title: Simulation for Teaching and Assessment of Nodule Perception on Chest Radiography in Nonradiology Health Care Trainees.
abstract: OBJECTIVE
  Simulation has been used as an educational and assessment tool in several fields, generally involving training of physical skills. To date, simulation has found limited application in teaching and assessment of skills related to image perception and interpretation. The goal of this pilot study was to evaluate the feasibility of simulation as a tool for teaching and assessment of skills related to perception of nodules on chest radiography.
  
  
  METHODS
  This study received an exemption from the institutional review board. Subjects consisted of nonradiology health care trainees. Subjects underwent training and assessment of pulmonary nodule identification skills on chest radiographs at simulated radiology workstations. Subject performance was quantified by changes in area under the localization receiver operating characteristic curve. At the conclusion of the study, all subjects were given a questionnaire with five questions comparing learning at a simulated workstation with training using conventional materials. Statistical significance for questionnaire responses was tested using the Wilcoxon signed rank test.
  
  
  RESULTS
  Subjects demonstrated statistically significant improvement in nodule identification after training at a simulated radiology workstation (change in area under the curve, 0.1079; P = .015). Subjects indicated that training on simulated radiology workstations was preferable to conventional training methods for all questions; P values for all questions were less than .01.
  
  
  CONCLUSIONS
  Simulation may be a useful tool for teaching and assessment of skills related to medical image perception and interpretation. Further study is needed to determine which skills and trainee populations may be most amenable to training and assessment using simulation.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. Electronic address: wauffer@emory.edu.
authors.forename: William F
authors.initials: WF
authors.lastname: Auffermann
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Travis S
authors.initials: TS
authors.lastname: Henry
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Brent P
authors.initials: BP
authors.lastname: Little
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Stefan
authors.initials: S
authors.lastname: Tigges
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia.
authors.forename: Srini
authors.initials: S
authors.lastname: Tridandapani
mesh_terms: D000328:Adult; D019540:Area Under Curve; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004521:Educational Measurement; D005240:Feasibility Studies; D005260:Female; D006282:Health Personnel / Q000193:education; D006801:Humans; D008297:Male; D010465:Perception; D010865:Pilot Projects; D012372:ROC Curve; D013902:Radiography, Thoracic; D011871:Radiology / Q000193:education*; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D018709:Statistics, Nonparametric; D013337:Students, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
keywords: Radiology; education; perception; simulation