Enhanced Teaching of Screening Mammography Using an Electronic Format

Abstract

Most mammography teaching materials provide only diagnostic images, often with obvious findings due to space constraints. In this work, we describe a method of incorporating full resolution digitized screening mammograms in text teaching file documents to enhance teaching of screening mammography. Teaching cases are constructed in a word processing document with images inserted. The four view screening mammogram is presented first and may be opened in an image viewing program using an embedded hyperlink to view at high resolution, similar to using a magnifying glass. The screening study is followed by feedback and presentation of diagnostic images. Feedback is again provided, followed by diagnosis, differential diagnosis, discussion, and references. A six-question survey of residents and fellows using 5-point Likert scales was used to assess performance. Teaching cases in this format mimic clinical practice by separately presenting screening and diagnostic views. Mammograms may be viewed at high resolution, allowing incorporation of subtle findings to build detection skills. Inclusion of diagnostic views builds judgment and management skills. Survey results from 15 residents and 2 fellows found a mean overall rating of the teaching file of 1.6 (1 = excellent, 5 = poor). Screening mammograms with subtle findings can be incorporated into breast teaching cases by embedding hyperlinks to open images at high resolution in an image-processing program.