Resident film interpretations and staff review

In this department 22% of examinations are interpreted independently by residents outside of normal hours. Staff radiologists review these studies in a process designed to train residents and assure appropriate radiologic consultation. The resident's written reports on 2,619 examinations were analyzed before and after staff review. Each film review session lasted an average of 1.1 hr. Potential changes were discussed in 9.1% of cases and mandated in 6.3%. About two-thirds of corrections were important enough to influence patient care. Correction rates declined significantly between the first and second/third years of residency; the proportion of clinically important changes also decreased. Omissions (false-negatives) were much more common than overcalls (false-positives). Residents correctly interpreted 89% of abnormal films and 96% of normal radiographs. Staff review resulted in a net improvement in interpretation of 4% of cases initially read by first-year residents and 2% by second- and third-year. The film review process provides opportunities for close resident-staff interaction and teaching and also ensures appropriate final reports.