title: Medical Student Usage of the  American College of Radiology  Appropriateness Criteria.
abstract: OBJECTIVE
  Educating medical students on appropriate imaging utilization has been increasingly recognized as important for patient care. The American College of Radiology Appropriateness Criteria (ACR-AC) is designed to support evidence-based imaging examination selection. We sought to assess whether medical students order imaging studies independently, what resources they use for guidance, and whether they use the ACR-AC in clinical practice. A secondary aim was to determine whether increasing familiarity with the ACR-AC could impact student usage.
  
  
  METHODS
  We surveyed third year medical students at a single institution on their imaging practices, familiarity with the ACR-AC, and preferences among available resources to guide proper examination selection. The survey was performed in person before a lecture. We also designed a brief intervention to improve familiarity with the ACR-AC and then reassessed students to determine any effect on utilization.
  
  
  RESULTS
  The response rate for the initial survey was 103 of 109 (94%) and the response rate for the second survey was 99 of 109 (91%).Our initial survey found students initiated imaging orders independently (74 of 100, 74.8%) and consulted resources to assist in examination selection (50 of 74, 67.6%). Students expressed a preference for non-ACR-AC resources, notably Up to Date via its online mobile application.Few students (8 of 71, 11.3%) were familiar with the ACR-AC. After an intervention to increase familiarity with the ACR-AC, student awareness of the ACR-AC increased to 61 of 74 (82.4%). However, usage among those familiar with the resource remained low, 13 of 61(21.3%) versus 3 of 8 (37.5%).
  
  
  CONCLUSIONS
  Use of the ACR-AC was low among third year medical students. After increasing students' familiarity with the ACR-AC, their usage in a clinical setting did not increase. The largest barrier to use may be the lack of a quick, easy to use online mobile application-based interface.
authors: Benjamin
authors: B
authors: Kozak
authors: Emily M
authors: EM
authors: Webb
authors: Baber K
authors: BK
authors: Khan
authors: Nicholas M
authors: NM
authors: Orozco
authors: Christopher M
authors: CM
authors: Straus
authors: David M
authors: DM
authors: Naeger
mesh_terms: D003258:Consumer Behavior; D003952:Diagnostic Imaging; D019317:Evidence-Based Medicine; D006801:Humans; D063731:Mobile Applications; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000592:standards*; D012955:Societies, Medical; D013337:Students, Medical / Q000706:statistics & numerical data*; D014481:United States