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Kim, Lee, Kim, Park, Kim, Choi, Koh, Kim, Kim, Nam, Choi, Kim, Lee, Bae, Kim, Kim, Seo, Jeong, and Lee: Effectiveness of Mammography Boot Camp for Radiology Residents
Breast Radiology
Original Article

Journal of the Korean Society of Radiology 2017; 76(1): 30-38.

Published online: 30 December 2016

DOI: https://doi.org/10.3348/jksr.2017.76.1.30

Effectiveness of Mammography Boot Camp for Radiology Residents

Keum Won Kim, MD1, Eun Hye Lee, MD2, Jin You Kim, MD3, Young Mee Park, MD4, Hae Jung Kim, MD5, Eun Jung Choi, MD6, Kyung Hee Koh, MD7, Youme Kim, MD8, Hye-Won Kim, MD9, Sang Yu Nam, MD10, Bobae Choi, MD11, Kyu Sun Kim, MD12, Jin Hwa Lee, MD13, Kyoungkug Bae, MD14, Dae Bong Kim, MD15, Young Joong Kim, MD1, Jae Young Seo, MD1, Sun Hye Jeong, MD2, Moo-Sik Lee, MD16

1Department of Radiology, Konyang University Hospital, Daejeon, Korea.

2Department of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

3Department of Radiology, Pusan National University Hospital, Busan, Korea.

4Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea.

5Department of Radiology, Kyungpook National University College of Medicine, Kyungpook National University Hospital, Daegu, Korea.

6Department of Radiology, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeonju, Korea.

7Department of Radiology, Bundang CHA Hospital, CHA University College of Medicine, Bundang, Korea.

8Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.

9Department of Radiology, Wonkwang University Hospital, Wonkwang University College of Medicine, Iksan, Korea.

10Department of Radiology, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea.

11Department of Radiology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.

12Department of Radiology, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea.

13Department of Radiology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.

14Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

15Department of Radiology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea.

16Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea.

Corresponding author: Eun Hye Lee, MD. Department of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea. Tel. 82-32-621-5851, Fax. 82-32-621-5018, grace@schmc.ac.kr

Received 18 July 2016       Revised 25 August 2016       Accepted 18 October 2016

Copyright © 2017 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate an educational effect of the mammography boot camp (MBC) for radiology residents and analyze affecting factors.

Materials and Methods

Between December 2014 and February 2015, radiology residents in 16 institutions performed the MBC program. We compared the educational effect (score difference between pre- and post-camp test) using 25 case series and analyzed the affecting factors including institution, grades of residents, training periods, presence of sub-specialized breast staff, breast density, and types of cases.

Results

The mean scores of 92 residents were 52.80 ± 18.10 and 72.50 ± 12.91 in the pre- and post-camp test, respectively (p = 0.001). There was no significant difference of educational effect according to institution (19.70 ± 16.31), grade, or training period. Although the educational effect of non-trainees was superior to that of trainees (28.10 ± 17.55 vs. 15.90 ± 14.22; p = 0.001), the scores of trainees were higher than those of non-trainees. The diagnostic accuracy showed more improvement in a fatty breast and cases with microcalcifications than compared with others.

Conclusion

The MBC showed an effective educational result for radiology residents when interpretating a mammography. It was helpful even for non-trainees. The institution, grades training period, and presence of sub-specialized breast staff did not affect the educational effect.

Keywords: Breast, Breast Neoplasm, Education, Mammography

Figures and Tables

Fig. 1

Mean scores of pre- and post- camp test and educational effects according to the institutions. Black bar: mean score of pre-camp test in each institution, Gray bar: mean score of post-camp test in each institution, White bar: educational effect in each institution, Mid dotted line: mean score of pre-camp testn all institutions, Upper dotted line: mean score of post-camp test all institutions, Lower dotted line: mean educational effect in all institutions.

jksr-76-30-g001
Fig. 2

Case No. 23. Invasive ductal carcinoma. Right mediolateral view (A) and right craniocaudal view (B) show a spiculated mass in the posterior portion of the upper inner quadrant. It was the most commonly answered true positive case showing diagnostic accuracy of 78.2% in the pre-camp test and 97.8% in the post-camp test.

jksr-76-30-g002
Fig. 3

Case No. 20. Invasive ductal carcinoma. Both mediolateral oblique (MLO) view shows an extremely dense breast. An asymmetrical spiculated margin is seen in the upper posterior portion of the right MLO view, but it was not included in the craniocaudal view (not shown). It was the most commonly answered false negative case showing diagnostic accuracy of 7.6% in the pre-camp test and 39.1% in the post-camp test.

