E2018. A Deliberate Practice Approach for Improving the Detection of Acute Stroke on Noncontrast CT
  1. Wasif Bala; Emory University
  2. Michael Essien; Emory University
  3. Elizabeth Krupinski; Emory University
  4. Brent Weinberg; Emory University
Novice radiology trainees develop skills primarily by producing preliminary radiology reports and correcting them under the supervision of a board-certified radiologist. Under this apprenticeship model, there is a passive reliance on disease incidence that translates to trainee strengths (with increased exposure) or weaknesses (with non-exposure). Unlike traditional learning approaches, a deliberate practice training model is an active approach targeted to developing abilities above the practitioner’s current performance level that can be mastered through repeated practice followed by direct feedback. Deliberate practice methods have been successfully employed across many disciplines, including imaging interpretation skills such as electrocardiograms and echocardiograms. Evaluation of noncontrast head CT for acute stroke is a task commonly encountered in practice and for which reliable identification is expected by the end of the trainee’s R1 year. In this exhibit, we utilize the principles of deliberate practice to improve detection of acute stroke and its clinically relevant imaging features on noncontrast head CT.

Educational Goals / Teaching Points
This educational exhibit reviews the key noncontrast CT imaging features of acute stroke and demonstrates the spectrum of complexity that these cases may present with. The prospective identification of these abnormalities may enhance retention of learned material through increased engagement and readily translates to image interpretation skills required in routine practice.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Participants are initially provided with an overview of basic imaging features of ischemic stroke. Afterwards, participants are presented with five practice cases progressively increasing in difficulty as determined by a faculty neuroradiologist. Each presentation begins with an unlabeled gif of a patient case. Based on these images, participants are asked to identify the most important impression points of the case (abnormality location, likely etiology, mass effect, and additional complications). After attempting to answer these questions, participants are presented with the expert response to these questions as well as representative labeled images.

Deliberate practice is an effective approach for enhancing performance across a variety of disciplines and can be incorporated into radiology education to efficiently develop image interpretation skills. Future work will develop a dynamic learning module that provides participants with learning cases targeted towards their individual strengths and weaknesses. This educational exhibit focuses on the interpretation of acute stroke by noncontrast head CT, but the underlying methodology can be readily applied to the interpretation of different diagnoses and other imaging modalities.