Developing a clinical competency examination in radiology: part II--test results

This is the second of two articles introducing a clinical competency examination in radiology. The first article described the structure, administration, and postexamination student comments for two versions of the radiology competency examination. This article reports the results obtained from these two administrations of the examinations.

To measure and identify potential outcome predictors of student aptitude in clinical film interpretation.

Experimental.

An examination was developed to simulate the radiologic interpretive skills needed in clinical chiropractic practice. Two versions of the examination were given to a class of 210 ninth trimester students in a 10-trimester chiropractic program. Linear regression and bivariate correlations were performed on possible predictors of student success and test scores on the version 2 examination.

On version 1 of the examination, students were able to identify an average of 59.6% of the normal cases as normal and 51.6% of abnormal cases as abnormal. On version 2, 55.6% of the normal cases were recognized as normal and 58.2% of abnormal cases as abnormal. On both versions, students were less successful at correctly categorizing, managing, or naming pathologic conditions they found. Of the predictors evaluated, only the students' grades in the third radiology course (tumors, arthritides, and extremity trauma) and the scores on the diagnostic imaging section of National Boards part II were significant predictors.

Our results should cause some concern for educators who use content-based radiology curricula. Students demonstrated poor abilities to recognize, categorize, manage, and identify common radiographic pathologic conditions. Educators cannot rely on National Board scores and course grades to determine student clinical competency. More radiology clinical competency exercises that emphasize film interpretation need to be incorporated into content-based curricula.