Retention of radiographic anatomy of the chest by 4th-year medical students

Rationale and Objectives. The authors performed this study to assess the ability of medical students to retain their knowledge of radiographic anatomy into the 4th year. Materials and Methods. One hundred ninety-four 4th-year medical students were quizzed on their ability to (a) identify 10 anatomic structures on chest radiographs and (b) search an abnormal radiograph to identify two important findings. Frontal and lateral views were used. The students had learned about radiographic anatomy of the chest and plain radiography search techniques in 1st- and 2nd-year courses and had proved their ability to perform these tasks, during their 2nd year of medical school, by achieving grades of 84% or more (average grade, 90%) on individual oral examinations administered by radiologists. Results. The mean test score was 4.47 out of 12. Only 10 students (5%) were able to identify the main pulmonary artery on the frontal view, and only nine (4%) identified the main bronchi on the lateral view. Of the 194 students, 192 failed to detect a collapsed vertebral body on the lateral view of a patient who had previously undergone a mastectomy. Conclusion. Specific radiologic anatomy facts and search techniques are poorly retained by 4th-year medical students. Preclinical teaching of imaging probably should stress principles rather than specific details.