A new study published in the Journal of the American College of Radiology (JACR) reveals that pediatric residents may need to consult with more radiologists when ordering the appropriate imaging exam recommended by the ACR. 

The study, “Online Survey of Radiologic Ordering Practices by Pediatric Trainees” by Hirsch, Ruzal-Shapiro, and Taragin used an online survey of resident pediatricians to evaluate their imaging ordering skills based on the ACR’s Appropriateness Criteria.

Ten scenarios were given to 69 pediatric residents at Children’s Hospital of New York at Columbia University Medical Center (CHONY) and another 75 pediatric residents at The Children’s Hospital at Montefiore Medical Center (CHAM).

52% of the CHAM residents responded and 59% of CHONY responded. The respondents were made up of about equal portions of first year, second year, and third year residents.

The results: Compared to the ACR appropriateness criteria, out of the 10 given scenarios, first-year residents responded with an average of 4.1 incorrect imaging exam orders, second-year residents ordered the incorrect exam on an average of 4.4 times, and third year residents gave an average of 4.5 inappropriate orders—slightly worse than the first years.

Based on the above, it would appear that regardless of the years of experience, these pediatricians in training had about the same error rate when ordering the appropriate pediatric imaging exams recommended by the ACR’s evidenced based criteria.

The researchers concluded in the abstract that “examinations are often ordered without the consultation of a radiologist. The decision each resident makes reflects individual training. To improve residents’ ability to make decisions regarding imaging examinations, radiologists must educate pediatric residents with uniform case-based and didactic sessions.”


(Source: Abstract)