Innovative assesment strategies: image based key feature questions for radiology postgraduate trainees

Background: Innovative assessment strategies are essential for determining clinical understanding in the evolving field of health profession education. Key feature questions (KFQs) have been developed as assessment tools to assess the clinical understanding of students. The purpose of this study is to determine the effectiveness of image-based key feature questions (IBKFQs) compared with traditional multiple-choice questions (MCQs) in radiology examinations. Additionally, this study aims to determine the correlation between test scores obtained in both test formats. Method: This quasi experimental, correlation study was conducted from September to December 2021 at a public medical university in Karachi, Pakistan. Thirty radiology residents from various training years participated in the study. Each resident completed a comprehensive written assessment comprising 50 MCQs and 50 IB-KFQs as part of their internal evaluation at the end of a module. Results: Out of thirty residents, 28 (93.3%) were females. The reliability score and Cronbach’s alpha were 0.944 for the MCQs and 0.881 for the IB-KFQs. Spearman's correlation coefficient revealed a positive correlation between the MCQ and IB-KFQ scores (rho = 0.823, p < 0.001). The mean scores were similar for the IB-KFQs (29.24 ± 6.31) and MCQs (28.93 ± 11.41). Conclusion: The findings of this study indicate that incorporating IB-KFQs alongside MCQs in written assessments of radiology residents is feasible. IB-KFQs offer a focused evaluation of critical skills such as film analysis, interpretation, and report writing. By complementing traditional MCQs, IB-KFQs enhance the assessment process.