_{Published October 20, 2022}

Since its introduction nearly 20 years ago, score-based peer review has not been shown to have a meaningful impact on or be an accurate measurement of radiologist performance [1]. A new paradigm—peer learning—has emerged, which is a group activity where practicing professionals review each other’s work, actively give and receive feedback in a constructive manner, teach and learn from one another, and mutually commit to improving performance as individuals and as a group. As my colleague, coauthor, and present chair of ARRS’ Professional & Performance Improvement Committee, Nadja Kadom, MD, first noted here in the pages of InPractice back in 2019, peer learning is “a system that uses accuracy of interpretation as a surrogate marker for competency” [2].

Many radiology practices are beginning to transition from score-based peer review to peer learning, but these same practices face distinct challenges and multiple barriers to implementation, especially considering the variety of leadership styles Dr. Kadom has recently detailed [3]. Case in point: nearly half of the 742 members of ARRS who participated in our 2020 AJR Original Research article, “Current Status and Future Wish List of Peer Review: A National Questionnaire of U.S. Radiologists,” reported insufficient learning outcomes from peer review [4]. Clarifying a minimum number of cases that required monthly review, as well as how interpretive discrepancies would be communicated, were two big factors where some level of standardization was clearly needed.

Perhaps most importantly, the demographics of our survey respondents reflected the current composition of this country’s imaging workforce. A total 742 (4.2% response rate) ARRS members replied to our 21-question, multiple-choice questionnaire. Among those respondents, 547 (73.7%) were board-certified, practicing radiologists also participating in a form of peer review. As you can see, most responders were in private practice (51.7%, 283/547), while the next largest cohort was in academic practice (32.4%). The most common practice size was 11–50 radiologists (50.5%), followed by groups of up to 10 radiologists (21.2%). The majority of responders practiced in urban settings (61.6%), too.

Practice Characteristic	No. (%)
Type
Private	283 (51.7)
Academica	177 (32.4)
Hybridb	45 (8.2)
Government	42 (7.7)
No. of radiologists
0–10	116 (21.2)
11–50	276 (50.5)
51–100	85 (15.5)
>100	70 (12.8)
Setting
Urban	337 (61.6)
Suburban	158 (28.9)
Rural	52 (9.5)

Nonetheless, in this largest nationwide questionnaire to imaging professionals regarding the present state of and their future needs for peer review, most radiologists working in the United States felt a better system is not only necessary, but that said system could even be feasible in daily practice.

To our knowledge, “Updates for Your Peer Learning Activities: Pitfalls, Tips, and Accreditations” remains the only course of its kind. Presented live as a Featured Sunday Session during the 2023 ARRS Annual Meeting in Honolulu, HI, this course is now in its second revised and expanded iteration, packed with practical tips to clinical success, all taught by experts in the field. Summarizing the current status and practice gap in peer review in radiology, sessions will include three didactic lectures to showcase the best practices and challenges of peer learning programs at multiple institutions, including Emory, NYU, Stanford and Mayo Clinic. Esteemed faculty will highlight potential barriers to starting and sustaining peer learning activities in both academic and private practice settings, each instructor sharing their own “top 5 tips” for overcome these challenges. We will also address the latest updates from the American College of Radiology’s Quality and Safety Commission regarding new accreditation pathways for peer learning [5].

The evolution of peer learning is of universal importance for the continuing education of all radiologists—in practice, during fellowship or residency. However, the intersecting concepts of peer learning, just culture, etc. are evolving at a breakneck pace, with brand-new accreditation pathways opening up and multiple acceptable approaches to finding the “right answer” [6]. For imaging professionals already involved in peer learning, come share your experience with our expert panel, ensuring you are getting the most out of your program. For those new to peer learning, come learn how to fish for the pearls, avoid the pitfalls, and hit the ground running. We will conclude with an interactive panel discussion with the audience—there in Hawaii, virtually, or on demand.

References

1. Larson DB et al. Transitioning from peer review to peer learning: report of the 2020 Peer Learning Summit. J Am Coll Radiol 2020; 17:1499–1508
2. Kadom N, Lee C. Moving from Peer Review to Peer Learning. ARRS InPractice website. ARRSInPractice.org/moving-from-peer-review-to-peer-learning. Published Fall 2019. Accessed October 3, 2022
3. Kadom N. Anything Goes—Is It True for Leadership Styles? RadTeams.org/2022/09/26/leadership-styles-radiology-teams. Published September Accessed September 10, 2022
4. Lee CS. Current status and future wish list of peer review: a national questionnaire of U.S. radiologists. AJR 2020; 214:493–497
5. ACR Commission on Quality and Safety. ACR website. www.acr.org/Member-Resources/Commissions-Committees/Quality-Safety. Updated August 29, 2022. Accessed October 3, 2022
6. Woodcock R. How to Do Peer Review in Radiology. Diagnostic Imaging website. www.diagnosticimaging.com/view/how-do-peer-review-radiology. Published February 4, 2014. Accessed October 3, 2022