Page 9 - Kansas Journal of Medicine, Volume 10 Issue 3
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KANSAS JOURNAL of M E D I C I N E                                            mented. This new program may impact the current study re-
                                                                             sults, therefore, a possible follow-up study may be beneficial.
MEDICAL STUDENTS CT INTERPRETATION IN                                        	 Similar studies at other institutions may provide groundwork
TRAUMA                                                                       for average radiographic education, but without national stan-
continued.                                                                   dards or expectations, it would be difficult to conclude if an in-
                                                                             tervention is necessary. Future studies confirming these results
DISCUSSION                                                                   might include comparison of students who had received imag-
	 By comparing pre- and post-evaluations, several studies have               ing-specific education, building upon studies such as at Boston
demonstrated that medical students CT interpretation abilities               University School of Medicine.6 At the campus in this study, stu-
improve with radiology-focused training.15-17 Sendra-Portero et al.15        dents are allowed to undergo a radiology elective in the fourth
and Scheiner et al.16 compared medical students of different years of        year. Comparisons between students who choose this elective
study and assessed their abilities in interpreting radiology images          with those who choose alternative electives may provide more
before and after a radiology-specific training. Results indicated that       solid results upon the benefits of imaging-specific education.
medical students improved in interpreting radiographs after the              	 The most appropriate intervention from this study would be
training, regardless of year of study.15,16 Dawes et al.17 also found medi-  continued comparisons after clinical rotations with the addition
cal students to improve in interpreting radiographs after participat-        of imaging-specific education. For our studies, pursuing a contin-
ing in a 26-week clinical training course. Results showed the propor-        ued study of current MS3s at the end of their third-year would
tion of correct answers improved from 8% pre-evaluation to 43%               provide stronger conclusions on the effect of radiographic-specific
post-evaluation (p<0.001). Our study had similar results; however,           education, as baseline CT knowledge already has been attained.
the improvement was only slightly better for fourth-year students.           Through this, more studies can be developed to achieve a thor-
	 Of the twenty-two possible answers, MS4s did better than MS3s              ough understanding of medical students’ radiographic knowl-
in all but two, indicating some improvement in reading CT imag-              edge, as well as how to improve their education and help them
ing. However, both groups had a high range of incorrect responses.           achieve optimal competency for residency and as physicians.
A median value of 93.1% incorrect by MS3s indicated the baseline             	 This study had several limitations. As this was a voluntary study
CT knowledge of medical students entering clinical rotations was             with no compensation provided to participants, there were no ex-
extremely low. As such, it is not surprising that MS4s had a mild            pectations for subject participation numbers, although similar
improvement. Other than diagnosis and treatment of epidural                  numbers were anticipated from both groups. However, due to the
hemorrhage, MS3s scored greater than 75% incorrect on all other              small number of fourth-year medical students, this group is not
questions. Although the median value for MS4s at 77.8% incorrect             represented adequately. Further, the study tested students with one
was lower than MS3s, it indicated a majority of students incor-              image slice of a CT scan as opposed to a complete CT scan set, a sce-
rectly identifying and ultimately treating injuries seen on CT scans.        nario unlikely in real life. Comparative slices on a CT scan may help
	 Both groups performed best in diagnosing and treating an                   the reader better analyze the severity and extent of the injury. Also,
epidural hematoma. As MS3s did best with this injury, it rais-               the patient’s clinical history could have assisted students in their
es the question if prior didactic learning regarding head inju-              evaluations. Finally, the findings may not be generalizable to other
ries may have better prepared the students. However, MS3s                    trauma centers since this study was conducted at a single center.
did not perform particularly better on the other head in-
juries when compared to MS4s. No particular trend was                        CONCLUSIONS
noted regarding percentage incorrect and body regions.                       	 The high percentage of incorrect responses reflects a strong defi-
	 Most surgeons expect MS3s to have a baseline ability to read               cit in baseline CT knowledge amongst medical students, particular-
CT scans and MS4s are expected to be able to identify life-threat-           ly in an environment with limited radiologic education. Outside of
ing images. Yet, this study showed a strong deficit in baseline CT           diagnosis and treatment of head injuries, most students from both
knowledge amongst medical students. Despite the low number                   groups answered diagnosis and treatment incorrectly for the major-
of MS4s, after a year of clinical rotations and overnight trauma             ity of the scans. If more than half of students are expected to identify
calls, which included education on CT imaging, they did show                 these images correctly, other interventions are necessary to ensure
some improvement in evaluating CT images. However, without a                 better radiographic education. This study argues that a re-evalua-
standard curriculum in radiology, it is difficult to conclude if this        tion of current standards for radiographic education of medical stu-
improvement is significant enough to warrant satisfactory expec-             dents is needed. In addition, the possibilities of how to implement
tations of a beginning fourth-year student. Still, for medical edu-          this education should be considered, whether it is through utilization
cation purposes, clinical rotations appear to provide a benefit to           of radiologist involvement and/or curriculum-specific education.
students in education of CT imaging of life-threatening injuries.
	 Areas for potential study include improving or expand-                                                                                            57
ing upon the findings of the current study. Within the study,
the benefits of viewing an entire CT scan may provide a more
thorough investigation of student abilities. In addition, after
completion of this study, a new radiology rotation was imple-
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