Application of an adapted hierarchical and progressive training model in enhancing self-perceived competence of nuclear medicine residents: a short-term pilot evaluation.

@article{wang2026application,
  title = {{Application of an adapted hierarchical and progressive training model in enhancing self-perceived competence of nuclear medicine residents: a short-term pilot evaluation.}},
  author = {Hao Wang and Chengtao Feng and Weiwei Zhang and Nan Liu and Lijuan Feng and Wei Zhang},
  journal = {BMC medical education},
  year = {2026},
  month = aug,
  doi = {10.1186/s12909-026-10093-1},
  url = {https://europepmc.org/article/MED/42972593},
  note = {CC BY-NC-ND},
}

TY  - JOUR
TI  - Application of an adapted hierarchical and progressive training model in enhancing self-perceived competence of nuclear medicine residents: a short-term pilot evaluation.
AU  - Hao Wang
AU  - Chengtao Feng
AU  - Weiwei Zhang
AU  - Nan Liu
AU  - Lijuan Feng
AU  - Wei Zhang
PY  - 2026
DA  - 2026/08/06
JO  - BMC medical education
DO  - 10.1186/s12909-026-10093-1
UR  - https://europepmc.org/article/MED/42972593
AB  - Background  The hierarchical and progressive training model (HPTM) has emerged as a promising alternative to enhance resident competencies by emphasizing individualized learning paths and progressive skill acquisition. This pilot study aimed to evaluate the short-term feasibility and perceived benefits of an adapted HPTM in enhancing the self-perceived competence of nuclear medicine residents compared to traditional training methods.Methods  This prospective, single-center, randomized controlled pilot trial was conducted from January to December 2024 at the Department of Nuclear Medicine, Sichuan Provincial People's Hospital, China. Eighty residents undergoing standardized training were randomly assigned to either the HPTM group (n = 40) or the traditional training group (n = 40) using a computer-generated randomization sequence with allocation concealment via sequentially numbered, opaque, sealed envelopes managed by an independent statistician. All randomized participants completed the full trial without dropping out, and an intention-to-treat analysis was applied to all statistical comparisons. The study was designed as a short-term adaptation of the longitudinal HPTM framework, implementing its core stratification principles within the standard 3-month nuclear medicine rotation rather than across the full three-year residency. The HPTM, based on Bloom's educational theory, stratified residents into beginner, intermediate, and advanced levels based on initial competency assessments. Training content was aligned to resident levels across three progressive tiers: primary (foundational knowledge and skills), intermediate (advanced concepts and clinical applications), and advanced (complex scenarios and research skills). Outcome assessors for theoretical and practical examinations were blinded to group allocation. The primary outcome was competency development assessed using a previously validated self-perceived competence assessment tool covering six core self-perceived competencies. Although the scale demonstrated excellent internal consistency (Cronbach's α = 0.89), self-reported competence metrics are subject to carry inherent response bias and cannot substitute for objective clinical performance evaluation. Secondary outcomes included theoretical knowledge scores, practical skills scores, and resident satisfaction evaluated via a 5-point Likert scale. All formal primary and secondary outcome assessments (competence questionnaire, theory exam, OSCE practical test, satisfaction survey) were uniformly administered on the final working day of the 3-month rotation; no mid-cycle formative assessments were counted as formal outcome indicators.Results  The HPTM group showed significant improvements in self-perceived competence development across multiple domains, including professional standards (Bonferroni-corrected P = 0.007), and learning capabilities (Bonferroni-corrected P = 0.007), compared to the control group. After strict Bonferroni adjustment to control Type I error inflation across six independent competency domains (corrected significance threshold P < 0.008), nominal uncorrected significant differences in professional skills (P = 0.028), patient care (P = 0.049), and teaching proficiency (P = 0.032) lost statistical significance and should only be interpreted as exploratory trends rather than robust intervention effects. No significant difference was found in the domain of interaction and teamwork (P = 0.793). The HPTM group also achieved higher theoretical knowledge scores (87.8 ± 6.7 vs. 77.6 ± 10.2, Cohen's d = 1.18, 95% CI: 0.73-1.62, P < 0.001) and practical skills scores (89.6 ± 6.8 vs. 80.5 ± 11.7, Cohen's d = 0.95, 95% CI: 0.52-1.38, P < 0.001). Resident satisfaction was significantly higher in the HPTM group, particularly regarding teaching methodologies, daily educational activities, and fulfillment of targeted clinical skills (overall satisfaction: 4.2 ± 0.9 vs. 3.5 ± 0.9, Cohen's d = 0.84, 95% CI: 0.41-1.26, P < 0.001).Conclusions  This short-term pilot evaluation suggests that an adapted HPTM may improve nuclear medicine residents' self-perceived competence and satisfaction compared with traditional training during a 3-month rotation. However, these preliminary short-term pilot results cannot reflect long-term skill retention or sustained clinical performance improvement after formal residency graduation. Multi-center trials with longitudinal follow-up and objective performance assessments are needed to determine whether these perceived benefits translate into sustained clinical competency.
SN  - 1472-6920
ER  -