Clinical-year Students' Competency in Chest X-ray Interpretation: A Theoretical-based Intervention

Chest radiography is important in detecting chest abnormalities, an essential skill for medical students during their transition into clinical years. Although critical, limited research has evaluated students' competencies in chest X-ray interpretation, a recognized area of weakness.

This study aims to (1) assess medical students' competencies and confidence in chest X-ray interpretation, (2) measure the effectiveness of an educational intervention, and (3) determine the influence of clinical history on students' decision-making.

This experimental pre- and post-design study included clinical-year students from College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, and was conducted between November 2022 and April 2023. It was executed in three phases: pre-intervention assessment, an intervention involving a lecture based on Thomas and Kern's six-step approach, and a post-intervention assessment.

The study comprised 77 students. Mean self-reported knowledge and confidence scores were 3.08 ± 0.6 and 2.78 ± 0.7, respectively. There was a significant difference in the mean scores for the pre-test without clinical history (6.29 ± 2.38) compared with the pre-test with clinical history scores (8.58 ± 2.65) (P < 0.001). Post-intervention scores were also significant (9.40 ± 2.91) compared to both pre-tests without and with clinical history (P < 0.001 and 0.034, respectively). Students exhibited high accuracy in diagnosing pneumoperitoneum with and without clinical history (88% and 97%, respectively). Confidence scores were elevated when clinical history was provided and the students had access to their patients' histories.

A lecture-based intervention built on Thomas and Kern's approach markedly enhanced students' capacities to interpret chest X-rays. Integrating clinical history proved beneficial, underscoring the necessity for comprehensive teaching methodologies in medical education.