Introducing the American College of Radiology Appropriateness Criteria to Medical Students to Increase Appropriate Imaging Selection

Abstract

Inappropriate radiological imaging contributes significantly to excessive healthcare expenditure and increased radiation exposure. The American College of Radiology (ACR) Appropriateness Criteria (AC) serves as an evidence-based resource to guide appropriate imaging utilization. However, knowledge and utilization of these guidelines is lacking in medical education. We introduce a short curriculum to teach medical students correct imaging selection and familiarize them with the ACR AC. Medical students attended a two-part lecture series to learn appropriate imaging selection in common clinical scenarios and the ACR AC. Participants completed a pre- and post-test questionnaire, each consisting of a 10-item test assessing student familiarity with the ACR AC, comfortability in answering, and satisfaction with the curriculum. Improvement in student knowledge and confidence was assessed by statistical analysis using t-tests. Prior to the lecture series, 20.3% of students had no familiarity with the ACR AC, and 41.8% only had slight familiarity. Students demonstrated a statistically significant improvement in the knowledge assessment and in their level of comfort in choosing appropriate imaging modalities. After the lecture series, 97.2% of students responded they would use the ACR AC in the future, with 98.6% of them satisfied with the curriculum. This short curriculum is effective at (1) increasing student knowledge of appropriate radiological studies to order in common clinical encounters and (2) increasing student familiarity of the ACR AC. Further studies will be conducted to assess this curriculum's efficacy in the earlier years of medical school and for first-year residents.