Residents who attend conferences that focus on missed or misinterpreted cases are 67% less likely to miss important findings when reading on-call musculoskeletal x-ray images, according to a new study published in the October issue of the American Journal of Roentgenology.
Dr. Jason Itri, of the Hospital of the University of Pennsylvania, and colleagues found that residents had 55 major discrepancies out of 5,326 x-ray studies of the shoulder, elbow, hand, wrist, ankle, foot, pelvis, and knee before the institution began holding regular missed case conferences. That number dropped to 18 major discrepancies out of 5,272 x-ray studies after the focus on missed-case conferences became part of the resident education program (AJR, October 2011, Vol. 197:4, pp. W696-W705).
Even better was that the major discrepancy rates for residents who attended the conferences were lower than those of board-certified fellows who did not attend the conferences, Itri's group found. During the time of the study, fellows had an overall major discrepancy rate of 1.5% for diagnosing musculoskeletal injuries related to topics discussed during the missed-case conferences, while the residents overall major discrepancy rate was only 0.8%, nearly half the miss rate for fellows.
As a result of the study, Itri's department now includes 10 focused missed-case conferences as part of a three-week course residents take before they can take independent call.
