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2351 Multicentre randomised controlled trial to assess the impact of online training on CT head interpretation performance: the simulation training for emergency department imaging 2 (STEDI2) trial
  1. Alex Novak1,
  2. Sarim Ather2,
  3. Jose Martinez1,
  4. Tanya Baron2,
  5. Simon Triscott3,
  6. Matthew Davies2,
  7. Divyansh Gulati4,
  8. Ravi Shashikala5,
  9. Sarah Wilson6,
  10. Liza Keating3
  1. 1Emergency Medicine Research Oxford (EMROx), Oxford University Hospitals NHS Foundation Trust, Oxford
  2. 2Oxford University Hospitals NHS Foundation Trust
  3. 3Royal Berkshire NHS Foundation Trust
  4. 4Milton Keynes University Hospital Trust
  5. 5Buckinghamshire Healthcare NHS Trust
  6. 6Frimley Health NHS Foundation Trust


Aims and Objectives CT Head scans are commonly requested in the Emergency Department (ED), but the increasing demand has led to longer radiology report turnaround times, affecting ED flow. This study aims to assess the accuracy of ED clinicians in interpreting CT head images, evaluate the impact of an online training simulation, and estimate the effects of clinician-led interpretation on patient flow.

Method and Design Methods A multicentre randomized controlled trial was conducted across six hospitals in the Thames Valley Emergency Medicine Research Network. Emergency medicine clinicians of various grades and backgrounds participated. In the online phase, participants completed a blinded baseline assessment of accuracy by interpreting 50 CT Head scans. Non-control participants received online training and practiced with 50 cases. They then retook the assessment to measure changes in reporting accuracy and confidence. Follow-up assessments were conducted at 3 and 6 months to assess knowledge retention. Training and assessment were conducted through the online platform In the prospective phase, participants interpreted 30 CT head scans during their clinical practice, and their findings and interpretation times were compared to radiology reports.

Registration ID NCT05427838

Results and Conclusion Results

A total of 206 participants took part in the study. The online phase showed a significant increase in pooled sensitivity (73.3% to 83%) and specificity (65.8% to 89.1%) in detecting acute abnormalities. Similar improvements were observed across all pathology subgroups. At six months post training, overall diagnostic performance remained elevated (sensitivity 80.6%, specificity 79.1%). In the prospective phase, 4,815 CT Head interpretations with linked radiology reports were recorded, and data analysis is ongoing.

Discussion and Conclusion Dedicated training significantly improved the interpretation accuracy of ED clinicians. Web-based self-directed simulation-based learning platforms can effectively deliver training, particularly in departments with high staff turnover. Further analysis of prospective results will assess accuracy and impact in a live ED setting.

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