E-learning for chest x-ray interpretation improves medical student skills and confidence levels

BMC Med Educ. 2018 Nov 12;18(1):256. doi: 10.1186/s12909-018-1364-2.


Background: Radiology is an important aspect of medicine to which medical students often do not receive sufficient exposure. The aim of this project was to determine whether the integration of an innovative e-learning module on chest x-ray interpretation of the heart would enhance the radiological interpretive skills, and improve the confidence, of first year graduate entry medical students.

Methods: All first-year graduate entry (all students had a prior university degree) medical students at the University of Limerick (n = 152) during academic year 2015-16 were invited to participate in this study. An assessment instrument was developed which consisted of 5 radiological cases to be interpreted over a designated and supervised 15-min time period. Students underwent a pre-, mid- and post-intervention assessment of their radiology interpretative skills. An online e-module was provided following the pre-test and additional practice cases were provided following the mid-intervention test. Assessment scores and confidence levels were compared pre-, mid- and post-intervention.

Results: The overall performance (out of a total score of 25) for the 87 students who completed all three assessments increased from 13.2 (SD 3.36) pre-intervention to 14.3 (SD 2.97) mid-intervention to 15.8 (SD 3.40) post-intervention. This change over time was statistically significant (p < 0.001) with a medium effect size (eta-squared = 0.35). Increases from pre- to post-intervention were observed in each of the five areas assessed, although performance remained poor in diagnosis post-intervention. Of the 118 students who provided feedback after the intervention, 102 (86.4%) stated that they would recommend the resource to a colleague to improve their interpretative skills.

Conclusions: This study suggests that early exposure to e-learning radiology modules is beneficial in undergraduate medical school curricula. Further studies are encouraged to assess how long the improvement may last before attrition.

Keywords: Chest X-ray; E-learning; Medical curriculum; Medical students; Modules; Online resource; Radiology; Undergraduate curriculum; X-ray interpretation.

MeSH terms

  • Adult
  • Clinical Competence / standards
  • Clinical Competence / statistics & numerical data*
  • Education, Medical, Undergraduate*
  • Educational Measurement
  • Female
  • Humans
  • Male
  • Observer Variation
  • Predictive Value of Tests
  • Program Evaluation
  • Radiographic Image Enhancement / standards*
  • Radiographic Image Interpretation, Computer-Assisted / standards
  • Radiographic Image Interpretation, Computer-Assisted / statistics & numerical data*
  • Radiography, Thoracic*
  • Radiology / education*
  • Reproducibility of Results
  • Students, Medical
  • Young Adult