Fourteen years of progress testing in radiology residency training: experiences from The Netherlands

Objectives: To describe the development of the Dutch Radiology Progress Test (DRPT) for knowledge testing in radiology residency training in The Netherlands from its start in 2003 up to 2016. Methods: We reviewed all DRPTs conducted since 2003. We assessed key changes and events in the test throughout the years, as well as resident participation and dispensation for the DRPT, test reliability and discriminative power of test items. Results: The DRPT has been conducted semi-annually since 2003, except for 2015 when one digital DRPT failed. Key changes in these years were improvements in test analysis and feedback, test digitalization (2013) and inclusion of test items on nuclear medicine (2016). From 2003 to 2016, resident dispensation rates increased (Pearson’s correlation coefficient 0.74, P-value <0.01) to maximally 16 %. Cronbach´s alpha for test reliability varied between 0.83 and 0.93. The percentage of DRPT test items with negative item-rest-correlations, indicating relatively poor discriminative power, varied between 4 % and 11 %. Conclusions: Progress testing has proven feasible and sustainable in Dutch radiology residency training, keeping up with innovations in the radiological profession. Test reliability and discriminative power of test items have remained fair over the years, while resident dispensation rates have increased. Key Points: • Progress testing allows for monitoring knowledge development from novice to senior trainee.• In postgraduate medical training, progress testing is used infrequently.• Progress testing is feasible and sustainable in radiology residency training

Госпіталі на Переяславщині в роки Великої Вітчизняної війни (1941/1943 рр.)

У статті подано перелік тимчасових польових пересувних госпіталів, які функціонували в Переяславському районі Київської області під час Великої Вітчизняної війни, а саме в 1941 та в 1943 роках, досліджується історія евакуаційного госпіталю №2028, який був сформований у Переяславі, та висвітлюється виснажлива робота медичних працівників цього лікувального закладу.В статье дается перечень временных полевых передвижных госпиталей, которые функционировали в Переяславском районе Киевской области во время Великой Отечественной войны, а именно в 1941 и в 1943 годах, исследуется история эвакуационного госпиталя №2028, который был сформирован в Переяславе, и освещается изнурительная работа медицинских работников этого лечебного учреждения.The article informs about all temporary hospitals, which existed during the 2 World War in the area of Pereyaslav in Kyiv region. It shows the evacuation history from the year 1941 till 1943 of the temporary hospital №2028, that has been organized in Pereyaslav. This article also shows the hard work of the medical workers

Acquiring Expertise in Radiology : Studies on Development & Assessment of Image Interpretation Skills

Radiological image interpretation is a complex skill and requires years of training to master. To improve education and performance in radiological image interpretation, it is key to understand visual diagnostic reasoning. The role of medical images in clinical decision-making is increasingly important and medical imaging techniques are developing very quickly. One of the most crucial developments in radiology has been the introduction of digital volumetric imaging, allowing radiologists to navigate through thin cross sections on a computer monitor instead of viewing two-dimensional hard-copy images on a light box. This development has changed the nature of the visual diagnostic task. How this development affects the visual diagnostic reasoning process and how we should align our training and assessment methods is largely unknown and is the subject of this thesis. We investigated which knowledge and skills are important for the development of expertise in radiological 2D and volumetric image interpretation and contributed to the development and evaluation of training and assessment methods to stimulate expertise development in radiological 2D and volumetric image interpretation. We identified knowledge and skills that are required for 2D and volumetric image interpretation. The main components of image interpretation were: perception, analysis, and synthesis. The knowledge and skills required for 2D image interpretation differed from those required for volumetric image interpretation: perception was dominant in volumetric image interpretation, while synthesis was dominant in 2D image interpretation. Visual search patterns differ across various levels of expertise and we found that search strategy training can improve volumetric image interpretation performance of trainees. The results contribute to the development of radiology training and assessment methods by providing several tools. We developed a framework of knowledge and skills that can be used as a guideline for developing radiology education, for example as a template for learning objectives or test blueprints. For teaching and assessing volumetric image interpretation skills, it is important to realize that the construct differs from 2D image interpretation. Two assessment methods were developed: a method that can be used to gain insight into error types and performance of learners and a method that can increase the authenticity of image interpretation assessment. These methods can be used in radiology education to stimulate the development of image interpretation expertise

How visual search relates to visual diagnostic performance : a narrative systematic review of eye-tracking research in radiology

