Elsevier

Academic Radiology

Volume 17, Issue 9, September 2010, Pages 1190-1194
Academic Radiology

Radiology resident education
Correlation Among On-Call Resident Study Volume, Discrepancy Rate, and Turnaround Time

https://doi.org/10.1016/j.acra.2010.06.003Get rights and content

Rationale and Objectives

With continued increase in imaging utilization and remote access image viewing technology, many academic radiology departments are presented with the suggestion to supplement on-call resident preliminary reports with an outsourced attending interpretation. This idea is often brought to administrative attention because of the subjective impression that outsourced studies will benefit from significantly faster interpretation times and lower discrepancy rates, especially when study volume is high. We attempt to retrospectively analyze on-call resident studies at a busy Trauma I university hospital and establish whether a statistical correlation exists among study volume, discrepancy rate, and turnaround time.

Materials and Methods

On-call computed tomography and ultrasound studies between January 2008 and June 2008 were retrospectively reviewed by blinded staff radiologists for discrepancies between preliminary and final reports. A correlation analysis between discrepancy rate and study volume per shift was performed. In addition, correlation analysis between volume per shift and interpretation time was also performed.

Results

A total of 1133 studies were reviewed. The major discrepancy rate is 1.85% with average turnaround time of 28.5 minutes. The correlation coefficient between major discrepancy rate and study volume is 0.35. The correlation coefficient between interpretation time and study volume is 0.29.

Conclusion

Our large retrospective review of preliminary reports from different residents reveals no significant correlation among discrepancy rate, turnaround time, and study volume. The overall discrepancy rate is similar to that reported by other studies. Other institutions can perform this study to analyze whether their volume and resident performance warrants supplemental assistance before depriving residents of the educational benefits the independent on-call experience affords.

Section snippets

Materials and methods

At our institution, emergency department inpatient and outpatient diagnostic studies initiated between 8:01 AM and 4 PM are interpreted by “day-shift” staff radiologists and residents. A “short-call” attending and resident are responsible for emergency department and critical inpatient computed tomography (CT) and ultrasound (US) studies initiated between 4:01 PM and 9 PM. A “night-float” resident arrives at 9 PM and interprets emergent CT and US studies between 9:01 PM and 11 PM with the

Results

A total of 1133 CT and US studies between January 1, 2008, and June 30, 2008, were retrospectively reviewed. Sixty-one night-float shifts were analyzed with a nearly even distribution of the six second-year radiology residents in the call pool. The average number of studies encountered per shift was 18.61 (standard deviation ± 7.49) though the spectrum ranged from 7 to 40 studies per shift.

The average interpretation time was 28.46 minutes (standard deviation ± 9.20) though the spectrum ranged

Discussion

Resident education and autonomy have to be weighed conscientiously with patient care and throughput of other clinical services in mind. Many prior studies have shown low radiology resident discrepancy rates without a negative impact on patient care 1, 3, 4, 5, 6, 7, 8, 9, 10. To fully assess whether resident coverage is meeting the needs of the emergency department during after-hours shifts, a more thorough investigation involving interpretation times and correlation statistics is necessary. To

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