Characteristics of trainee interpretation time during simulated screening mammography

Efficiency in screening mammogram interpretation is complex and involves the time to view the images and report the findings. The purpose of this study was to evaluate the factors impacting the interpretation time of screening mammograms by radiology residents.

In this IRB-approved prospective study, radiology residents performed screening mammography simulations during their breast imaging rotations. The research simulation space replicated the clinical practice area without the interruptions. Residents interpreted 50 enriched screening mammograms and completed eye tracking on the first ten cases (six digital breast tomosynthesis (DBT) and four full-field digital mammogram (FFDM) cases). The amount of time to interpret (visual inspection) and report the 10 eye-tracking cases (electronic reporting) was evaluated and compared based on the breast imaging rotation (first, second, or third) and postgraduate year level (PGY). We present the time for each of the 10 eye tracking cases that were subdivided into visual inspection time of the mammogram and reporting time. Comparisons were performed with t-test and significance at p≤0.05.

25 residents performed the simulation with eye tracking: 14 residents during their first rotation, 7 in their second, and 4 in their third. There were 5 PGY2, 8 PGY3, 7 PGY4 and 5 PGY5 residents.The average overall interpretation time for 50 cases was 4.12 hours (SD=1.26), and 1.35 hours for the 10 eye tracking cases. For the eye-tracking cases, the average visual inspection time per case was 2.13 minutes with a reporting time of 3.08 minutes for an overall interpretation time of 5.21 minutes per case.For eye-tracking cases, the overall interpretation time significantly decreased from those completing their first (6.0 min) to third (4.2 min) breast rotation (p<0.001) and from PGY2 (6.6 min) to PGY5 (4.8 min) (p=0.004). The visual inspection time significantly decreased from PGY2 (2.6 min) compared to PGY5 (1.8 min) (p=0.001) level and from the first to the third rotation (p=0.021).No significant differences were observed for overall interpretation time between DBT (5.29 min) and FFDM (5.69 min) (p=0.319) or visual inspection time per case for DBT (2.20 min) and FFDM (2.03 min) (p=0.335).

Interpretation time for screening mammography decreases with increasing PGY level and the number of breast imaging rotations, which is likely due to experience and confidence with the types of exams. No difference was noted between DBT and FFDM average times.