS

Nineteen radiology residents completed a course that consisted of 17 1-hour chest radiology conferences. All seven 1st-year radiology residents were required to attend every conference; more senior-level residents were encouraged to attend, but their attendance was not mandatory. All conferences were given by the same instructor with the use of a didactic slide and radiograph presentation, videotape, heart-lung model, and a 120-page syllabus. Residents were encouraged to participate in a daily quiz. Resident learning was measured by means of a pre- and postcourse examination.

RESULTS

Conference attendance rate was 93% for 1st-year residents and 75% for more senior residents. Nineteen residents took both the pre- and postcourse examination; mean scores increased from 65.6% to 86.2% (P < .0001), and course evaluation scores were very positive (means ranged from 1.0 to 1.1, with 1 = very good and 5 = poor).

CONCLUSION

An educational program in chest radiology was developed for residents. Both objective and subjective evaluations indicated that resident participation in the introductory chest course was an effective means of learning the basics of chest radiology. The residents were in support of making this course a required part of the residency curriculum.