A nationwide analysis of emergency medicine residents' CT interpretation in trauma: The Tract-EM study.

Mehmet Ali Aslaner, G��ltekin Kad��, Sevcihan Kesen, Atiye Cenay Karab��rk K��l����, ��zlem Co��kun, Fikret Bildik, Ayfer Kele��, Ahmet Demircan, H��seyin Koray K��l����, Burak ��i��ik, ��mer Faruk Korkak, G��lhan Kurto��lu ��elik, Volkan Arslan, Alten Oskay, ��zge Can, Necmi Baykan, Secdeg��l Co��kun Ya��, Merve Yazla, Elif Yaka, Mehmet G��ktu�� Efgan, Melih ��mamo��lu, Ahmet Ak, Ay��a Koca, Fatih ��al����kan, Metin Yadigaro��lu, Serkan Emre Ero��lu, S��leyman ��bze, Mahmut Yaman, Mahmut Ta��, ��enol Ard����, Nalan Kozac��, Yunsur ��evik, Mustafa Sabak, Ali Ayg��n, Mehmet Ko��argelir, Yusuf Ertu��rul Aslan, G��rkan Altunta��, Nurdan Acar, Bu��ra ��lhan, TraCT-EM study group
Author Information
  1. Mehmet Ali Aslaner: Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, T��rkiye. Electronic address: maliaslaner@gazi.edu.tr.
  2. G��ltekin Kad��: Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, T��rkiye. Electronic address: gultekinkadi@gmail.com.
  3. Sevcihan Kesen: Department of Radiology, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  4. Atiye Cenay Karab��rk K��l����: Department of Radiology, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  5. ��zlem Co��kun: Department of Medical Education and Informatics, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  6. Fikret Bildik: Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  7. Ayfer Kele��: Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  8. Ahmet Demircan: Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  9. H��seyin Koray K��l����: Department of Radiology, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  10. Burak ��i��ik: Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  11. ��mer Faruk Korkak: Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, T��rkiye.
  12. G��lhan Kurto��lu ��elik: Clinic of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, T��rkiye.
  13. Volkan Arslan: Department of Emergency Medicine, Hacettepe University Faculty of Medicine, Ankara, T��rkiye.
  14. Alten Oskay: Department of Emergency Medicine, Pamukkale University Faculty of Medicine, Denizli, T��rkiye.
  15. ��zge Can: Department of Emergency Medicine, Ege University Faculty of Medicine, ��zmir, T��rkiye.
  16. Necmi Baykan: Clinic of Emergency Medicine, Kayseri City Hospital, Kayseri, T��rkiye.
  17. Secdeg��l Co��kun Ya��: Clinic of Emergency Medicine, Ankara Training and Research Hospital, Ankara, T��rkiye.
  18. Merve Yazla: Clinic of Emergency Medicine, Ankara Etlik City Hospital, Ankara, T��rkiye.
  19. Elif Yaka: Department of Emergency Medicine, Kocaeli University Faculty of Medicine, Kocaeli, T��rkiye.
  20. Mehmet G��ktu�� Efgan: Department of Emergency Medicine, ��zmir Katip ��elebi University Faculty of Medicine, ��zmir, T��rkiye.
  21. Melih ��mamo��lu: Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, T��rkiye.
  22. Ahmet Ak: Department of Emergency Medicine, Sel��uk University Faculty of Medicine, Konya, T��rkiye.
  23. Ay��a Koca: Department of Emergency Medicine, Ankara University Faculty of Medicine, Ankara, T��rkiye.
  24. Fatih ��al����kan: Department of Emergency Medicine, Ondokuz May��s University Faculty of Medicine, Samsun, T��rkiye.
  25. Metin Yadigaro��lu: Department of Emergency Medicine, Samsun University Faculty of Medicine, Samsun, T��rkiye.
  26. Serkan Emre Ero��lu: Department of Emergency Medicine, University of Health Sciences, Umraniye Health Practice and Research Center, ��stanbul, T��rkiye.
  27. S��leyman ��bze: Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Antalya, T��rkiye.
  28. Mahmut Yaman: Department of Emergency Medicine, Dicle University Faculty of Medicine, Diyarbak��r, T��rkiye.
  29. Mahmut Ta��: Clinic of Emergency Medicine, Gazi Ya��argil Training and Research Hospital, Diyarbak��r, T��rkiye.
  30. ��enol Ard����: Department of Emergency Medicine, Trabzon Kanuni Training and Research Hospital, Trabzon, T��rkiye.
  31. Nalan Kozac��: Department of Emergency Medicine, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, T��rkiye.
  32. Yunsur ��evik: Clinic of Emergency Medicine, Ankara Atat��rk Sanatoryum Training and Research Hospital, Ankara, T��rkiye.
  33. Mustafa Sabak: Department of Emergency Medicine, Gaziantep University Faculty of Medicine, Gaziantep, T��rkiye.
  34. Ali Ayg��n: Department of Emergency Medicine, Ordu University Faculty of Medicine, Ordu, T��rkiye.
  35. Mehmet Ko��argelir: Clinic of Emergency Medicine, Haydarpa��a Numune Training and Research Hospital, ��stanbul, T��rkiye.
  36. Yusuf Ertu��rul Aslan: Department of Emergency Medicine, Erciyes University Faculty of Medicine, Kayseri, T��rkiye.
  37. G��rkan Altunta��: Department of Emergency Medicine, Recep Tayyip Erdo��an University Faculty of Medicine, Rize, T��rkiye.
  38. Nurdan Acar: Department of Emergency Medicine, Eski��ehir Osmangazi University School of Medicine, Eski��ehir, T��rkiye.
  39. Bu��ra ��lhan: Department of Emergency Medicine, K��r��kkale University Faculty of Medicine, K��r��kkale, T��rkiye.

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.

Keywords

MeSH Term

Humans
Internship and Residency
Cross-Sectional Studies
Emergency Medicine
Clinical Competence
Turkey
Male
Female
Tomography, X-Ray Computed
Adult
Wounds and Injuries
Emergency Service, Hospital

Word Cloud

Created with Highcharts 10.0.0CTinterpretationresidentsaccuracytraumastudyOR95 %CIEM1emergencymedicineInterpretationfailureradiologyfactorsTraCT-EMTraumanationwidesenior42ratefindings02reports3trainingprogramsOBJECTIVE:evaluatedetermineinfluencingproficiencyamongTurkeyEMergencyPhysiciansMETHODS:multicentercross-sectionalconducted29academicdepartmentsEDsApril2023March2024total401participatedinterpretingstandardizedsetseriescranialmaxillofacialcervicalderivedsevenpatientsassessedpredictinganalyzedusingunivariatemultivariateregressionmodelsRESULTS:median649 %highernormalUsingAngoffmethod14 %scoredpassingthresholdFactorsassociatedincludedshortertimes9795-099lowerself-confidencedetectingseriouspathologies5042-4reliancein-hospitaldepartment4547-805receivingfinalscans3067-652lackin-department5134-470CONCLUSION:highlighted65 %specificpredictorsidentifiedsuggestneedtailorededucationstrategiesenhancecompetencyoptimizationeducationaladdressgapsultimatelyimprovingpatientoutcomescareanalysisresidents'trauma:Tract-EMComputedtomographyEducationEmergencyRadiology

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