Evaluation of Pre‐Clinical Radiology Study Habits and Performance
Authors: Stokes Madison , Hryniuk Alexa , Edmondson Anna 
Published: April 2020

Introduction

Medical imaging is the primary approach to visualize normal and pathological anatomy in clinical practice and is used in almost every specialty. As such, it is imperative that medical students learn how to view and interpret radiological images early in training. At the Medical College of Georgia, medical imaging is integrated into first year anatomy lectures and labs and tested on written exams and lab practicals.

Aim

The aim of this study was to determine student study strategies for radiology and evaluate their effectiveness. We hypothesized that students utilizing active learning strategies would be more effective in learning and retaining radiology content.

Methods

Following completion of the first year curriculum, medical students (n=140 out of 191) completed a survey to ascertain radiology study strategies. Students also completed a radiology formative assessment that included 10 questions from previous lab practicals. Data from anatomy practicals throughout the year were analyzed. Students were split into quartiles (n=35) based on overall Anatomy grade (1st quartile: 88.6 ± 2.5; 2nd quartile: 82.7 ± 1.2; 3rd quartile: 78.7 ± 1.2; 4th quartile: 72.7 ± 3.7). One‐way ANOVA with Tukey’s post‐hoc analysis and unequal variance two tailed t‐tests were used to compare study strategies and grades among quartiles. IRB approval was obtained from Augusta University.

Results

The most commonly cited study strategies included attending faculty reviews (70%), individual studying (64%), using pre‐labeled 2D images instead of 3D image stacks (55%), and using radiology websites (51%). Students scored significantly lower on the end of year questions (38.1 ± 2.1) compared to performance on lab practicals during the year (86.2 ± 1.2) (p<0.05). Students in the 1st and 2nd quartiles scored significantly higher on select radiology items from lab practicals throughout the year compared to the 4th quartile (1st: 92.6 ± 9.4, 2nd: 91.1 ± 6.7, 4th: 75.7 ± 14.0; p<0.05). End of year radiology assessment scores were also significantly higher in the 1st and 2nd quartiles compared to the 4th quartile (1st: 50.0 ± 19.6, 2nd: 42.6 ± 17.3, 4th: 28.0 ± 16.2; p<0.05). Students in the 1st quartile used active learning study strategies such as 3D images stacks (40% ± 4.9%) and practice questions (51.4% ± 5.0%) significantly more often than students in the 4th quartile (11.4% ± 3.2%; 20.0% ± 4.0% respectively) (p<0.05).

Conclusions

These data show that current study strategies used by students do not promote long term retention of radiology content; however, those students using active learning study strategies retain more. Although top quartile students scored significantly better on the end of year radiology assessment, they only retained ~50% of radiology material. Based on the results of this study, the radiology curriculum has been revised to address concerns about long term retention. These changes include more frequent exposure to radiological images and more formative assessments that require students to scroll through 3D image stacks. Further studies will address if these changes are effective in promoting long term retention.