Interdisciplinary collaborative teaching in vascular surgery training: A randomized trial of radiologist-surgeon partnership in China

ERCT Criteria Breakdown

• Level 1 Criteria

  • C

    Class-level RCT

    • Randomization occurred at the individual trainee level rather than by intact classes (or equivalent teaching units), so the ERCT class-level randomization requirement is not satisfied.
    • "Participants: A total of 40 vascular surgery residents were recruited for the study, with a mean age of 26.3 years and 80% male. Participants were randomly assigned to either the experimental group or the control group, with 20 people in each group."
    • Relevant Quotes: 1) "Forty trainees were randomized into two groups: one receiving collaborative teaching, which included joint lectures, radiologist-attended ward rounds, and interdisciplinary case conferences; and the other undergoing traditional vascular single-discipline training." (Abstract) 2) "Participants: A total of 40 vascular surgery residents were recruited for the study, with a mean age of 26.3 years and 80% male. Participants were randomly assigned to either the experimental group or the control group, with 20 people in each group." (Materials and methods, Study design) Detailed Analysis: ERCT criterion C requires random assignment at the class level (or stronger, such as school/site level), to reduce contamination risks when participants share teachers, rotations, or informal learning networks. The paper explicitly describes randomizing "Forty trainees" / "40 vascular surgery residents" into two arms with 20 per group, which indicates individual-level randomization within a single residency training setting. The intervention (joint lectures, collaborative conferences, and ward rounds) is inherently social, so spillovers between residents across arms are plausible unless entire cohorts/units are randomized and separated. Final sentence: Criterion C is not met because randomization was at the individual resident level rather than by intact classes (or stronger units).
  • E

    Exam-based Assessment

    • Outcomes were assessed with study-assembled case sets and rating scales rather than a widely recognized standardized exam.
    • "The accuracy of residents’ CT image interpretations was evaluated using 5 randomly selected CT cases, each representing distinct vascular pathologies (e.g., aortic aneurysms, aortic dissections, arteriosclerotic occlusions)."
    • Relevant Quotes: 1) "The accuracy of residents’ CT image interpretations was evaluated using 5 randomly selected CT cases, each representing distinct vascular pathologies (e.g., aortic aneurysms, aortic dissections, arteriosclerotic occlusions)." (Materials and methods, Outcome measures) 2) "Case Selection: Diagnostic accuracy was assessed using 25 standardized cases(including 5 acute/chronic limb ischemia, 5 aortic aneurysms, 5 aortic dissections, 5 visceral artery diseases, and 5 venous disorders) that included clinical histories, physical examination findings, and imaging data." (Materials and methods, Outcome measures) 3) "The reasonability of treatment plans is assessed using a validated 5-point Likert scale specifically designed for vascular surgery scenarios." (Materials and methods, Outcome measures) 4) "Assessment Tool: The Communication Skills Inventory (CSI) was used for assessment." (Materials and methods, Outcome measures) Detailed Analysis: ERCT criterion E requires standardized exam-based assessments that are widely recognized beyond the study itself (e.g., national or formal in-training exams), rather than bespoke cases/ratings created or assembled for the trial. Here, key outcomes are measured via (a) a small, study-selected set of CT cases with a scoring rubric, (b) a study-provided set of "standardized cases" with expert-defined gold standards, (c) a Likert scale for treatment plan rationality used in this context, and (d) a communication inventory (CSI). While CSI is a validated instrument, it is not an exam-based standardized educational achievement test, and the other measures are explicitly assembled as case sets for this study. Final sentence: Criterion E is not met because outcomes rely on study-assembled cases and rating scales rather than a widely recognized standardized exam.
  • T

    Term Duration

    • The stated study period spans from July 18, 2024 to March 31, 2025, which exceeds a typical academic term length.
    • "Scenario setting: The study was conducted at Sichuan Provincial People’s Hospital from 18/07/2024–31/03/2025."
    • Relevant Quotes: 1) "Scenario setting: The study was conducted at Sichuan Provincial People’s Hospital from 18/07/2024–31/03/2025." (Materials and methods, Study design) Detailed Analysis: ERCT criterion T requires that outcomes be measured at least one full academic term after the intervention begins (often ~3–4 months). The paper provides a start and end window for the study of roughly 8.5 months (18/07/2024–31/03/2025), which comfortably exceeds a term-length threshold. The paper does not separately state the exact date(s) when each outcome assessment was administered, but the reported study window indicates that the intervention and its evaluation were conducted over a period longer than a typical academic term. Final sentence: Criterion T is met because the documented study period spans substantially longer than one academic term.
  • D

    Documented Control Group

    • The control condition is described, but the paper does not provide control-group baseline demographics and baseline performance suitable for ERCT documentation expectations.
    • "Conventional vascular surgery teaching was provided, which included standard lectures, case discussions, and ward rounds led solely by vascular surgeons. The entire teaching content was independently completed by vascular surgeons."
    • Relevant Quotes: 1) "Participants: A total of 40 vascular surgery residents were recruited for the study, with a mean age of 26.3 years and 80% male. Participants were randomly assigned to either the experimental group or the control group, with 20 people in each group." (Materials and methods, Study design) 2) "Conventional vascular surgery teaching was provided, which included standard lectures, case discussions, and ward rounds led solely by vascular surgeons. The entire teaching content was independently completed by vascular surgeons." (Materials and methods, Interventions) Detailed Analysis: ERCT criterion D requires that the control group be well documented, typically including (at minimum) a clear control condition description plus baseline participant characteristics and baseline performance information for control versus treatment to assess initial comparability. The control instruction is clearly described. However, baseline demographics are only given for the full sample (mean age; % male) and are not reported separately for the control group. The paper also does not report baseline (pre-intervention) performance measures (e.g., pretest CT interpretation or diagnostic accuracy) for control versus experimental arms. Final sentence: Criterion D is not met because the paper describes the control condition but does not provide control-arm baseline characteristics and baseline performance in sufficient detail.

