Prevalence of abnormal cases in an image bank affects the learning of radiograph interpretation.
Medical Education 2012: 46: 289-298 Objectives Using a large image bank, we systematically examined how the use of different ratios of abnormal to normal cases affects trainee learning. Methods This was a prospective, double-blind, randomised, three-arm education trial conducted in six academic trai...
| Publicado en: | Medical Education Vol. 46; no. 3; pp. 289 - 299 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104515767&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104515767 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03080110 ESF jtl: Medical Education issn: 03080110 maglogo: Y pubinfo: dt: Mar2012 vid: 46 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104515767 71546723 10.1111/j.1365-2923.2011.04165.x NLM22324528 104515767 ppf: 289 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Prevalence of abnormal cases in an image bank affects the learning of radiograph interpretation. aug: au: Pusic, Martin V Andrews, John S Kessler, David O Teng, David C Pecaric, Martin R Ruzal-Shapiro, Carrie Boutis, Kathy affil: Department of Paediatrics, Columbia University, New York, New York, USA; Department of Paediatrics, New York University Langone Medical Center/Bellevue Hospital Center, New York University, New York, New York, USA sug: subj: Picture Archiving and Communication Systems Methods Ankle Fractures Radiography Prevalence Evaluation Outcomes of Education Randomized Controlled Trials Random Assignment Double-Blind Studies Prospective Studies Internship and Residency Sensitivity and Specificity Descriptive Statistics Two-Way Analysis of Variance One-Way Analysis of Variance Post Hoc Analysis Effect Size Confidence Intervals Funding Source Coefficient alpha Software Outcomes Research Human Rasch Analysis Data Analysis Software Algorithms Interns and Residents Univariate Statistics Physicians Education Type II Error ab: Medical Education 2012: 46: 289-298 Objectives Using a large image bank, we systematically examined how the use of different ratios of abnormal to normal cases affects trainee learning. Methods This was a prospective, double-blind, randomised, three-arm education trial conducted in six academic training programmes for emergency medicine and paediatric residents in post-licensure years 2-5. We developed a paediatric ankle trauma radiograph case bank. From this bank, we constructed three different 50-case training sets, which varied in their proportions of abnormal cases (30%, 50%, 70%). Levels of difficulty and diagnoses were similar across sets. We randomly assigned residents to complete one of the training sets. Users classified each case as normal or abnormal, specifying the locations of any abnormalities. They received immediate feedback. All participants completed the same 20-case post-test in which 40% of cases were abnormal. We determined participant sensitivity, specificity, likelihood ratio and signal detection parameters. Results A total of 100 residents completed the study. The groups did not differ in accuracy on the post-test (p = 0.20). However, they showed considerable variation in their sensitivity-specificity trade-off. The group that received a training set with a high proportion of abnormal cases achieved the best sensitivity (0.69, standard deviation [SD] = 0.24), whereas the groups that received training sets with medium and low proportions of abnormal cases demonstrated sensitivities of 0.63 (SD = 0.21) and 0.51 (SD = 0.24), respectively (p < 0.01). Conversely, the group with a low proportion of abnormal cases demonstrated the best specificity (0.83, SD = 0.10) compared with the groups with medium (0.70, SD = 0.15) and high (0.66, SD = 0.17) proportions of abnormal cases (p < 0.001). The group with a low proportion of abnormal cases had the highest false negative rate and missed fractures one-third more often than the groups that trained on higher proportions of abnormal cases. Conclusions Manipulating the ratio of abnormal to normal cases in learning banks can have important educational implications. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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