Perceptual training to improve hip fracture identification in conventional radiographs

<div><p>Diagnosing certain fractures in conventional radiographs can be a difficult task, usually taking years to master. Typically, students are trained ad-hoc, in a primarily-rule based fashion. Our study investigated whether students can more rapidly learn to diagnose proximal neck of femur fractures via perceptual training, without having to learn an explicit set of rules. One hundred and thirty-nine students with no prior medical or radiology training were shown a sequence of plain film X-ray images of the right hip and for each image were asked to indicate whether a fracture was present. Students were told if they were correct and the location of any fracture, if present. No other feedback was given. The more able students achieved the same level of accuracy as board certified radiologists at identifying hip fractures in less than an hour of training. Surprisingly, perceptual learning was reduced when the training set was constructed to over-represent the types of images participants found more difficult to categorise. Conversely, repeating training images did not reduce post-training performance relative to showing an equivalent number of unique images. Perceptual training is an effective way of helping novices learn to identify hip fractures in X-ray images and should supplement the current education programme for students.</p></div

The number of participants in Experiments 1–6.

<p>The number of participants in Experiments 1–6.</p

Le Courrier

17 mai 18251825/05/17 (A0,N137)

Examples of images shown to participants.

<p><b>(a)</b> An example of the image initially shown to a participant. The image is of the right hip and pelvic region of a 76-year-old female. A fracture is visible. <b>(b)</b> An example of the feedback the participant would receive if the participant were, in this case, to incorrectly state that there was no fracture.</p