Optimizing Radiology Resident Competency in Pediatric Musculoskeletal Radiograph Interpretation.

Area of Science:

• Medical Education
• Radiology
• Pediatric Musculoskeletal Imaging

Background:

• Current educational methods for pediatric musculoskeletal (pMSK) radiograph interpretation by radiology post-graduate trainees (R-PGT) are insufficient.
• There is a need for innovative, evidence-based, and feasible interventions to enhance R-PGT skills in interpreting pMSK radiographs.

Purpose of the Study:

• To evaluate the effectiveness of a novel web-based educational intervention for pMSK radiograph interpretation.
• To improve R-PGT's ability to identify fractures and dislocations and to accurately stratify their risk.
• To identify specific cases and anatomical locations most susceptible to diagnostic errors.

Main Methods:

• A multicenter prospective cross-sectional study involving R-PGTs in the US and Canada.
• A web-based intervention utilizing 1609 pMSK extremity radiographs across six anatomical regions.
• R-PGTs engaged in deliberate practice to identify, locate, and risk-stratify fractures until a performance standard was met.

Main Results:

• Significant learning gains were observed in diagnostic sensitivity (14.9%), fracture location accuracy (14.1%), and risk stratification (23.6%).
• 77.5% of R-PGTs achieved the performance standard, with a median of 173 cases (41.5 minutes) required.
• Higher accuracy was noted in older children and cases without suspected non-accidental injury. Elbow, pelvis, and ankle were high-risk false-negative locations.

Conclusions:

• A competency-focused, web-based intervention effectively enhances pMSK radiograph interpretation skills among R-PGTs.
• The intervention successfully identifies pediatric fracture cases prone to diagnostic errors, aiding targeted education.
• Findings support the value of deliberate practice in radiology education for improving diagnostic accuracy.