title: Resident experience increases diagnostic rate of thyroid fine-needle aspiration biopsies.
abstract: OBJECTIVE
  The aim of this study was to determine whether the diagnostic yield of thyroid fine-needle aspirations (FNAs) changes over the course of residency training.
  
  
  METHODS
  We identified 5418 ultrasound-guided thyroid nodule FNAs performed in our radiology department from 2004 through 2012. For each FNA, we recorded if the FNA was performed by a resident and if so the name of the resident and supervising attending radiologist. For each resident, we determined the level of training based on their graduation year from our residency program and the date of the FNA as well as prior surgical training and if they completed subsequent interventional radiology fellowship. Pathology reports were reviewed, and FNAs were classified as diagnostic or nondiagnostic (ND). Generalized mixed models were used to assess ND rate with postgraduate years, including residents with and without prior surgical training or if they subsequently completed an interventional radiology fellowship.
  
  
  RESULTS
  Of the 5418 thyroid FNAs, 3164 (58.4%) were performed by a radiology resident under the direct supervision of an attending physician. There was a significant decrease in ND rate as postgraduate years increased (P < .05). A significant decrease in ND rate was found as postgraduate years increased for residents without prior surgical training (P = .0007) or subsequent training in interventional radiology (P = .0014); however, no significant decrease was found for residents with surgical training (P = .37) or completing an interventional radiology fellowship (P = .08). In addition, no significant difference was found for ND rate between postgraduate year 4 (PGY4) and PGY5 (P > .05).
  
  
  CONCLUSIONS
  ND thyroid FNA rates progressively decrease with training level, suggesting that early and continued participation in procedures throughout residency improves outcomes. This is particularly true for residents without prior surgical training or subsequent interventional radiology fellowship.
authors.affiliation: Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903. Electronic address: mbeland@lifespan.org.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Beland
authors.affiliation: Department of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: Thomas J T
authors.initials: TJ
authors.lastname: Anderson
authors.affiliation: Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Atalay
authors.affiliation: Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903.
authors.forename: David J
authors.initials: DJ
authors.lastname: Grand
authors.affiliation: Department of Diagnostic Imaging, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903.
authors.forename: John J
authors.initials: JJ
authors.lastname: Cronan
mesh_terms: D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011361:Professional Competence / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: FNA; Thyoid; biopsy; fine needle aspriration; resident training