Resident Case Volume Correlates with Clinical Performance: Finding the Sweet Spot.
RATIONALE AND OBJECTIVES
To determine whether the total number of studies interpreted during radiology residency correlates with clinical performance as measured by objective criteria.


MATERIALS AND METHODS
We performed a retrospective cohort study of three graduating classes of radiology residents from a single residency program between the years 2015-2017. The total number of studies interpreted by each resident during residency was tracked. Clinical performance was determined by tracking an individual resident's major discordance rate. A major discordance was recorded when there was a difference between the preliminary resident interpretation and final attending interpretation that could immediately impact patient care. Accreditation council for graduate medical education milestones at the completion of residency, Diagnostic radiology in-training scores in the third year, and score from the American board of radiology core exam were also tabulated. Pearson correlation coefficients and polynomial regression analysis were used to identify correlations between the total number of interpreted films and clinical, test, and milestone performance.


RESULTS
Thirty-seven residents interpreted a mean of 12,709 studies (range 8898-19,818; standard deviation [SD] 2351.9) in residency with a mean major discordance rate of 1.1% (range 0.34%-2.54%; stand dev 0.49%). There was a nonlinear correlation between total number of interpreted films and performance. As the number of interpreted films increased to approximately 16,000, clinical performance (p = 0.004) and test performance (p = 0.01) improved, but volumes over 16,000 correlated with worse performance.


CONCLUSION
The total number of studies interpreted during radiology training correlates with performance. Residencies should endeavor to find the "sweet spot": the amount of work that maximizes clinical exposure and knowledge without overburdening trainees.
['Agarwal|Vikas|V|', 'Bump|Gregory M|GM|', 'Heller|Matthew T|MT|', 'Chen|Ling-Wan|LW|', 'Branstetter|Barton F|BF|', 'Amesur|Nikhil B|NB|', 'Hughes|Marion A|MA|']
D002983:Clinical Competence D005260:Female D006801:Humans D007396:Internship and Residency D008297:Male D015588:Observer Variation D011859:Radiography D011871:Radiology D012189:Retrospective Studies D014481:United States
Milestones Error rate Radiology residency performance Residency performance