"3 + X D" structured report in radiology standardized resident training: Can it meet high-level teaching objectives?

Purpose: To evaluate the impact of the innovative "3 + X D" structured report (SR) designed based on Bloom's taxonomy on the learning outcomes of radiology residents during standardized training.

Methods: This is a prospective study that recruited 120 radiology residents from our hospital between 2020 and 2022. Randomly selected 60 residents from the 2020 grade to constituted the control group, and randomly selected 60 residents from the 2021 grade to formed the experimental group. The former group was trained utilizing the Free-text Reports (FTR) template, while the latter group received training with the "3 + X D" structured reports (SR) template. The learning outcomes of both groups was evaluated utilizing both objective and subjective measures. Objective assessments encompassed examinations of theoretical knowledge, diagnostic skills, and total scores, aligning with the cognitive domains of remembering, understanding, applying, and analyzing as outlined by Bloom's Taxonomy. Subjective assessments, on the other hand, comprised survey questionnaires administered to residents and feedback from clinical instructors, which correlated with the higher-order cognitive level of analyzing, evaluating, and creating within Bloom's Taxonomy.

Results: On 60 residents (mean age, 24.15 years ± 2.11[SD]; 25 male) from control group, and 60 residents (mean age, 24.58 years ± 1.88 [SD]; 27 male) from experimental group. Following the training, significant improvements were observed in the theoretical knowledge, diagnostic skills, and total scores for both groups (p < 0.001). Furthermore, the experimental group demonstrated significantly higher diagnostic skills and total scores compared to the control group (p < 0.001). However, no significant difference was observed in the theoretical knowledge exam between the two groups (p = 0.236). The questionnaire used for subjective assessments had good reliability (Cronbach α was 0.826) and acceptable validity (The KMO was 0.692). Additionally, the survey questionnaires indicated that the experimental group rated higher than the control group in terms of cultivating imaging thinking ability, diagnostic confidence, diagnostic speed, and the convenience of the templates (p < 0.001). Clinicians' feedback scores for the experimental group markedly surpassed those for the control group (p < 0.05).

Conclusions: Utilizing the "3 + X D" SR template grounded in Bloom's taxonomy for training, the professional competency of radiology residents, particularly their diagnostic skills, saw a marked enhancement, successfully meeting the higher-level educational objectives. Consequently, the "3 + X D" SR template is highly recommended for the standardized training of radiology residents.