Pediatric radiologist-driven didactics for a pediatric residency program: a quality initiative

Pediatric residents exhibit knowledge gaps in appropriateness of imaging utilization.

This study evaluates the value of radiologist-driven imaging education in a pediatric residency program. The primary goals of this educational program were to provide pediatric residents with resources such as the American College of Radiology Appropriateness Criteria, support optimal resource utilization and patient care, increase resident understanding of radiation risk, and determine the value of integrating radiologists into pediatric education.

A needs assessment was performed in which the chief residents of a large pediatric program were surveyed. The consensus of chief residents was that a four-part lecture series delivered by a pediatric radiology fellow would be beneficial to the pediatric residents. Topics included general radiation risk as well as basic imaging topics in the chest, abdomen, neurological system, extremities and vasculature. Each lecture integrated appropriate ordering, ALARA (As Low As Reasonably Achievable)/Image Gently, and basic image interpretation. Residents were asked, using a Likert scale, to rate their understanding of radiation risk, the ACR Appropriateness Criteria, and other topics of interest before and after each lecture. Pediatric residents were given a 10-item quiz before and after the lecture series to assess their knowledge regarding the best test to order in clinical scenarios.

The average pre-lecture score for knowledge of radiation risk was 3.27 (95% confidence interval [CI]: 3.02–3.51) out of 5, which improved to 4.27 (95% CI: 4.09–4.57) post-lecture. There was an increase in understanding of ACR appropriateness, with pre-lecture rating of knowledge increasing from 1.91 (95% CI 1.54–2.29) out of 5 to 3.61 (95% CI 3.33–3.90) post-lecture. The residents averaged 82.7% (95% CI 77.3%–88.1%) on the appropriateness pre-test and 93.8% (95% CI 90.3%–97.2%) on the post-test. Residents provided positive feedback upon conclusion of the program and reported a beneficial effect on their education.

A radiologist-driven lecture series in a pediatric residency can improve resident understanding of appropriate ordering practices and radiation risk. Radiologist participation in pediatric residency training is well-received.