ARRS 2022 Abstracts

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2110. A Short Curriculum to Introduce the ACR Appropriateness Criteria and Increase Appropriate Imaging Selection Among Medical Students
Authors * Denotes Presenting Author
  1. Abdullah Memon; University of Illinois
  2. Salman Islam *; University of Chicago
  3. John Biren-Fetz; University of Illinois
  4. Karen Xie; University of Illinois College of Medicine
Objective:
Inappropriate radiological imaging contributes significantly to excessive healthcare expenditure and increased patient radiation exposure in the United States. The American College of Radiology (ACR) Appropriateness Criteria serve as an evidence-based resource to guide appropriate imaging utilization. However, knowledge and utilization of these guidelines is lacking across all levels of medical education and practice, especially among medical students. We introduce a short curriculum to teach medical students correct imaging selection and familiarize them with the ACR Appropriateness Criteria.

Materials and Methods:
A two-part lecture series was created to teach appropriate imaging selection in commonly encountered clinical scenarios and introduce the ACR Appropriateness Criteria. Fourth year medical students in radiology clerkships were the participants. Five distinct cohorts of such students received this curriculum. Students completed a pre-test questionnaire prior to the first lecture and a post-test questionnaire immediately after the completion of the second lecture. The two questionnaires each consisted of a 10-item knowledge assessment along with questions assessing student familiarity with the ACR Appropriateness Criteria, comfortability in choosing answers, and satisfaction with the curriculum on a five-point Likert scale. Improvement in student knowledge and confidence was assessed by statistical analysis of mean pre-test and post-test scores using t-tests.

Results:
Prior to the lecture series, 20.3% of students had no familiarity with the ACR Appropriateness Criteria, and another 41.8% only had slight familiarity. Students demonstrated a statistically significant improvement in the knowledge assessment from a mean pretest score of 5.59 (SD 1.81) to a mean post-test score of 7.85 (SD 1.60), with p<0.0001. Students also reported a statistically significant (p<0.0001) improvement in their level of comfort in choosing appropriate imaging modalities, from a pre-test mean of 3.06 (SD 0.88) to a post-test mean of 4.31 (SD 0.65) on a five-point Likert scale. After the lecture series, 97.2% of students responded that they would use the Appropriateness Criteria in the future. Student satisfaction was also very high: 98.6% of students were satisfied with the short curriculum, with 74% of those students reporting that they were “extremely satisfied.”

Conclusion:
This short curriculum is effective at 1) increasing student knowledge of appropriate radiological studies to order in common clinical encounters and 2) increasing student familiarity of the ACR Appropriateness Criteria. It was met with very high levels of student satisfaction. The vast majority of students stated that they will incorporate the ACR Appropriateness Criteria into future clinical decision-making. This curriculum is quick (delivered in just two sessions) and can easily be implemented for fourth year medical students across the United States. Further studies will be conducted to assess this curriculum’s efficacy in the earlier years of medical school as well as for first-year residents.