E1100. The Disproportionate Impact of Peer Learning in Emergency Radiology
  1. Jan Czerminski; Yale University
  2. Melissa Davis; Yale University
  3. Jay Pahade; Yale University
  4. Jonathan Mezrich; Yale University
The use of peer learning methods in radiology continues to grow as a means to constructively learn from past mistakes. This study evaluates whether this model impacts subspecialities in an academic radiology practice differently. Specifically, we examined whether emergency radiologists (ERs) receive a disproportionate amount of peer learning feedback entered as potential learning opportunities (PLO), which could play a significant role in stress and career satisfaction. At our institution ERs interpret a wide range of x-ray, ultrasound and CT exams on both adults and pediatric patients with 24-7 attending coverage.

Materials and Methods:
Peer learning submissions entered as PLO at a single large academic medical center over a span of 3 years were assessed by subspecialty distribution and correlated with the number of attending radiologists in each section. Total number of studies performed on patients in the emergency department and throughout the hospital system were obtained for comparison purposes. Data was assessed using analysis of variance and posthoc analysis.

ERs received 2.6x more PLO submissions than the next closest subspeciality division, and ERs received more yearly PLO submissions per attending compared to other subspeciality divisions (14.5 vs. 5.1, <em>p</em> = 0.01). Additionally, ERs received more PLO submissions per 1000 studies interpreted compared to the rest of the department (1.59 vs. 0.85, <em>p</em> = 0.04).

ERs in this study received significantly more PLO submissions than their nonemergency colleagues. Reasons for this discrepancy may include a higher error rate secondary to wider range of studies interpreted, demand for shorter turn-around times, and higher volumes of examinations read per shift. In addition, ERs often interpret the initial imaging in an acute setting, whereas other services have the benefit of follow-up imaging, which can predispose ERs to entries from hindsight bias. Increased exposure to PLO feedback, even if not meant to be punitive or evaluative, could lead to increased stress, burnout, and job dissatisfaction particularly when combined with higher imaging volumes and off-hour work. Interventions should be explored to minimize unintended moral distress that may stem from peer learning programs.