Year 2021
October 2021


Abstract Title
Designing an Effective eLearning Module on X-ray Discrepancies For Junior Doctors in Emergency Department



MOH Holdings Pte Ltd (MOHH)1, Tan Tock Seng Hospital2

Background & Hypothesis

The emergency department (ED) often starts patient management before radiologists report X-rays. X-ray discrepancies refer to x-ray abnormalities missed in the ED. They are discussed opportunistically during Mortality and Morbidity meetings.  An eLearning module was designed to provide structured, more effective, and flexible learning.  These benefits extend to the inpatient junior doctor, who may be required to interpret X-rays on-call.


The eLearning module was designed in collaboration with the Department of Radiology using an instructional design methodology and applying cognitive load theory.  X-rays chosen were those observed to be i) more challenging, ii) more frequently missed, or iii) associated with significant harm if missed. Incoming junior doctors accessed this module in the first month of their rotation.


25 residents and 26 medical officers completed the module from January to June 2021. 54.9% of the learners were post-graduate year (PGY) 3, 29.4% were PGY 4-5, and 15.7% were PGY >5. All learners agreed the module’s objectives were met and gained new knowledge. 98% felt the module duration was appropriate; 1% thought it was too short. Qualitative feedback included clear, precise, and relevant explanations and illustrations and a good variety of cases. Notably, three doctors stated learning was more enjoyable and memorable based on clinical scenarios coupled with in-depth explanations.

Discussion & Conclusion

The eLearning module is a practical, safe, and enjoyable learning experience, especially during the COVID pandemic. It is a promising tool for further professional development. The effect of the module in reducing missed x-ray discrepancies should be studied.