Eye tracking research has been conducted for decades to gain understanding of visual diagnosis such as in radiology. For educational purposes, it is important to identify visual search patterns that are related to high perceptual performance and to identify effective teaching strategies. This review of eye-tracking literature in the radiology domain aims to identify visual search patterns associated with high perceptual performance. Databases PubMed, EMBASE, ERIC, PsycINFO, Scopus and Web of Science were searched using 'visual perception' OR 'eye tracking' AND 'radiology' and synonyms. Two authors independently screened search results and included eye tracking studies concerning visual skills in radiology published between January 1, 1994 and July 31, 2015. Two authors independently assessed study quality with the Medical Education Research Study Quality Instrument, and extracted study data with respect to design, participant and task characteristics, and variables. A thematic analysis was conducted to extract and arrange study results, and a textual narrative synthesis was applied for data integration and interpretation. The search resulted in 22 relevant full-text articles. Thematic analysis resulted in six themes that informed the relation between visual search and level of expertise: (1) time on task, (2) eye movement characteristics of experts, (3) differences in visual attention, (4) visual search patterns, (5) search patterns in cross sectional stack imaging, and (6) teaching visual search strategies. Expert search was found to be characterized by a global-focal search pattern, which represents an initial global impression, followed by a detailed, focal search-to-find mode. Specific task-related search patterns, like drilling through CT scans and systematic search in chest X-rays, were found to be related to high expert levels. One study investigated teaching of visual search strategies, and did not find a significant effect on perceptual performance. Eye tracking literature in radiology indicates several search patterns are related to high levels of expertise, but teaching novices to search as an expert may not be effective. Experimental research is needed to find out which search strategies can improve image perception in learners

Fourteen years of progress testing in radiology residency training : experiences from The Netherlands

OBJECTIVES: To describe the development of the Dutch Radiology Progress Test (DRPT) for knowledge testing in radiology residency training in The Netherlands from its start in 2003 up to 2016. METHODS: We reviewed all DRPTs conducted since 2003. We assessed key changes and events in the test throughout the years, as well as resident participation and dispensation for the DRPT, test reliability and discriminative power of test items. RESULTS: The DRPT has been conducted semi-annually since 2003, except for 2015 when one digital DRPT failed. Key changes in these years were improvements in test analysis and feedback, test digitalization (2013) and inclusion of test items on nuclear medicine (2016). From 2003 to 2016, resident dispensation rates increased (Pearson's correlation coefficient 0.74, P-value <0.01) to maximally 16 %. Cronbach´s alpha for test reliability varied between 0.83 and 0.93. The percentage of DRPT test items with negative item-rest-correlations, indicating relatively poor discriminative power, varied between 4 % and 11 %. CONCLUSIONS: Progress testing has proven feasible and sustainable in Dutch radiology residency training, keeping up with innovations in the radiological profession. Test reliability and discriminative power of test items have remained fair over the years, while resident dispensation rates have increased. KEY POINTS: • Progress testing allows for monitoring knowledge development from novice to senior trainee. • In postgraduate medical training, progress testing is used infrequently. • Progress testing is feasible and sustainable in radiology residency training

Support for external validity of radiological anatomy tests using volumetric images

RATIONALE AND OBJECTIVES: Radiology practice has become increasingly based on volumetric images (VIs), but tests in medical education still mainly involve two-dimensional (2D) images. We created a novel, digital, VI test and hypothesized that scores on this test would better reflect radiological anatomy skills than scores on a traditional 2D image test. To evaluate external validity we correlated VI and 2D image test scores with anatomy cadaver-based test scores. MATERIALS AND METHODS: In 2012, 246 medical students completed one of two comparable versions (A and B) of a digital radiology test, each containing 20 2D image and 20 VI questions. Thirty-three of these participants also took a human cadaver anatomy test. Mean scores and reliabilities of the 2D image and VI subtests were compared and correlated with human cadaver anatomy test scores. Participants received a questionnaire about perceived representativeness and difficulty of the radiology test. RESULTS: Human cadaver test scores were not correlated with 2D image scores, but significantly correlated with VI scores (r = 0.44, P < .05). Cronbach's α reliability was 0.49 (A) and 0.65 (B) for the 2D image subtests and 0.65 (A) and 0.71 (B) for VI subtests. Mean VI scores (74.4%, standard deviation 2.9) were significantly lower than 2D image scores (83.8%, standard deviation 2.4) in version A (P < .001). VI questions were considered more representative of clinical practice and education than 2D image questions and less difficult (both P < .001). CONCLUSIONS: VI tests show higher reliability, a significant correlation with human cadaver test scores, and are considered more representative for clinical practice than tests with 2D images