Missed Case Feedback and Quality Assurance Conferences in Radiology Resident Education: A Survey of United States Radiology Program Directors

Abstract

Diagnostic Radiology (DR) residents typically generate preliminary reports for imaging examinations, but few publications discuss feedback regarding missed or misinterpreted findings. Our goal was to determine the practices of United States DR residencies with respect to missed case feedback, including the role of Quality Assurance (QA) conferences. A 23-item survey containing multiple-choice questions and several free text fields was created and hosted on SurveyMonkeyR. An invitation to complete the survey was sent via email to all DR Program Directors (PDs) or representatives. Responses were tabulated and analyzed using SurveyMonkeyR analytic tools and Microsoft Excel. 188 PDs or representatives were emailed, resulting in 45 survey responses. Common types of missed case feedback included resident QA case conferences (81%), resident self review of cases (72%), discussion during readout at the end of shift (70%), and faculty-resident meetings (67%). A minority of programs reported using automated methods of resident feedback, such as PACS integration or automated emails. Most resident QA conferences were held monthly (64%). Typical formats of conferences included informal discussion (43%), formal presentation (30%), or case conferences (30%). The majority (78%) of respondents rated resident missed case feedback mechanisms at their institution as at least "good". DR residencies use a variety of mechanisms to provide feedback to residents regarding missed or misinterpreted cases, including QA conferences. Although several possibilities for improvement in feedback mechanisms were highlighted by survey responses, most respondents had a favorable view of their program's feedback processes.