title: Influences of Radiology Trainees on Screening Mammography Interpretation.
abstract: OBJECTIVE
  Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes.
  
  
  METHODS
  Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded.
  
  
  RESULTS
  A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P < .0001). Overall cancer detection rate for attending radiologists reading alone was 5.7 per 1,000 compared with 5.2 per 1,000 when reading with a trainee (P = .517). When reading with a trainee, dense breasts represented a greater portion of recalls (P = .0001), and more frequently, greater than one abnormality was described in the breast (P = .013). Detection of ductal carcinoma in situ versus invasive carcinoma or invasive cancer type was not significantly different. The mean size of cancers in patients recalled by attending radiologists alone was smaller, and nodal involvement was less frequent, though not statistically significantly.
  
  
  CONCLUSIONS
  These results demonstrate a significant overall increase in recall rate when interpreting screening mammograms with radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives.
authors.affiliation: The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: jeffrey.hawley@osumc.edu.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Hawley
authors.affiliation: The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Clayton R
authors.initials: CR
authors.lastname: Taylor
authors.affiliation: Loyola University Medical Center, Maywood, Illinois.
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Cubbison
authors.affiliation: The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: B Selnur
authors.initials: BS
authors.lastname: Erdal
authors.affiliation: Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Vedat O
authors.initials: VO
authors.lastname: Yildiz
authors.affiliation: The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Selin
authors.initials: S
authors.lastname: Carkaci
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D055088:Early Detection of Cancer; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008327:Mammography; D008875:Middle Aged; D011871:Radiology / Q000193:education*; D012189:Retrospective Studies
keywords: Screening mammography; breast radiologist; medical education; radiology education; radiology trainees