Objective: The objective of our study was to evaluate the preparedness of postgraduate year (PGY)-2 residents for independent call responsibilities and the impact of the radiology residency training program on call preparedness using an objective DICOM-based simulation module over a 5-year period.
Materials and methods: A month-long emergency radiology lecture series, conducted over 5 consecutive years, was designed and given to radiology residents at all levels. A DICOM-based, interactive, computer-based testing module with actual emergency department cases was developed and administered at the end of the lecture series. Comparison was made between first-year and upper-level resident test scores using a Student's t test, generalized estimating equations, and individual fixed effects to determine PGY-2 residents' before-call preparedness and the effectiveness of the simulation module to assess call preparedness. Resident scoring on the simulation module was also plotted as a function of progression through their residency program to evaluate the impact of the training program on call preparedness.
Results: Over 5 years, 45 PGY-2, 34 PGY-3, 32 PGY-4, and 35 PGY-5 residents attended the lecture series and completed the computer-based testing module. PGY-2 residents scored an average of 71% +/- 15% (SD), PGY-3 residents scored 79% +/- 11%, PGY-4 residents scored 84% +/- 10%, and PGY-5 residents scored 86% +/- 11% of the total points possible. A statistically significant (p < 0.05) difference in scoring on the simulation module was identified between the PGY-2 residents and each upper-level class over the 5-year period and during 4 of 5 examination years analyzed separately. A trend toward higher average scores for each cohort of residents as they progressed through residency training was identified.
Conclusion: Over a 5-year period, first-year radiology residents scored significantly lower than upper-level colleagues on an emergency radiology simulation module, suggesting a significant improvement in the ability of residents to interpret typical on-call imaging studies after the PGY-2 year.