jksr-76-30-g003
Table 1

Comparison of Scores of Pre- and Post-Camp Tests According to Grades of Residents

jksr-76-30-i001
Grade Pre-Camp Post-Camp p-Value* Educational Effect p-Value†
(Mean ± SD) (Mean ± SD) (Mean ± SD)
1st (n = 29) 41.20 ± 14.62 65.10 ± 15.11 0.000 23.90 ± 16.65 0.259
2nd (n = 32) 56.80 ± 17.32 74.50 ± 10.93 0.000 17.60 ± 17.21
3rd (n = 31) 59.30 ± 17.13 77.40 ± 9.33 0.003 18.10 ± 14.71
Total (n = 92) 52.80 ± 18.10 72.50 ± 12.91 0.000 19.70 ± 16.31

Educational effect = score of post-camp test-score of pre-camp test.

*By paired t-test.

†By one way ANOVA.

Table 2

Comparison of Scores of Pre- and Post-Camp Tests in Trainees and Non-Trainees

jksr-76-30-i002
Training Pre-Camp Post-Camp p-Value* Educational Effect p-Value†
(Mean ± SD) (Mean ± SD) (Mean ± SD)
Trainee (n = 63) 59.30 ± 16.30 75.30 ± 14.75 0.003 15.90 ± 14.22 0.001
Non-trainee (n = 29) 38.10 ± 13.25 66.20 ± 11.88 0.001 28.10 ± 17.55

Educational effect = score of post-camp test-score of pre-camp test.

*By paired t-test.

†By independent t-test.

Table 3

Comparison of Scores of Pre- and Post-Camp Tests According to Training Periods

jksr-76-30-i003
Period Pre-Camp Post-Camp p-Value* Educational Effect p-Value†
(Mean ± SD) (Mean ± SD) (Mean ± SD)
1 month (n = 23) 59.70 ± 16.35 75.50 ± 14.83 0.002 15.80 ± 13.72 0.805
2 months (n = 23) 60.90 ± 16.44 76.50 ± 11.33 0.003 14.60 ± 16.20
≥ 3 months (n = 17) 56.20 ± 14.99 73.90 ± 10.59 0.019 17.65 ± 12.57
Total (n = 63) 59.60 ± 15.94 75.40 ± 12.39 15.90 ± 14.22

Educational effect = score of post-camp test-score of pre-camp test.

*By paired t-test.

†By one way ANOVA.

Table 4

Comparison of Diagnostic Accuracy of Pre- and Post-Camp Tests According to Type of Case Series

jksr-76-30-i004
Type Case No. Results Pre-Camp Post-Camp p-Value* Difference
Mass 3 IDC 41.2 72.8 0.000 21.6
4 IDC 52.1 96.7 0.000
6 IDC 73.9 94.5 0.000
10 IDC 54.3 80.4 0.000
11 IDC 55.4 77.1 0.002
14 IDC 45.6 34.8 0.133
13 IDC 46.7 73.9 0.000
19 IDC 51.1 75.0 0.000
22 IDC 48.9 76.0 0.000
23 IDC 78.2 97.8 0.000
24 IDC, bilateral 61.9 68.4 0.353
Asymm 7 MIC 60.8 92.3 0.000 23.4
12 ILC 56.5 80.4 0.000
15 IDC 59.7 81.5 0.000
17 IDC 65.2 82.6 0.007
20 IDC 7.6 39.1 0.000
21 IDC 62.9 77.2 0.000
Calcifications 1† IDC 33.6 66.3 0.000 27.2
2† IDC 61.9 90.2 0.000
8 IDC 48.9 64.1 0.026
25 DCIS 26.0 58.7 0.000
Benign 5 Hamartoma 50.0 71.7 0.003 −33.0
Negative 9 Negative 77.1 69.5 0.243
16 Negative 50.0 23.9 0.000
18 Negative 71.7 71.7 1.000

*By chi-square test.

†Microcalcifications with mass.

Asymm = asymmetry, Calcifications = microcalcifications with or without mass, Case No. = serial number of case, DCIS = ductal carcinoma in situ, Difference = difference of diagnostic accuracy between pre- and post-camp test, IDC = invasive ductal cancer, ILC = invasive lobular cancer, MIC = microinvasive cancer

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