Table 2.
Participants Reactions to Test Set Difficulty and Continuing Medical Education in General According to Perceived Agreement with Reference Diagnosis (Performance Gap) - All Diagnostic Groups Combined (Benign, Atypia, Ductal Carcinoma In Situ, Invasive) (n=92)
| Participant Characteristics | Performance Gap * | p-value† | |||
|---|---|---|---|---|---|
| Total n (col %) | Under Estimated Performance n (row %) | Closely Estimated Performance n (row %) | Over Estimated Performance n (row %) | ||
| Perceptions of Test Set Difficulty (pre-program only unless otherwise noted) | |||||
| Within the entire spectrum of breast pathology you see in your practice, how similar were the types of cases included in the sample sets? | |||||
| I never see cases like these | 0 (0.0) | 0 (.) | 0 (.) | 0 (.) | 0.047 |
| I sometimes see cases like these | 21 (23.6) | 4 (19.0) | 14 (66.7) | 3 (14.3) | |
| I often see cases like these | 46 (51.7) | 5 (10.9) | 38 (82.6) | 3 (6.5) | |
| I always see cases like these | 22 (24.7) | 4 (18.2) | 11 (50.0) | 7 (31.8) | |
| Relative to breast cases you review in practice over the course of a year, did you find these sample sets: | |||||
| Less Challenging | 2 (2.2) | 0 (0.0) | 2 (100.0) | 0 (0.0) | 0.38 |
| Equally Challenging | 60 (67.4) | 9 (15.0) | 43 (71.7) | 8 (13.3) | |
| More Challenging | 27 (30.3) | 4 (14.8) | 18 (66.7) | 5 (18.5) | |
| Continuing Medical Education Experiences | |||||
| How many hours of continuing medical education in breast pathology interpretation (not including this program) did you complete last year: | |||||
| None | 16 (17.6) | 3 (18.8) | 10 (62.5) | 3 (18.8) | 0.20 |
| 1 – 5 hours | 35 (38.5) | 6 (17.1) | 24 (68.6) | 5 (14.3) | |
| 6 – 8 hours | 14 (15.4) | 1 (7.1) | 13 (92.9) | 0 (0.0) | |
| 9 – 12 hours | 6 (6.6) | 2 (33.3) | 2 (33.3) | 2 (33.3) | |
| 13 – 18 hours | 6 (6.6) | 1 (16.7) | 4 (66.7) | 1 (16.7) | |
| >18 hours | 14 (15.4) | 1 (7.1) | 10 (71.4) | 3 (21.4) | |
| Which of the following types of continuing medical education do you most prefer: | |||||
| Instructor-led Programs | 60 (65.9) | 8 (13.3) | 44 (73.3) | 8 (13.3) | 0.55 |
| Self-Directed Programs | 24 (26.4) | 6 (25.0) | 15 (62.5) | 3 (12.5) | |
| Other | 7 (7.7) | 0 (0.0) | 4 (57.1) | 3 (42.9) | |
| Alignment of Perceptions | |||||
| If you and the continuing medical education breast pathology experts disagree on some cases, do you think it would be more likely that you would: | |||||
| Over interpret the case | 25 (27.5) | 5 (20.0) | 19 (76.0) | 1 (4.0) | 0.72 |
| Under interpret the case | 16 (17.6) | 3 (18.8) | 12 (75.0) | 1 (6.3) | |
| Unsure/Don’t Know | 50 (54.9) | 6 (12.0) | 32 (64.0) | 12 (24.0) | |
| When you and the breast pathology experts disagreed on a case the experts called atypia was it more likely that you: (post-program only) | |||||
| Over interpreted the case (call it more serious than experts) | 32 (34.8) | 4 (12.5) | 23 (71.9) | 5 (15.6) | 0.91 |
| Under interpret the case (call it less serious than experts) | 41 (44.6) | 6 (14.6) | 28 (68.3) | 7 (17.1) | |
| No trend for either over or under interpretation | 19 (20.7) | 4 (21.1) | 13 (68.4) | 2 (10.5) | |
| Did you learn new information and strategies that you can apply to your work or practice? (post-program only) | |||||
| No | 18 (20.2) | 5 (27.8) | 12 (66.7) | 1 (5.6) | 0.75 |
| Yes | 71 (79.8) | 8 (11.3) | 50 (70.4) | 13 (18.3) | |
note: low cutoff point is mean − 1 standard deviation (12.0) is −7.0 and high cutoff point is mean + 1 standard deviation is 18.0 where mean is 6.0 and standard deviation is 12.0
*
Performance Gap is the difference between actual agreement and the weighted average perceived agreement for four diagnostic classes (mapping 1) of breast cancer
†
p-value for cumulative logit model adjusted for actual agreement