Transitioning from peer reviews to peer learning: Benefits, challenges and implementation

As many radiology practices transition from peer reviews to peer learning, it is important to consider the benefits and challenges that accompany a program’s execution 

Errors in radiology are inevitable, but they do call for special attention as they can lead to medical malpractice suits. Typically, diagnostic errors are accounted for in peer reviews, which measure a provider’s competency based on a numerical score. However, many practices have begun transitioning away from traditional peer review approaches and opting for peer learning instead. 

In contrast to standard physician peer reviews, the authors of a new study published in Clinical Imaging suggest that peer learning offers more educational opportunities and fosters a less punitive, more supportive environment. The authors focused their research on peer learning in a breast imaging setting, since delays in breast cancer diagnosis are the most common culprit of medical malpractice suits in the U.S. 

“Due to the common association of breast imaging errors in medical malpractice cases and concerns about being sued for malpractice by radiologists who perform breast imaging, peer learning can be helpful in creating a safe environment to discuss and reduce error and create avenues to increase safety and quality in practice,” corresponding author Kanchan Phalak, with the department of radiology at the University of Texas MD Anderson Cancer Center, and co-authors explained.

Multiple studies have received favorable feedback from radiologists who have participated in peer learning programs, the authors wrote. These programs include case submissions from errors, as well as “good calls" to place the focus on educational opportunities and improvement in groups, rather than placing blame. Previous studies have found that these submissions increased after implementation of peer learning programs, citing that physicians are more comfortable with pointing out errors when they know their peers will not be judged for them. 

Implementation of such programs varies based on practice preferences and size, but the authors found that a common theme among organizations that adhere to peer learning is the designation of a “peer learning leader.” This individual has protected time allocation to put toward finding cases, reviewing medical literature, consulting with experts, providing feedback and leading conferences. When selected by their peers, this individual also promotes staff engagement and supports program participation. 

Of course, the authors explain, there are challenges to executing peer learning programs. Deciding how to submit cases—randomly or via peer selection—can be difficult, and the experts acknowledge that there may be a level of discomfort among colleagues when choosing cases. Additionally, randomly selected cases could vary in their educational value. 

Despite any challenges, the authors imply that peer learning programs could still be especially beneficial in a breast imaging setting, where radiologists often feel the added pressure of errors leading to lawsuits. 

“Although there have been challenges to implementation, there has been success through the peer learning process with learning, practice improvement, and cultivation of interpersonal relationships in a non-punitive environment when compared to peer review,” the experts said. 

You can view the full article in Clinical Imaging

More on peer learning programs and mentorship:

Peer learning program receives positive feedback from community radiologists

Radiology research publications see marked increase thanks to resident-managed peer mentor program

Most radiologists have moved toward peer learning, but many want more standardization

4 guidelines for transitioning from peer review to peer learning

Hannah murhphy headshot

In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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