ARRS 2022 Abstracts

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E1943. Data-Driven Education: Walking in the Residents’ Shoes to Optimize the Pre-Call Curriculum
Authors
  1. Marcus Lacey; Virginia Mason Medical Center
  2. Barbara Williams; Virginia Mason Medical Center
  3. Jennifer Kohr; Virginia Mason Medical Center
  4. C. Craig Blackmore; Virginia Mason Medical Center
Background
Resident preparation for independent call is a vital part of radiology education. The pre-call curriculum typically consists of a review of common acute/emergent pathologies, but one size does not fit all programs. Every hospital system cares for different populations presenting with varying pathologies during call shifts. We sought to optimize alignment between our pre-call curriculum and residents’ call experience through systematic analysis of call cases, including spectrum of diagnoses and miss/misinterpretation rates. We reviewed all consecutive body imaging resident call cases from December 2018–November 2019. A senior radiology resident retrospectively assigned up to three diagnoses for each case and whether a miss or misinterpretation was present. Misses were defined as findings not mentioned in the resident’s report, whereas misinterpretations were findings that were mentioned but mischaracterized. We also created 26 diagnostic subgroups by organ system to facilitate a broad evaluation of trends.

Educational Goals / Teaching Points
Our goal is to deliver a targeted case-based pre-call educational exhibit guided by our analysis of frequently encountered pathology and utilizing representative missed/misinterpreted cases. These cases are grouped into themes based on the spectrums of pathology that we identified as having the highest discrepancy rates. Each case includes imaging findings and summary text detailing the diagnosis, interpretation error that occurred, as well as pearls to help accurately identify and characterize the findings in the future. This will be tailored towards residents, particularly first- and second-year residents currently undergoing pre-call education or taking their first year of call.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We analyzed a total of 1956 unique body imaging call exams. These were predominantly CT abdomen and pelvis studies; 72% were emergency department cases with the majority occurring during the first half of the call shifts (58%). The most common diagnoses encountered were pulmonary opacities (3.7%) and obstructing renal calculi (3.0%), and the most missed diagnoses were pulmonary embolus and colitis. Subgroup analysis revealed the highest discrepancy rates in categories of pulmonary embolus (15%), fractures (12%), and gynecology (9%). Relatively high discrepancy rates were also seen in bowel (7%), which is notable given the high frequency of bowel pathology encountered.

Conclusion
Our retrospective analysis of body imaging call cases identified which diagnoses are most frequently encountered and missed by our residents. This is one method to facilitate a tailored approach to pre-call education. Currently we are engaged in targeted modifications to the curriculum including edits to current pre-call lectures and new teaching files that will utilize representative cases from our analysis. This educational exhibit is one example of the type of tailored pre-call education our residents will receive.