Journal Article Multicenter Study Ppublish
PubMed: 39255684 DOI: 10.1016/j.ajem.2024.08.038
A nationwide analysis of emergency medicine residents' CT interpretation in trauma: The Tract-EM study.
Am J Emerg Med 85:123-129
Authors: Mehmet Ali Aslaner, Gültekin Kadı, Sevcihan Kesen, Atiye Cenay Karabörk Kılıç, Özlem Coşkun, Fikret Bildik, Ayfer Keleş, Ahmet Demircan, Hüseyin Koray Kılıç, Burak Şişik, Ömer Faruk Korkak, Gülhan Kurtoğlu Çelik, Volkan Arslan, Alten Oskay, Özge Can, Necmi Baykan, Secdegül Coşkun Yaş, Merve Yazla, Elif Yaka, Mehmet Göktuğ Efgan, Melih İmamoğlu, Ahmet Ak, Ayça Koca, Fatih Çalışkan, Metin Yadigaroğlu, Serkan Emre Eroğlu, Süleyman İbze, Mahmut Yaman, Mahmut Taş, Şenol Ardıç, Nalan Kozacı, Yunsur Çevik, Mustafa Sabak, Ali Aygün, Mehmet Koşargelir, Yusuf Ertuğrul Aslan, Gürkan Altuntaş, Nurdan Acar, Buğra İlhan
Affiliations
- Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye.
- Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye.
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Türkiye.
- Department of Medical Education and Informatics, Gazi University Faculty of Medicine, Ankara, Türkiye.
- Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye.
- Clinic of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, Türkiye.
- Department of Emergency Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye.
- Department of Emergency Medicine, Pamukkale University Faculty of Medicine, Denizli, Türkiye.
- Department of Emergency Medicine, Ege University Faculty of Medicine, İzmir, Türkiye.
- Clinic of Emergency Medicine, Kayseri City Hospital, Kayseri, Türkiye.
- Clinic of Emergency Medicine, Ankara Training and Research Hospital, Ankara, Türkiye.
- Clinic of Emergency Medicine, Ankara Etlik City Hospital, Ankara, Türkiye.
- Department of Emergency Medicine, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye.
- Department of Emergency Medicine, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Türkiye.
- Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye.
- Department of Emergency Medicine, Selçuk University Faculty of Medicine, Konya, Türkiye.
- Department of Emergency Medicine, Ankara University Faculty of Medicine, Ankara, Türkiye.
- Department of Emergency Medicine, Ondokuz Mayıs University Faculty of Medicine, Samsun, Türkiye.
- Department of Emergency Medicine, Samsun University Faculty of Medicine, Samsun, Türkiye.
- Department of Emergency Medicine, University of Health Sciences, Umraniye Health Practice and Research Center, İstanbul, Türkiye.
- Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Antalya, Türkiye.
- Department of Emergency Medicine, Dicle University Faculty of Medicine, Diyarbakır, Türkiye.
- Clinic of Emergency Medicine, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye.
- Department of Emergency Medicine, Trabzon Kanuni Training and Research Hospital, Trabzon, Türkiye.
- Department of Emergency Medicine, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, Türkiye.
- Clinic of Emergency Medicine, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Türkiye.
- Department of Emergency Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye.
- Department of Emergency Medicine, Ordu University Faculty of Medicine, Ordu, Türkiye.
- Clinic of Emergency Medicine, Haydarpaşa Numune Training and Research Hospital, İstanbul, Türkiye.
- Department of Emergency Medicine, Erciyes University Faculty of Medicine, Kayseri, Türkiye.
- Department of Emergency Medicine, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye.
- Department of Emergency Medicine, Eskişehir Osmangazi University School of Medicine, Eskişehir, Türkiye.
- Department of Emergency Medicine, Kırıkkale University Faculty of Medicine, Kırıkkale, Türkiye.
Abstract
OBJECTIVE
To evaluate the accuracy and determine the factors influencing trauma CT interpretation proficiency among emergency medicine (EM) residents in Turkey through the TraCT-EM study (Interpretation of Trauma CT by EMergency Physicians).
METHODS
This nationwide, multicenter, cross-sectional study was conducted in 29 academic emergency departments (EDs) from April 2023 to March 2024. A total of 401 senior EM residents participated in the study, each interpreting a standardized set of 42 trauma CT series (cranial, maxillofacial, and cervical) derived from seven patients. Interpretation accuracy was assessed, and factors predicting interpretation failure were analyzed using univariate and multivariate regression models.
RESULTS
The median accuracy rate of residents was 64.9 %, with higher accuracy in normal CT findings. Using the Angoff method, 14 % of residents scored below the passing threshold. Factors associated with interpretation failure included shorter interpretation times (OR, 0.97; 95 % CI, 0.95-0.99), lower self-confidence in detecting serious pathologies (OR, 2.50; 95 % CI, 1.42-4.42), reliance on in-hospital radiology department reports (OR, 3.45; 95 % CI, 1.47-8.05), and receiving final radiology reports for CT scans (OR, 3.30; 95 % CI, 1.67-6.52), and lack of in-department training programs (OR, 2.51; 95 % CI, 1.34-4.70).
CONCLUSION
The TraCT-EM study highlighted a 65 % accuracy rate for senior EM residents in trauma CT interpretation, with specific predictors of failure identified. These findings suggest a need for tailored radiology education strategies to enhance training and competency in trauma CT interpretation for EM residents. Further optimization of educational programs could address these gaps, ultimately improving patient outcomes in trauma care.
MeSH
Emergencies, Emergency Medicine, Radiology, Education, Wounds And Injuries