Impact of resident call eligibility on major discrepancy rate.
OBJECTIVE
The Resident Review Committee (RRC) recently changed the policy concerning first-year resident call. Our study is intended to evaluate whether the additional 6 months of training before a resident's first call made a significant difference in the resident's ability to provide patient care. To evaluate this, we assessed the discrepancy rates between preliminary interpretations made by residents and final reports by attendings.


METHODS
All cross-sectional imaging interpreted by on-call residents (5 PM to 8 AM) during the first 6 months of call duties was reviewed for discrepant findings between the preliminary resident report and the final interpretation by an attending. Only major discrepancies were evaluated. A major discrepancy was defined as a change made to the resident preliminary report by an attending radiologist where a delay in communicating that finding had the potential to negatively affect clinical outcomes. Major discrepancy rates between groups were then compared.


RESULTS
During the second 6 months of the 2008-2009 academic year, first-year residents interpreted 3331 studies. Fifty-nine of those were declared to be discrepancies after an attending over-read, a rate of 1.8%. During the first 6 months of the 2009-2010 academic year, second-year residents interpreted 4649 studies with 49 discrepancies, a rate of 1.0%. This difference is statistically significant (P = .008).


CONCLUSIONS
The recent RRC policy change requiring 6 additional months of training before assuming independent on-call responsibilities has significantly decreased the major discrepancy rate at our institution.
Flink
Carl C
CC
Department of Radiology, Allegheny General Hospital, Pittsburgh PA 15212, USA. cflink@wpahs.org
Mueller
Jeffrey S
JS
Kiproff
Paul M
PM
D039602:After-Hours Care / Q000706:statistics & numerical data*; D003479:Curriculum; D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data*; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D007396:Internship and Residency / Q000706:statistics & numerical data*; D010414:Pennsylvania; D011361:Professional Competence / Q000706:statistics & numerical data*