The Impact of Structured Intensive Training on the Preliminary Image Evaluation Performance of Medical Imaging Technologists in Taranaki, New Zealand

Abstract

Introduction Preliminary Image Evaluation (PIE) is an abnormality detection system where medical imaging technologists (MITs) write a comment outlining acute abnormalities they have detected on X-ray examinations performed in the emergency department (ED), or that no abnormality was detected. Initially developed in the United Kingdom due to a shortage of radiologists and a subsequent delay in radiology reports, PIE has spread to other parts of the world, notably in Australia, where a similar shortage of radiologists exists. Studies have demonstrated that training MITs in PIE improves their sensitivity, specificity, and overall accuracy. There are, however, concerns about whether this improvement is maintained over time. One suggestion is to provide ongoing feedback to MITs when participating in a PIE system to maintain this performance improvement. This pre-post-intervention study aimed to investigate the impact intensive training in PIE, along with regular feedback on commonly missed abnormalities, had on MIT’s sensitivity, specificity, overall accuracy, and comment accuracy when performing PIE on extremity X-ray examinations in EDs in two provincial hospitals in NZ. Methods This study was a pre-post-intervention design using image evaluation tests (IETs) to assess participants’ performance when detecting and describing acute abnormalities on acute extremity X-ray examinations in ED before, immediately after, and six months following a two-day intensive, structured training course in PIE. Additionally, during the six months following the intensive training, regular feedback consisting of fortnightly e-mails and monthly revision sessions was provided to assist participants in maintaining their post-training PIE performance. Results The participants in this study demonstrated an improvement in PIE performance immediately following intensive training. When re-assessed six months later, the participants' sensitivity was the same as their pre-intervention sensitivity. However, the participants demonstrated increased specificity, comment accuracy, and overall accuracy. Additionally, the clinical evaluation demonstrated an improvement over six months. Conclusion As the participant's overall accuracy improved and was maintained for six months following intensive training, it is recommended that MITs undertake additional training to improve PIE performance before participating in a PIE system. Additionally, regular feedback on commonly missed abnormalities may be useful to ensure participants' improved performance when performing PIE is maintained over time.