Providing comparison normal examples alongside pathologic thoracic radiographic cases can improve veterinary students’ ability to identify abnormal findings or diagnose disease

Sally L. Sukut, Marcel D'Eon, Joshua Lawson, Monique N. Mayer

Background: This study investigated the effect of providing comparison normal examples alongside pathologic thoracic radiographic cases on veterinary students’ ability to identify abnormal findings or diagnose disease.

Study: The study was a randomized, prospective, parallel-group study that involved 113 second- and third-year veterinary students from the Western College of Veterinary Medicine, University of Saskatchewan. The students were assigned to either a control group that received only cases or an intervention group that received cases with side-by-side comparison normal images. The students had to answer multiple-choice questions based on 12 thoracic radiographic cases, 10 of which had common pathologies and 2 of which were normal.

Methods: The correctness of the students’ responses was tracked using a learning platform called Top Hat. The data were analyzed using Mann–Whitney U test and Cohen’s D to compare the scores between the groups and the years. The sample size was limited by the class size and the estimated detectable effect was calculated for non-significant effects.

Results: The results showed that the intervention group had a significantly higher percentage of correct answers than the control group (52% vs. 45%, P = 0.01), indicating that comparison learning was helpful in identifying disease. This effect was more pronounced for the pathologic cases than for the normal cases. There was no significant difference between the second- and third-year students in their performance, suggesting that they were still at a novice level of skill acquisition in radiology interpretation.

Limitations: The limitations of the study included the two-step process of perception and cognition that may have added difficulty to the assignment, the possible inherent comparison learning that the control group may have had by scrolling through the cases, the lack of image manipulation tools such as zoom, pan, or window/level, the uncontrolled environment that may have influenced the students’ time and effort, and the small sample size that may have reduced the power to detect small differences.

Conclusions: The study concluded that providing normal comparison images alongside thoracic radiographic cases improved the students’ ability to correctly identify the abnormal findings or diagnose select diseases involving the thorax21. The study also highlighted the students’ struggle with the interpretation of common pathologies, likely due to their lack of exposure to a multitude of cases and normal variants. The study suggested that comparison learning may be an effective teaching strategy for veterinary radiology, especially in the early stages of training.