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

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.