Imaging specialties require both perceptual and interpretation skills. Except in very simple cases, data perception and interpretation vary among clinicians. This variability makes for difficulty in measuring these skills with traditional assessment tools. The script concordance approach is conceived to allow standardized assessment in contexts of uncertainty. In this exploratory study, the authors tested the usefulness of the approach for assessment of perceptual and interpretation skills in radiology. A perception test (PT) and an interpretation test (IT) were designed according to the approach. Both tests used plain chest X-rays. Three groups were tested: clerkship students (20), junior residents (R1-R3; 20), senior residents (R4-R5; 20). Eleven certified radiologists, all currently appointed to chest reading, provided the answers by aggregate scoring method. Statistics included descriptive, ANOVA, regression analysis, Pearson and Spearman correlation coefficients. Cronbach alpha values were 0.79 and 0.81 for the PT and IT respectively. Score progression was statistically significant in both tests. Perception scores progressed more rapidly than interpretation scores during training. Effect size was large in discriminating low versus higher level of expertise, 2.2 (PT) and 1.6 (IT). The Pearson correlation coefficient between both tests was 0.58. Cronbach alpha coefficient values indicate reasonable reliability for both tests. The linear progression of scores, each at its own pace, and the positive and moderate magnitude of the Pearson correlation coefficient are arguments suggesting measurement of two different skills. More studies are necessary to document the approach usefulness for assessment in radiology training.

The cricoarytenoid (CA) joint is a true diarthrodial joint that can be affected by rheumatoid disease. Its strategic location in the airway anatomy makes its evaluation of clinical importance. Direct fiberoptic laryngoscopy (DFL) and high-resolution computerized tomography (HRCT) were used to assess the larynx in 32 rheumatoid patients. Abnormalities were seen in 75% of patients at endoscopic examination. HRCT studies showed abnormalities in 72%. Erosion-luxation of the CA joint and surrounding soft-tissue swelling can be demonstrated on HRCT scans. A radiologic grading of the rheumatoid larynx is proposed, stressing that accurate evaluation of the larynx should be part of the diagnostic evaluation of every rheumatoid arthritic patient, given the high frequency of occurrence of rheumatoid laryngitis.

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R é s u m éCo n t ex t e : L' é valuation est réputée représenter la prochaine étape pédagogique à franchir pour l' é d u c ation en éthique médicale. Bu t : É l a b o rer une stratégie d' é valuation de l'éthique médicale des résidents cohére n t e o m p l e xe, tra n s versale, dialogique se construisant tout au long de la formation clinique, l'éthique s' i n t è g re à la f o rmation clinique dans l' e xemple fourni. Son évaluation doit être intera c t i ve, de médiation humaine, et doit s u i v re toute la formation. L' é valuation de l'éthique doit être va r i é e : le carnet de stage, les séances d' a p p re n t i s s a g e au raisonnement éthique (ARE) et l' o b s e rvation directe couvrent l' é ventail de la réalité clinique dont l'éthique est indissociable. Co n c l u s i o n : Le modèle de l' a p p roche dialogique de l'éthique comme compétence clinique peut guider l' é valuation de l'éthique professionnelle des résidents. Mots clés