PurposeDiagnostic errors are common in radiology. The gestalt impression of an image refers to the rapid holistic understanding one formulates about an image and may facilitate improved diagnostic accuracy. The ability to generate a gestalt impression is typically acquired over time and is generally not explicitly taught. Our study aims to assess whether perceptual training using second look and minification technique (SLMT) can help image interpreters formulate a holistic understanding of an image and become more accurate at evaluating medical images.ApproachFourteen healthcare trainees voluntarily participated in a perceptual training module, comparing the differences in detection of nodules and other actionable finding (OAF) on chest radiographs before and after perceptual training intervention. The experimental group received SLMT training, and the control group did not.ResultsSurvey results were positive for all items, with the p-values < 0.01. There was improvement in the performance in detection of nodules and OAF in both groups. However, this change was statistically significant only for OAFs in the control group (p-value < 0.05) but not the experimental group.ConclusionsSLMT training was viewed by participants as an extremely helpful educational tool. Survey results indicated that participants felt the SLMT was a beneficial educational intervention. The experimental group’s detection of nodules and OAF improved after SLMT, though not statistically significantly so, which may be related to the small sample size or lack of training effect. Perceptual training using SLMT may help as a useful educational technique, help radiologists identify abnormalities, and improve workflow.
PurposeGamification is used in several fields as an adjunct to standard educational methods but has found limited application in radiology to date. Gamification may be useful for teaching radiology skills typically acquired through experience, such as perceptual skills. The goal of our study is to use a gamified radiology workstation to teach skills related to identification of pulmonary nodules and evaluate for changes in trainee performance.ApproachWe constructed a game called RADHunters to teach perceptual skills related to identification of pulmonary nodules on chest radiographs. Control and experimental groups were tasked with identifying nodules on chest radiographs on two sets of cases. The experimental group received gamified training for nodule identification using RADHunters between case sets, while the control group did not. Performance at nodule identification, localization, and confidence were compared. A poststudy survey was administered to assess for participants’ thoughts about the gamified nodule detection training.ResultsSurvey responses were very positive with p-values for all survey responses <0.001, indicating subjects felt this training was beneficial. Experimental and control groups had a statistically significant improvement in their ability to identify and localize nodules with p-values < 0.05. There was no significant difference between control and experimental groups. Neither group showed a statistically significant increase in their confidence in nodule localization.ConclusionsPerceptual training using gamification may be a useful adjunct to conventional methods of radiology education.
Identification of abnormalities in radiology is predicated on one’s gestalt understanding of normal imaging findings. This study assesses whether perceptual training using high-volume chest radiography (HVCXR) can help develop an understanding of the normal appearance of a chest radiograph (CXR) and improve one’s ability to identify pulmonary nodules on CXR. Eight radiology residents were split into two groups where the experimental group received high volume chest radiography training, where they viewed 500 CXRs at the rate of 1 CXR every 3 seconds, while the control group did not. Both groups were then tasked to identify pulmonary nodules on a set of chest radiographs. Afterwards, the two groups switched interventions and worked on localizing pulmonary nodules on a third case set of chest radiographs. Performance at nodule identification was worse in the experimental and control groups after they had received HVCXR training, which was unexpected. We hypothesize that this decrease in performance was due to fatigue from the HVCXR intervention.
Prior studies have shown positive effects of perceptual training (PT), however there is a paucity of literature regarding the long-term retention. The goal of this study is to assess the degree of long term retention three months after an initial PT training session. Eight first year residents underwent perceptual training with repeat training 87 days later. Comparison of their performance showed that though their performance was lower compared to the initial training, this was not statistically significant, suggesting some degree of retention of PT.
KEYWORDS: Radiology, Chest imaging, Radiography, Statistical analysis, Medicine, Psychology, Medical imaging, Perceptual learning, Medical research, Education and training
Prior research has demonstrated that perceptual training can improve the ability of healthcare trainees in identifying abnormalities on medical images, but it is unclear if the improved performance is due to learning or attentional shift—the diversion of perceptional resources away from other activities to a specified task. Our objective is to determine if research subject performance in perceiving the central venous catheter position on radiographs is improved after perceptional training and if improved performance is due to learning or an attentional shift. Forty-one physician assistant students were educated on the appropriate radiographic position of central venous catheters and then asked to evaluate the catheter position in two sets of radiographic cases. The experimental group was provided perceptional training between case sets one and two. The control group was not. Participants were asked to characterize central venous catheters for appropriate positioning (task of interest) and to assess radiographs for cardiomegaly (our marker for attentional shift). Our results demonstrated increased confidence in localization in the experimental group (p-value <0.001) but not in the control group (p-value = 0.882). The ability of subjects to locate the catheter tip significantly improved in both control and experimental groups. Both the experimental (p-value = 0.007) and control groups (p-value = 0.001) demonstrated equivalent decreased performance in assessing cardiomegaly; the difference between groups was not significant (p-value = 0.234). This suggests the performance improvement was secondary to learning not due to an attentional shift.
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