Purpose or Case Report: Resident trainees in East Africa are challenged in learning pediatric radiology due to limited access to subspecialty knowledge and mentorship. The ubiquitous use of smartphones provides the opportunity to use free instant messaging apps to deliver medical education. To test this approach, we delivered case-based modules via WhatsApp to residents to assess knowledge of pediatric radiology and elicited their feedback for evaluation.
Methods & Materials: After IRB approval, 72 radiology residents from multiple programs in East Africa were recruited and provided informed consent. Through WhatsApp, 40 participants completed the pre-study survey, a 3-month course, and a post-study survey. The course consisted of weekly case-based imaging questions sent as PDFs in a WhatsApp group chat. Participants were encouraged to use available resources to analyze the case, present questions, and report their answer confidence level directly to the facilitator. Participants then received the answer and case explanation. The surveys assessed experience level and comfort with pediatric imaging studies and elicited free response feedback. Descriptive statistics were used to summarize the data. Categorical variables captured by the pre-course and post-course surveys were compared using McNamar’s chi-squared tests (significance level: two-sided alpha of 0.05).
Results: A statistically significant difference in comfort level reading pediatric imaging studies pre and post intervention (p = 0.027) is noted. 55% of participants reported “little comfort” before the coursework and “mostly comfortable” after. The average “usefulness” rating was 3.8/4 (1 not useful, 4 very useful). The average “convenience” rating was 3.4/4 (1 inconvenient, 4 very convenient). Participants found the modules “moderately difficult” with a rating of 2.2/4 (1 not difficult, 4 very difficult). 18 requested more cases and 19 reported a lack of pediatric radiology exposure as a learning barrier.
Conclusions: Findings support the premise that resident trainees do not receive the necessary exposure and training to interpret pediatric studies. Pediatric radiology coursework disseminated through WhatsApp is a well-received and useful way to increase comfort level with reading pediatric studies in areas with poor access to radiology subspecialty training. Effectiveness is limited by the quantity and frequency of information delivery and the availability of mentors. Future iterations should therefore include as many mentors and participants as possible.