Teaching evidence-based imaging in the radiology clerkship using the ACR appropriateness criteria

Given escalating health care costs and limited resources, the effective utilization of imaging is essential to permit optimal patient care. Because only 21.4% of medical schools require radiology clerkships, most students do not understand the indications for and clinical effectiveness of most imaging tests. Therefore, the authors introduced two focused sessions on evidence-based imaging during the required radiology core clerkship at their institution.

From June 2008 to September 2009, 259 students in the radiology core clerkship participated in a didactic session on principles of evidence-based imaging and/or a small-group session and self-directed learning exercise using the American College of Radiology (ACR) Appropriateness Criteria. Students evaluated the exercise on a five-point scale for its effectiveness in teaching imaging strategies and its impact on their future careers.

Two hundred twenty-eight of 259 students (88%; 93 third year, 135 fourth year) participated in the two sessions. Two hundred thirteen of 223 (96%) were not aware of the ACR's Web site as a resource prior to this exercise. Two hundred fourteen of 228 (94%) found the ACR Appropriateness Criteria a useful resource. Two hundred two of 228 (89%) stated that they would likely use this resource in other clinical rotations and future practice. Two hundred three of 228 (89%) reported having a solid understanding of the indications for imaging tests following the sessions. Students praised the ACR's Web site for its comprehensive coverage of different modalities and their relative radiation risks. They valued working collaboratively on common clinical scenarios.

The ACR Appropriateness Criteria are a valuable resource for teaching evidence-based imaging to medical students. A majority of students indicated that they plan to use this resource in the future.