Support for external validity of radiological anatomy tests using volumetric images

Cécile J. Ravesloot, Anouk van der Gijp, Marieke F. van der Schaaf, Josephine C.B.M. Huige, Koen L. Vincken, Christian P. Mol, Ronald L.A.W. Bleys, Olle T. ten Cate, Jan P.J. van Schaik

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)


RATIONALE AND OBJECTIVES: Radiology practice has become increasingly based on volumetric images (VIs), but tests in medical education still mainly involve two-dimensional (2D) images. We created a novel, digital, VI test and hypothesized that scores on this test would better reflect radiological anatomy skills than scores on a traditional 2D image test. To evaluate external validity we correlated VI and 2D image test scores with anatomy cadaver-based test scores.

MATERIALS AND METHODS: In 2012, 246 medical students completed one of two comparable versions (A and B) of a digital radiology test, each containing 20 2D image and 20 VI questions. Thirty-three of these participants also took a human cadaver anatomy test. Mean scores and reliabilities of the 2D image and VI subtests were compared and correlated with human cadaver anatomy test scores. Participants received a questionnaire about perceived representativeness and difficulty of the radiology test.

RESULTS: Human cadaver test scores were not correlated with 2D image scores, but significantly correlated with VI scores (r = 0.44, P < .05). Cronbach's α reliability was 0.49 (A) and 0.65 (B) for the 2D image subtests and 0.65 (A) and 0.71 (B) for VI subtests. Mean VI scores (74.4%, standard deviation 2.9) were significantly lower than 2D image scores (83.8%, standard deviation 2.4) in version A (P < .001). VI questions were considered more representative of clinical practice and education than 2D image questions and less difficult (both P < .001).

CONCLUSIONS: VI tests show higher reliability, a significant correlation with human cadaver test scores, and are considered more representative for clinical practice than tests with 2D images.

Original languageEnglish
Pages (from-to)640-645
JournalAcademic Radiology
Issue number5
Publication statusPublished - 2015
Externally publishedYes


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