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Radiology resident competency in detecting basilar artery occlusion: a simulation-based assessment.

Abheek G Raviprasad1, Kevin Pierre2, Scott A McGaugh3

  • 1Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA. raviprasada@ufl.edu.

Emergency Radiology
|November 23, 2023
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Summary

Radiology residents struggle to identify basilar artery occlusion on CT scans, with only 14% correctly diagnosing this critical condition. This highlights a potential gap in training for emergent stroke detection.

Keywords:
Basilar artery occlusionRadiologyResidentsSimulationTraining

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Area of Science:

  • Neurology
  • Radiology
  • Medical Education

Background:

  • Basilar artery strokes are uncommon but present distinct imaging characteristics.
  • These findings can be easily missed, impacting patient outcomes.
  • Early detection is crucial for timely intervention.

Purpose of the Study:

  • To evaluate radiology residents' proficiency in detecting basilar artery occlusion on CT.
  • To assess diagnostic accuracy in a simulated emergency radiology call setting.

Main Methods:

  • Utilized the Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM).
  • Assessed 454 residents using a single case of basilar artery occlusion over two testing years.
  • Residents reviewed non-contrast CT images and provided free-text responses, manually scored by faculty.

Main Results:

  • Basilar artery occlusion was significantly underdiagnosed across all training levels.
  • An average of only 14% of residents correctly identified the condition.
  • Diagnostic accuracy remained low irrespective of the residents' year of training.

Conclusions:

  • A notable deficiency exists in radiology residency training regarding basilar artery occlusion detection.
  • Increased educational focus on recognizing emergent CT findings of stroke is warranted.
  • Improving resident performance in identifying critical vascular events is essential.