Implementation of a competency check-off in diagnostic fluoroscopy for radiology trainees: impact on reducing radiation for three common fluoroscopic exams in children

Sweta Shah, Stephane L. Desouches, Lisa H. Lowe, Nima Kasraie, Brenton Reading

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Fluoroscopy is an important tool for diagnosis in the pediatric population, but it carries the risk of radiation exposure. Because radiology resident education and experience in the use of fluoroscopy equipment in children vary, we implemented an intervention to standardize fluoroscopy training. Objective: The purpose of this study is to determine the impact of implementing a fluoroscopy competency check-off for radiology resident trainees aimed at decreasing radiation exposure in three common pediatric fluoroscopic studies. Materials and methods: A fluoroscopy competency check-off form was developed for radiology resident trainees performing pediatric procedures. Techniques used to limit radiation exposure for common pediatric radiologic studies were reviewed as part of the check-off process. Pediatric radiologists supervised each trainee until they demonstrated competence to independently perform three specified procedures. Radiation dose was recorded for the three procedures, upper GI (UGI), voiding cystourethrogram (VCUG) and oropharyngeal (OPM) exams, over 6 months preceding and 6 months following implementation of the competency check-off. The mean cumulative dose for each procedure was compared before and after implementation of competency check-off using a Kruskal-Wallis test. Results: During the 12-month study period doses from 909 fluoroscopic procedures were recorded. In the 6 months preceding competency check-off implementation, procedures were performed by 24 radiology resident trainees including 171 UGI, 176 VCUG and 171 OPM exams. In the 6 months following competency check-off, 23 trainees performed 114 UGI, 145 VCUG and 132 OPM exams. After competency check-off implementation, a statistically significant reduction in average radiation dose was found for all three studies (P < 0.001). Median cumulative doses (mGy) were decreased by 33%, 36% and 13% for UGIs, VCUGs and OPMs, respectively. Conclusion: Implementation of a competency check-off for radiology resident trainees can reduce average radiation doses in pediatric patients undergoing three common fluoroscopic studies.

Original languageEnglish (US)
Pages (from-to)228-234
Number of pages7
JournalPediatric Radiology
Volume45
Issue number2
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Fluoroscopy
Radiology
Radiation
Pediatrics
Mental Competency
Education
Equipment and Supplies
Population
Radiation Exposure

Keywords

  • Children
  • Cumulative dose
  • Fluoroscopy
  • Radiation exposure
  • Radiology resident
  • Training

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

Cite this

Implementation of a competency check-off in diagnostic fluoroscopy for radiology trainees : impact on reducing radiation for three common fluoroscopic exams in children. / Shah, Sweta; Desouches, Stephane L.; Lowe, Lisa H.; Kasraie, Nima; Reading, Brenton.

In: Pediatric Radiology, Vol. 45, No. 2, 01.01.2015, p. 228-234.

Research output: Contribution to journalArticle

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abstract = "Background: Fluoroscopy is an important tool for diagnosis in the pediatric population, but it carries the risk of radiation exposure. Because radiology resident education and experience in the use of fluoroscopy equipment in children vary, we implemented an intervention to standardize fluoroscopy training. Objective: The purpose of this study is to determine the impact of implementing a fluoroscopy competency check-off for radiology resident trainees aimed at decreasing radiation exposure in three common pediatric fluoroscopic studies. Materials and methods: A fluoroscopy competency check-off form was developed for radiology resident trainees performing pediatric procedures. Techniques used to limit radiation exposure for common pediatric radiologic studies were reviewed as part of the check-off process. Pediatric radiologists supervised each trainee until they demonstrated competence to independently perform three specified procedures. Radiation dose was recorded for the three procedures, upper GI (UGI), voiding cystourethrogram (VCUG) and oropharyngeal (OPM) exams, over 6 months preceding and 6 months following implementation of the competency check-off. The mean cumulative dose for each procedure was compared before and after implementation of competency check-off using a Kruskal-Wallis test. Results: During the 12-month study period doses from 909 fluoroscopic procedures were recorded. In the 6 months preceding competency check-off implementation, procedures were performed by 24 radiology resident trainees including 171 UGI, 176 VCUG and 171 OPM exams. In the 6 months following competency check-off, 23 trainees performed 114 UGI, 145 VCUG and 132 OPM exams. After competency check-off implementation, a statistically significant reduction in average radiation dose was found for all three studies (P < 0.001). Median cumulative doses (mGy) were decreased by 33{\%}, 36{\%} and 13{\%} for UGIs, VCUGs and OPMs, respectively. Conclusion: Implementation of a competency check-off for radiology resident trainees can reduce average radiation doses in pediatric patients undergoing three common fluoroscopic studies.",
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