Assessing Competence in Emergency Radiology Using an Online Simulator.

Area of Science:

• Medical Education
• Radiology
• Simulation-based Assessment

Background:

• Traditional radiology assessments often focus narrowly on the Medical Expert role using limited static images.
• There is a need to evaluate a broader range of competencies, including non-medical expert roles, in radiology residency.

Purpose of the Study:

• To design and implement an Emergency Radiology Simulator to assess both Medical and Non-Medical Expert domains in radiology residents.
• To evaluate resident performance across different postgraduate years (PGY-2 to PGY-5) using the simulator.

Main Methods:

• An online simulator presenting typical emergency radiology cases was administered to 48 radiology residents (PGY-2 to PGY-5).
• Residents' preliminary reports were graded for style and content (Medical Expert role).
• Prioritization, protocoling, counseling, and handover exercises assessed Non-Medical Expert roles.

Main Results:

• A significant difference in Medical Expert role performance was observed between PGY-2 residents and more senior residents.
• No significant performance differences were found between PGY levels for Non-Medical Expert roles.
• PGY-2 residents demonstrated lower performance in medical expert domains (findings, diagnosis, recommendations, clinical relevance).

Conclusions:

• Simulation effectively assesses radiology resident performance across multiple domains.
• Competence in Emergency Radiology appears to be achieved early in residency, potentially by the PGY-2 year.
• The simulator's utility could be expanded to other radiology subspecialties to better discriminate performance.