Purpose or Case Report: Peer review is an essential component of quality improvement in radiology departments. Over the last years, several papers described a shift towards peer learning, emphasizing that feedback in the form of comments and peer learning conferences creates a more productive environment for reviewing and understanding perceptual or interpretive errors of peer radiologists, with improved diagnostic performance as the objective.
At our institution, we instituted a three-month scoreless peer review pilot period. Radiologists’ impressions regarding the current comment-enhanced numerical system and the pilot scoreless, comments-only period were collected through an online survey.
Methods & Materials: The survey containing 17 questions was distributed twice to the radiologists in our group to evaluate and compare their perceptions regarding the numerical scoring and the scoreless peer review systems. A Likert-style rating scale of 1-5 was used for the survey, ranging from strongly disagree (1) to strongly agree (5). The first survey, administered at the inception of our pilot period, was applied towards the numerical scoring system. The second survey, administered at the end of the pilot period, targeted the scoreless peer review system. Responses from both surveys were compared.
Results: 16 out of 20 radiologists in our group responded to both surveys. Overall satisfaction was slightly higher (weighted average of 3.64 versus 3.5) for the scoreless peer review compared to the numerical scoring system. Our colleagues felt more likely to underreport while reviewing a case with the numerical system as compared to the scoreless one. Reported negative emotional impact from discordances was slightly higher with the scoring system. Radiologists felt more inclined to provide a comment for educational purposes when agreeing with the interpretation while using the scoreless system. Comments were felt to be important in both systems.
Conclusions: A scoreless comments-only peer review system shows promise in providing more educational opportunities than a comment-enhanced numerical system, with less negative emotional impact on participant radiologists. This benefit may be even greater in practices in which radiologists are prone to underscore their colleagues.