Medical Interns' Skill Levels in Emergency Chest X-ray Interpretation

Abstract

Objectives: The research aims to evaluate the proficiency of medical interns in identifying critical findings on chest X-rays, such as pneumothorax, pleural effusion, pulmonary edema, pneumonia, and other urgent conditions. It also seeks to determine the interns' capability to differentiate between normal and abnormal findings, as well as their ability to prioritize and communicate these findings to senior medical staff promptly. Materials and Methods: A cross-sectional online questionnaire-based form was used to collect data from medical interns across different medical schools around Saudi Arabia. Pearson correlation was carried out to see the relationship between x-ray interpretation scores and degree of confidence. A Fischer exact test was conducted to find an association between the demographic characteristics and diagnostic accuracy of X-rays. Results: A total of 545 medical interns from different universities participated in this study. The lowest diagnosis accuracy (27%) was when identifying a case of left lower lobe pneumonia. On the other hand, the most identified case (60.9%) was COVID-19 pneumonia. In cases of life-threatening conditions, only 13.1% of them have high confidence in their diagnosis of pneumoperitoneum, and 23.8% have high confidence in their diagnosis of pneumothorax. Normal CXR was answered incorrectly by 47.7% of the participants. The performance among recently started interns for some conditions is better than that of recently finished interns. Moreover, there are no significant differences in performance between those who are interested in radiology and those who are not. More than half of the participants advise doing extracurricular courses, practical case-based training in college, and volunteer work in radiology to improve their CXR interpretation skills. Conclusion: The competence of medical interns in interpreting chest X-rays varied across different medical conditions. Only 27.0% of interns correctly identified left lower lobe pneumonia, while 60.9% of them were able to identify COVID-19 pneumonia. Medical interns' competencies have limitations across different medical conditions; therefore, increasing exposure to radiological cases during internships and adequate training in college are recommended.