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J Accid Emerg Med. 1997 Sep;14(5):295-8.

Interpretation of trauma radiographs by junior doctors in accident and emergency departments: a cause for concern?

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1
Royal Devon and Exeter (Wonford) Hospital, Exeter, UK.

Abstract

OBJECTIVES:

To investigate how well junior doctors in accident and emergency (A&E) were able to diagnose significant x ray abnormalities after trauma and to compare their results with those of more senior doctors.

METHODS:

49 junior doctors (senior house officers) in A&E were tested with an x ray quiz in a standard way. Their results were compared with 34 consultants and senior registrars in A&E and radiology, who were tested in the same way. The quiz included 30 x rays (including 10 normal films) that had been taken after trauma. The abnormal films all had clinically significant, if sometimes uncommon, diagnoses. The results were compared and analysed statistically.

RESULTS:

The mean score for the abnormal x rays for all the junior doctors was only 32% correct. The 10 junior doctors were more experience scored significantly better (P < 0.001) but their mean score was only 48%. The mean score of the senior doctors was 80%, which was significantly higher than the juniors (P < 0.0001).

CONCLUSIONS:

The majority of junior doctors misdiagnosed significant trauma abnormalities on x ray. Senior doctors scored well, but were not infallible. This suggests that junior doctors are not safe to work on their own in A&E departments. There are implications for training, supervision, and staffing in A&E departments, as well as a need for fail-safe mechanisms to ensure adequate patient care and to improve risk management.

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PMID:
9315930
PMCID:
PMC1343093
[Indexed for MEDLINE]
Free PMC Article
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