title: Assessing Medical Student Knowledge of Imaging Modality Selection Before and After a General Radiology Elective: A Comparison of MS-IIs, MS-IIIs, and MS-IVs.
abstract: OBJECTIVE
  Correct selection of imaging tests is essential f or clinicians but until recently has been largely neglected in medical education. How and when students acquire such non-interpretive skills are unknown. This study will assess student knowledge of imaging test selection before and after a general radiology elective.
  
  
  METHODS
  Between 2008 and 2015, an unannounced 13-item test was administered to second, third, and fourth-year students on the first and last days of the Johns Hopkins School of Medicine radiology elective. Scores (0–13) were based on the American College of Radiology Appropriateness Criteria. Pre- and posttest means were compared using paired samples t tests. Whether performance on the pretest and posttest differed by class year was assessed using analysis of variance and Kruskal-Wallis, respectively, and whether year was associated with posttest score after controlling for pretest score was assessed using analysis of covariance.
  
  
  RESULTS
  Posttest means were significantly higher than pretest means for students in all years (P values <.0001). Pretest scores differed by year (F(2, 360) = 66.85, P <.0001): fourth-year students scored highest (mean = 9.96 of 13) and second-year students scored lowest (mean = 7.01 of 13). Posttest scores did not differ (χ2(2, 270) = 0.348, P = .841). Year in school had no independent effect on posttest score (F(2, 239) = 0.45, P = .637).
  
  
  CONCLUSIONS
  Knowledge of modality selection increases with clinical training, but room for improvement remains. A general radiology elective increases this knowledge. Second-year students improve most, suggesting that taking radiology early is efficient, but further research to evaluate retention of this knowledge is needed. Medical student education in radiology must increasingly recognize and address non-interpretive skills and intelligent imaging utilization.
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Gispen
authors.forename: Donna
authors.initials: D
authors.lastname: Magid
mesh_terms: D065187:Controlled Before-After Studies; D003952:Diagnostic Imaging / Q000379:methods; D004501:Education, Medical; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D011871:Radiology / Q000193:education*; D013337:Students, Medical