Adaptive tutorials help medical students learn diagnostic imaging

Adaptive tutorials can help medical students gain a better understanding of diagnostic imaging, according to a recent study published in Academic Radiology.

Gary M. Velan, PhD, of the faculty of medicine at the University of New South Wales in Sydney, and colleagues wrote that it is crucial for all medical students to learn about medical imaging.

“Failure to develop basic radiology skills also has significant health care and economic implications,” the authors wrote. “In the United States, up to 30% of imaging studies are reported to be ordered inappropriately. This places a huge burden on the health budget and often results in unnecessary harm to patients.”

Velan and colleagues also argued that gaining a proper understanding of diagnostic imaging takes a lot of practice.

“It is only by reviewing many images that students can begin to understand radiologic interpretation and diagnosis, and therefore, its use in clinical care,” the authors wrote. “Online educational resources best support this requirement for access to large image sets. In a study conducted in the United Kingdom, students reported high levels of satisfaction and increased confidence in image interpretation after implementation of an online radiology module. Thus, creation of high-quality digital imaging resources that allow flexible and interactive learning in radiology could potentially improve health care, reduce unnecessary tests, prevent harm to patients, and increase equity in resource distribution.”

And this is where the adaptive tutorials come into play. There is definite value to self-directed learning, the authors explained, but students need to possess the necessary knowledge before they can truly learn on their own. Adaptive tutorials are specifically designed to help students reach that point.

“In the adaptive tutorials, which were deliberately targeted at an introductory level, static screens providing information were interspersed with rich interactive elements such as multiple-choice questions and drag-and-drop questions,” the authors wrote. “The tutorials provided immediate feedback that was adapted to individual student responses.”

Velan and his co-authors tested the efficiency and effectiveness of adaptive tutorials by dividing medical students enrolled in a six-year undergraduate medical program into two groups. Both groups studied the use and interpretation of chest x-rays, but one group used an adaptive tutorial while the other group used a peer-reviewed online resource, Diagnostic Imaging Pathways.

The groups then studied CT scans of the head, chest, and abdomen, but the tutorial group switched to the online resource, and the online resource group switched to the tutorial.

After studying for one week, each group would be given an online assessment, and the results showed that the group using the adaptive tutorial outperformed the group using the online resource in every instance. When studying chest x-rays, the mean assessment scores for the groups were 68.2 (adaptive tutorial) and 60.5 (online resource). When studying CT scans of the head, chest, and abdomen, the mean assessment scores for the groups were 61.1 (adaptive tutorial) and 53.9 (online resource).

Senior medical students (those in years three or four of their six-year program) especially benefitted from using the adaptive tutorial, a fact the authors attribute to the senior students’ previous experience studying the topics.

“In this cohort, adaptive tutorials on diagnostic imaging had significant quantitative and qualitative learning benefits for senior medical students,” the authors wrote.

The statistics also showed that students studying chest x-rays using the online resource studied approximately one half hour longer than those who used the tutorial.

“The learning benefits of the adaptive tutorials were achieved while participants spent equivalent, or in some cases, less time, studying the adaptive tutorial than the Diagnostic Imaging Pathways Web site,” the authors wrote. “From these data, we infer that the adaptive tutorials assisted learning in a time-efficient.”

Students were also asked to assess the adaptive tutorials via questionnaires, and the answers showed an overall acceptance and appreciation of the technology.

More critical responses included complaints about technical difficulties (incompatibility with browsers, slow loading times for images) and requests for the user interface’s back-and-forth navigation to be improved.