Assessing Medical Student's Ability to Interpret Traumatic Injuries on Computed Tomography Before and After the Third Year Clerkships.

INTRODUCTION: Exposure to radiologic images during clinical rotations may improve students' skill levels. This study aimed to quantify the improvement in radiographic interpretation of life-threatening traumatic injuries gained during third year clinical clerkships (MS-3). METHODS: We used a paired-sample prospective study design to compare students' accuracy in reading computed tomography (CT) images at the beginning of their third year clerkships (Phase I) and again after completion of all of their third year clerkships (Phase II). Students were shown life-threatening injuries that included head, chest, abdomen, and pelvic injuries. Overall scores for Phase II were compared with Phase I, as well as sub-scores for each anatomical region: head, chest, abdomen, and pelvis. RESULTS: Only scores from students participating in both Phase I and Phase II (N = 57) were used in the analysis. After completing their MS3 clerkship, students scored significantly better overall and in every anatomical region. Phase I and Phase II overall mean scores were 1.2 ± 1.1 vs. 4.6 ± 1.8 (p < 0.001). Students improved the most with respect to injuries of the head and chest and the area of least improvement was in interpreting CT scans of the abdomen. Although improvements in reading radiographic images were noted after the clerkship year, students accurately diagnosed only 46% of life-threatening images on CT scan in the trauma setting. CONCLUSIONS: These results indicated that enhanced education is needed for medical students to interpret CT scans.

Comparisons of Medical Student Knowledge Regarding Life-Threatening CT Images Before and After Clinical Experience.

BACKGROUND: Currently, no national standard exists for educating medical students regarding radiography or formal research indicating the level of improvement regarding computed tomography (CT) interpretation of medical students during clinical rotations. METHODS: Students were evaluated based on their response to twenty-two open-ended questions regarding diagnosis and treatment of eleven de-identified CT images of life-threatening injuries. The number of incorrect answers was compared with correct or partially correct answers between students starting third-year clinical rotations and those starting their fourth year. RESULTS: Survey results were collected from 65 of 65 (100%) beginning third-year students and 9 of 60 (15%) beginning fourth-year students. Students in their fourth-year had less incorrect answers compared to third-year students, with five questions reflecting a statistically significant reduction in incorrect responses. The image with the least incorrect for both groups was epidural hemorrhage, 33.9% and 18.5% incorrect for third-year students for diagnosis and treatment, respectively, and 11.1% and 0% incorrect for fourth-year students. Outside of this image, the range of incorrect answers for third-year students was 75.4% to 100% and 44.4% to 100% for fourth-year students. CONCLUSION: Baseline CT knowledge of medical students, regardless of clinical experience, indicated a strong deficit, as more students were incorrect than correct for the majority of CT images.