Perceptual Learning of Appendicitis Diagnosis in Radiological Images

A sizeable body of work has demonstrated that participants have the capacity to show substantial increases in performance on perceptual tasks given appropriate practice. This has resulted in significant interest in the use of such perceptual learning techniques to positively impact performance in real-world domains where the extraction of perceptual information in the service of guiding decisions is at a premium. Radiological training is one clear example of such a domain. Here we examine a number of basic science questions related to the use of perceptual learning techniques in the context of a radiology-inspired task. On each trial of this task, participants were presented with a single axial slice from a CT image of the abdomen. They were then asked to indicate whether or not the image was consistent with appendicitis. We first demonstrate that, although the task differs in many ways from standard radiological practice, it nonetheless makes use of expert knowledge, as trained radiologists who underwent the task showed high (near ceiling) levels of performance. Then, in a series of four studies we show that (1) performance on this task does improve significantly over a reasonably short period of training (on the scale of a few hours); (2) the learning transfers to previously unseen images and to untrained image orientations; (3) purely correct/incorrect feedback produces weak learning compared to more informative feedback where the spatial position of the appendix is indicated in each image; and (4) there was little benefit seen from purposefully structuring the learning experience by starting with easier images and then moving on to more difficulty images (as compared to simply presenting all images in a random order). The implications for these various findings with respect to the use of perceptual learning techniques as part of radiological training are then discussed.