Training Novices to Detect Glass in Wounds

A new study examines whether medical students can be easily trained to accurately detect tiny glass foreign bodies (GFBs) using low-power portable fluoroscopy.

Researchers at the Northwestern University Feinberg School of Medicine (Chicago, IL, USA) taught 21 medical students with no prior experience to use fluoroscopy to detect 1-mm GFBs in chicken legs by training over three separate days, or by training on one day. Skills were reassessed at three months. The number of mean correct responses was compared between the two groups.

The results of the study suggested that asymptotic accuracy was achieved after 15-30 training specimens. The final accuracy was similar between protocols, and was comparable to prior accuracy reports of plain film radiography. The results were maintained in both protocols at the three-month follow-up. The study was published in the June 1, 2007, issue of Emergency Medicine Journal.

"Novices can easily be taught to detect GFBs using fluoroscopy, with accuracy comparable to that achieved by radiologists using plain films,” concluded Matthew R Levine, M.D., and colleagues of the department of emergency medicine. "Further studies are needed to assess doctors' use of the technique in real patients.”

Fluoroscopy is commonly used to obtain real-time images of the internal structures of patients. In its simplest form, a fluoroscope consists of an x-ray source and fluorescent screen between which a patient is placed; modern fluoroscopes couple the screen to an x-ray image intensifier and a video camera allowing the images to be played and recorded on a monitor.


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Northwestern University Feinberg School of Medicine