title: The Effect of Teaching Search Strategies on Perceptual Performance.
abstract: Radiology expertise is dependent on the use of efficient search strategies. The aim of this study is to investigate the effect of teaching search strategies on trainee's accuracy in detecting lung nodules at computed tomography.
  
  
  
  Two search strategies, "scanning" and "drilling," were tested with a randomized crossover design. Nineteen junior radiology residents were randomized into two groups. Both groups first completed a baseline lung nodule detection test allowing a free search strategy, followed by a test after scanning instruction and drilling instruction or vice versa. True positive (TP) and false positive (FP) scores and scroll behavior were registered. A mixed-design analysis of variance was applied to compare the three search conditions.
  
  
  
  Search strategy instruction had a significant effect on scroll behavior, F(1.3) = 54.2, P < 0.001; TP score, F(2) = 16.1, P < 0.001; and FP score, F(1.3) = 15.3, P < 0.001. Scanning instruction resulted in significantly lower TP scores than drilling instruction (M = 10.7, SD = 5.0 versus M = 16.3, SD = 5.3), t(18) = 4.78, P < 0.001; or free search (M = 15.3, SD = 4.6), t(18) = 4.44, P < 0.001. TP scores for drilling did not significantly differ from free search. FP scores for drilling (M = 7.3, SD = 5.6) were significantly lower than for free search (M = 12.5, SD = 7.8), t(18) = 4.86, P < 0.001.
  
  
  
  Teaching a drilling strategy is preferable to teaching a scanning strategy for finding lung nodules.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628.
authors.forename: Anouk
authors.initials: A
authors.lastname: van der Gijp
authors.affiliation: Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Koen L
authors.initials: KL
authors.lastname: Vincken
authors.affiliation: Office of Medical Education, University of California, San Francisco, San Francisco, California.
authors.forename: Christy
authors.initials: C
authors.lastname: Boscardin
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Webb
authors.affiliation: Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Olle Th J
authors.initials: OTJ
authors.lastname: Ten Cate
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave., M-391, San Francisco, CA 94143-0628. Electronic address: david.naeger@ucsf.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Naeger
mesh_terms: D018592:Cross-Over Studies; D003951:Diagnostic Errors / Q000517:prevention & control; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D011871:Radiology / Q000193:education* / Q000379:methods
keywords: Radiology education; medical image perception; pulmonary nodules; search strategies