After-hours CT report discrepancies: evaluating radiology resident performance.

Area of Science:

• Radiology
• Medical Education
• Healthcare Quality Improvement

Background:

• International studies report radiology resident reporting discrepancy rates between 1-10%.
• Limited data exists on after-hours resident CT reporting discrepancy rates.
• Residents often report most or all studies during after-hours shifts at training institutions.

Purpose of the Study:

• Determine after-hours resident CT report discrepancy rates.
• Assess the clinical significance of these discrepancies.
• Identify factors influencing resident performance.

Main Methods:

• Retrospective review of 2000 after-hours resident CT reports.
• Comparison of preliminary resident reports with attending radiologist finalized reports.
• Categorization of discrepancies and review of electronic medical records for clinical significance.

Main Results:

• Overall discrepancy rate was 44.3%, with 19.9% major and 2.45% clinically significant discrepancies.
• Diagnostic misses and overcalls were the most common major discrepancies.
• Discrepancies were higher in second-year residents, early evening shifts, and weekdays.

Conclusions:

• Most after-hours CT discrepancies by residents are minor.
• The institution shows a low rate of clinically significant discrepancies, aligning with lower end of prior study rates.
• Findings support high resident performance and the effectiveness of the current after-hours model.