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Resident Case Volume Correlates with Clinical Performance: Finding the Sweet Spot
Vikas Agarwal1, Gregory M Bump2, Matthew T Heller1
1Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St., Suite 200 East Wing, Pittsburgh, PA.
Radiology resident performance improves with interpreting approximately 16,000 studies, but higher volumes correlate with worse clinical outcomes. Finding the optimal number of interpreted studies is key for maximizing trainee knowledge without causing burnout.
Area of Science:
- Medical Education
- Radiology Residency Training
- Clinical Performance Metrics
Background:
- The correlation between the volume of interpreted studies and clinical performance in radiology residents is not well-defined.
- Understanding this relationship is crucial for optimizing resident training and patient care quality.
Purpose of the Study:
- To investigate the association between the total number of studies interpreted during radiology residency and objective measures of clinical performance.
- To identify if there is an optimal volume of interpreted studies that maximizes resident performance.
Main Methods:
- Retrospective cohort study of 37 radiology residents from 2015-2017.
- Tracked total interpreted studies, major discordance rates, Accreditation Council for Graduate Medical Education milestones, in-training exam scores, and American Board of Radiology core exam scores.
- Utilized Pearson correlation coefficients and polynomial regression analysis to assess correlations.
Main Results:
- Residents interpreted a mean of 12,709 studies with a mean major discordance rate of 1.1%.
- A nonlinear correlation was observed between study volume and performance.
- Performance improved up to approximately 16,000 interpreted studies, after which performance declined.
Conclusions:
- The total number of studies interpreted during radiology residency training correlates with resident performance.
- An optimal "sweet spot" exists for study volume, balancing clinical exposure and trainee well-being.
- Residency programs should aim to optimize workload to maximize learning without overburdening residents.
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