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Knowledge of family medicine residents regarding the interpretation of chest X-rays in Jeddah, Saudi Arabia

Ahmed M Sheikh.

Background: Despite the widespread use of chest X-ray and the absence of radiologists in primary healthcare centers in Saudi Arabia, studies have shown that the competence of in-training residents in the interpretation of chest X-rays is poor. Misinterpretation of chest X-rays adversely affects the diagnosis and management plan of physicians, making competence in this skill even more crucial. Despite it being a required skill to attain by the Saudi Council for Health Specialties in most residency programs, no such evaluative study has been carried out on Saudi medical physicians.

Objectives: The objective of this study is to assess the knowledge of residents in the Saudi Family Medicine Program in Jeddah with regard to their interpretation of X-rays of common chest conditions within the context of their training and experience, to contribute to the enhancement of their radiological skills and consequently improve their radiological diagnosis of common chest conditions.

Materials and Methods: A cross-sectional study was conducted on 74 of 88 registered residents – across the four levels – training in the Family Medicine program in Jeddah at the time of the study. Ten standardized chest X-ray images were presented. For each image, residents filled a multiple-choice form consisting of two parts; pathological radiographic findings and diagnosis.

Results: The residents correctly established 38.1% of the radiographic findings and 47.7% of the diagnosis. The overall performance of the residents in consideration with their training level, completion of in-training radiology rotation, attendance of extracurricular radiological courses, or prior work experience in the field was statistically insignificant–be it in identifying the findings or selecting a possible diagnosis for each image.

Conclusion: Based on the results of this study, we conclude that the radiological skills of the family medicine residents–in Jeddah–do not meet the curricular requirements of the training program in identifying pathological findings in chest X-rays nor in correlating them to chest conditions to reach a possible diagnosis. Moreover, the residents’ ability to correctly diagnose chest radiographs decline further by their final training year (R4). It is recommended that family medicine residents be exposed to a wider range of chest X-rays during their rotation in the radiology department and to improve the quality of their rotation. Training activities on chest X-ray interpretation should also be introduced throughout the residency program.

Key words: Chest X-ray Interpretation; Primary Healthcare; In-Training Residents; Family Physicians

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