E-learn Computed Tomographic Angiography: A Proposed Educational Tool for Computed Tomographic Angiography in Acute Stroke

• Published in: Journal of stroke and cerebrovascular diseases Vol. 21; no. 8; pp. 684 - 688
• Main Authors: Havsteen, Inger, MD, Christensen, Anders, MD, PhD, Nielsen, Jens K., MD, Christensen, Louisa, MD, Krieger, Derk W., MD, PhD, Christensen, Hanne, MD, PhD, DM Sci
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2012
• Subjects: Cardiovascular; Cerebral Hemorrhage - diagnostic imaging; Clinical Competence; Computed tomographic angiography; Computer-Assisted Instruction; e-learning; Education, Medical, Continuing - methods; Education, Medical, Graduate - methods; Emergency Service, Hospital; Humans; Internship and Residency; Neurology; Observer Variation; Predictive Value of Tests; Referral and Consultation; Reproducibility of Results; spot sign; Stroke - diagnostic imaging; Tomography, X-Ray Computed; vascular occlusion; vascular occlusion; e-learning; spot sign; Computed tomographic angiography
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2011.03.001

Background Computed tomographic angiography (CTA) is widely available in emergency rooms to assess acute stroke patients. To standardize readings and educate new readers, we developed a 3-step e-learning tool based on the test-teach-retest methodology in 2 acute stroke scenarios: vascular occlusion and “spot sign” in acute intracerebral hemorrhage. We hypothesized that an e-learning program enhances reading skills in physicians of varying experience. Methods We developed an HTML-based program with a teaching segment and 2 matching test segments. Tests were taken before and after the teaching segment; the test size was 40% of the teaching segment size. We assessed diagnostic accuracy and readers’ confidence. Results were compared using the Wilcoxon rank sum test. Results Four neurologic consultants and four radiologic residents completed the program. The vascular occlusion teaching segment increased diagnostic accuracy from 42% to 68% ( P = .005). The neurologic consultants showed significant progress, with average scores of 50% versus 75% ( P = .027). The radiologic residents showed trend with progress, with average scores of 33% versus 60% ( P = .081). The entire group detected spot sign correctly 69% before versus 92% after teaching ( P = .009) and reported a median self-perceived diagnostic certainty of 50% versus 75% ( P = .030). Self-perceived diagnostic certainty revealed no significant increase for vascular occlusion. Conclusions The e-learning program is a useful educational tool for users of varying experience, and it enhances diagnostic confidence.