Competency in Chest Radiography Interpretation by Junior Doctors and Final Year Medical Students at a Teaching Hospital

Abstract

Background. Chest radiography (CXR) is a widely used imaging technique for assessing various chest conditions; however, little is known on the medical doctors’ and medical students’ level of skills to interpret the CXRs. This study assessed the residents, medical officers, house officers, and final year medical students’ competency in CXRs interpretation and how the patient’s clinical history influences the interpretation. Methods. We conducted a cross-sectional study in the Cape Coast Teaching Hospital in the Central Region of Ghana among 99 nonradiologists, comprising 10 doctors in residency programmes, 18 medical officers, 33 house officers, and 38 final year medical students. The data collection was done with a semistructured questionnaire in two phases. In phase 1, ten CXRs were presented without patient’s clinical history. Phase 2 involved the same ten CXRs presented in the same order alongside the patient’s clinical history. Participants were given 3 minutes to interpret each image. Median and interquartile ranges were used to describe continuous variables, while frequencies and percentages were used to describe categorical variables. Test of significant difference and association was conducted using a Wilcoxon rank-sum test/Kruskal–Wallis test and chi-square (X2) test, respectively. Results. The average score for interpreting CXRs was 7.0 (IQR = 5–8) and 4.0 (IQR = 3-4), when CXRs were, respectively, presented with and without clinical history. No significant difference was seen in average scores regarding the levels of formal training. Without clinical history, only 40.0% of residents, 22.2% of medical officers, 24.2% of house officers, and 13.2% of medical students correctly interpreted CXRs, while more than 75% each of all categories correctly interpreted CXRs when presented with clinical history. However, all participants had difficulties in identifying CXR with pneumothorax (27.3% vs. 30.3%), pneumomediastinum or left rib fracture (8.1% vs. 33.3%), and lung collapse (37.4% vs. 37.4%) in both situations, with and without patient clinical history. Conclusion. The patient’s clinical history was found to greatly influence doctors’ competence in interpreting CXRs. We found a gap in doctors’ and medical students’ ability to interpret CXRs; hence, the development of this skill should be improved at all levels of medical training.

Avaliação dos aspectos físicos e parâmetros de normalidade da radiografia de tórax por estudantes de medicina em faculdade de Teresina-PI

“…No entanto, o conhecimento sobre radiografia de tórax seja de grande importância em diversos âmbitos da prática médica, o treinamento formal varia amplamente. O ensino apresenta uma grande variabilidade entre os programas de treinamento em residência médica e faculdade de medicina (Geel et al, 2019;Jimah et al, 2020).…”

The Effects of Various Teaching Methods on Chest X-ray Interpretation Skills Among Medical Students and Interns: A Systematic Review

“…In addition, Dao et al [ 29 ] used pre- and post-intervention surveys with two tests: exam 1, with the aid of Chester, an artificial intelligence (AI) tool, for the experimental group, and exam 2, without using the tool for both the experimental and control groups. Further, Jimah et al [ 9 ] administered two tests, a pre-test without clinical history and a post-test including clinical history, to assess the accuracy and competency of CXR interpretation concerning clinical history.…”

A Performance-Based Competency Assessment of Pediatric Chest Radiograph Interpretation Among Practicing Physicians

“…There were no significant differences between specialties (P = .21) and physician geographic location (P = . 16) with respect to the proportion of participants that completed cases to competency. Initial Diagnostic Performance and Median Number of Cases to Performance Benchmark.…”

“…4,11–13 Although systems are often in place for the correction of errors made at the bedside, the final report by a radiologist may not be available in a timely manner to influence immediate decision-making, and in resource limited settings, there may be no radiologist over-read of the pCXR at all. 1,9,14–16…”