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Objective:
The American Board of Radiology (ABR) announced the reimplementation of an oral test for the Certifying Exam. This will alter the preparation methods of radiology residents, as oral-based examinations require skills that are less emphasized by the current residency education curriculum including the ability to accurately and concisely detect, describe, and analyze unknown radiology cases and give both a differential diagnosis and most-likely diagnosis. Teaching these skills requires junior residents to “take cases” in a large conference setting in front of not only their peers, but also upper-level residents and staff. This method of learning can result in increased anxiety and hesitancy of junior residents to participate in case conferences. We believe a peer-led case conference targeting first year residents held outside of work hours can provide a relaxed environment where residents can freely practice taking cases without fear of judgement, decreasing anxiety, and increasing confidence. We believe this will ultimately better prepare residents for the ABR Certifying Exam.

Materials and Methods:
At our institution, we implemented a new biweekly "first year only" case conference series to advance early development of skills for oral boards. The purpose of the opening conference was to teach the class the importance of formal case taking, common modality-specific terminology, and the “four D’s” style of oral case taking. The subsequent conferences have presented each resident with a case tailored to his or her current clinical rotation to practice taking cases using the four D’s format. Pre and post surveys are collected at each conference to determine the levels of anxiety and confidence surrounding different aspects of case taking, such as anxiety over taking cases in front of peers versus attending physicians and confidence levels in identifying an abnormal findings, using radiologic language to describe a finding, developing a differential, and narrowing to one diagnosis.

Results:
This study is ongoing, with four case conferences completed since the start of the academic year. Preliminarily, this conference series has decreased self-reported anxiety about the traditional case conference format by 46%. It has increased confidence in detecting a radiologic abnormality by 21%, increased confidence in using radiology terminology to describe findings by 38%, increased confidence in developing a focused differential diagnosis by 38%, and increased confidence in making a diagnosis by 33%.

Conclusion:
Preliminarily, our conclusions demonstrate that a peer-led first year case conference eases anxiety when formally taking cases and increases confidence in all areas. These results are significant with the reimplementation of an oral-based test for the ABR Certifying Exam, as radiology residents will be required to be proficient in these skills as they advance. Our hope is to showcase the success of a peer-led first year case conference, provide a model for developing such a conference series, and promote the adoption of this model at other academic institutions.