Evaluation of an intervention to improve skills in diagnostic radiology of rural physicians over one year in four rural hospitals.
BACKGROUND
Primary health care and patient triage are two basic functions of rural hospitals. As a routine test, the diagnostic radiology is still unavailable in some rural hospitals in China. Therefore, high-level hospitals are often the first choice of rural residents when they feel unwell. It brings serious social problems. This study was designed to propose an on-the-job drilling schema with integration of practical medical recordings and experienced radiological doctors as tutors to improve skills in diagnostic radiology of rural physicians.


METHODS
The information technology was used to help the contact between rural doctors and tutors. In a longitudinal pre/post-test control study design, a cohort of 20 young physicians, each of whom was working in a rural hospital and had a work experience less than two years, were established as the trial group over one year. Another 20 similar counterparts were established as the control group. Participants' performances were evaluated in four categories at five-time point (TP).


RESULTS
The trial group significantly outscored the control group on the style of writing at the second TP (d = 2.28); on the accuracy of the image description at final TP (d = 1.11); on the accuracy of the diagnosis at the fourth TP (d = 3.62); and on the correct treatment selection at the third TP (d = 6.45). The aspects with the most improvement were the accuracies of the diagnosis and the treatment selection.


CONCLUSIONS
This study provided the detailed evidences that applying the on-the-job drilling schema has a significant effect on the skills improvement in diagnostic radiology of rural physicians. It was also concluded that the educational intervention based on practical cases was better than that only based on didactic slides presentation.
School of Life Sciences and Technology, Tongji University, Yangpu, Shanghai, China; Department of Disaster and Emergency Medicine, Eastern Hospital, Tongji University School of Medicine, Pudong, Shanghai, China.
Tienan
T
Feng
Shanghai Pulmonary Hospital affiliated to Tongji University, Yangpu, Shanghai, China.
Xiwen
X
Sun
Department of Disaster and Emergency Medicine, Eastern Hospital, Tongji University School of Medicine, Pudong, Shanghai, China.
Wenxin
W
Niu
Department of Disaster and Emergency Medicine, Eastern Hospital, Tongji University School of Medicine, Pudong, Shanghai, China.
Hengjing
H
Wu
Department of Disaster and Emergency Medicine, Eastern Hospital, Tongji University School of Medicine, Pudong, Shanghai, China.
Chenghua
C
Jiang
D016022:Case-Control Studies; D002681:China; D002983:Clinical Competence / Q000592:standards*; D004502:Education, Medical, Continuing / Q000379:methods*; D006780:Hospitals, Rural / Q000592:standards*; D006801:Humans; D011859:Radiography / Q000379:methods* / Q000592:standards