• Level 2 Criteria

  • S

    School-level RCT

    • This is a single-site residency program trial with individual randomization, not a school- (or institution-) level RCT.
    • "Scenario setting: The study was conducted at Sichuan Provincial People’s Hospital from 18/07/2024–31/03/2025."
    • Relevant Quotes: 1) "Scenario setting: The study was conducted at Sichuan Provincial People’s Hospital from 18/07/2024–31/03/2025." (Materials and methods, Study design) 2) "Participants: A total of 40 vascular surgery residents were recruited for the study, with a mean age of 26.3 years and 80% male. Participants were randomly assigned to either the experimental group or the control group, with 20 people in each group." (Materials and methods, Study design) Detailed Analysis: ERCT criterion S requires randomization at the school/site (i.e., institution/implementation unit) level, involving multiple sites that are assigned to intervention vs control. The paper describes one site (Sichuan Provincial People’s Hospital) and individual-level randomization of residents into two arms. No multi-site randomization is described. Final sentence: Criterion S is not met because the study is single-site with individual randomization rather than site-level assignment.
  • I

    Independent Conduct

    • Although assessors were blinded for communication skills, the paper does not document that implementation and evaluation were conducted by an independent third party separate from the intervention designers.
    • "Assessors were blinded to the group allocation of participants to eliminate bias."
    • Relevant Quotes: 1) "Assessment Process and Assessors: The assessment was conducted by trained senior clinicians and nursing staff to ensure objectivity. Assessors were blinded to the group allocation of participants to eliminate bias." (Materials and methods, Outcome measures) 2) "Joint Lectures: A series of lectures were held, with 50% of the content delivered by radiologists and 50% by vascular surgeons." (Materials and methods, Interventions) Detailed Analysis: ERCT criterion I requires that the study be conducted independently from the intervention designers/providers, usually via an explicitly independent evaluation team or third-party management of implementation and/or analysis. The paper documents assessor blinding for the communication skills assessment, which helps reduce measurement bias for that outcome. However, blinding is not the same as independence. The teaching intervention is delivered by radiologists and vascular surgeons, and the authors themselves are from radiology and vascular surgery at the same hospital. The paper does not state that an external team independent from the intervention designers conducted the trial, managed data collection, or performed the analyses. Final sentence: Criterion I is not met because the paper does not clearly document third-party independent conduct beyond assessor blinding for one outcome.
  • Y

    Year Duration

    • The reported study window (July 2024 through March 2025) spans about 8.5 months, which exceeds 75% of a typical 9–10 month academic year, meeting the ERCT year-duration threshold.
    • "Scenario setting: The study was conducted at Sichuan Provincial People’s Hospital from 18/07/2024–31/03/2025."
    • Relevant Quotes: 1) "Scenario setting: The study was conducted at Sichuan Provincial People’s Hospital from 18/07/2024–31/03/2025." (Materials and methods, Study design) Detailed Analysis: ERCT criterion Y requires outcomes to be measured at least 75% of one academic year after the intervention begins. The paper reports a study duration of roughly 8.5 months, which exceeds 75% of a typical 9–10 month academic year. The paper does not explicitly define the residency program’s "academic year" length, but the stated interval is long enough to satisfy the ERCT 75% year-duration threshold under typical academic-year conventions. Final sentence: Criterion Y is met because the reported study window spans about 8.5 months, meeting the ERCT 75% year-duration requirement.
  • B

    Balanced Control Group

    • The experimental condition includes added radiologist involvement that is integral to the teaching model being tested against conventional training, so the resource difference is the treatment rather than an unacknowledged confound.
    • "Radiologist-Involved Ward Rounds: Radiologists accompanied vascular surgery teams during ward rounds, providing real-time imaging interpretation and facilitating bedside teaching."
    • Relevant Quotes: 1) "Joint Lectures: A series of lectures were held, with 50% of the content delivered by radiologists and 50% by vascular surgeons." (Materials and methods, Interventions) 2) "Weekly Collaborative Case Conferences: Every week, residents participated in case conferences where radiologists and vascular surgeons jointly discussed complex cases, highlighting the interdisciplinary approach to patient care." (Materials and methods, Interventions) 3) "Radiologist-Involved Ward Rounds: Radiologists accompanied vascular surgery teams during ward rounds, providing real-time imaging interpretation and facilitating bedside teaching." (Materials and methods, Interventions) 4) "Conventional vascular surgery teaching was provided, which included standard lectures, case discussions, and ward rounds led solely by vascular surgeons. The entire teaching content was independently completed by vascular surgeons." (Materials and methods, Interventions) Detailed Analysis: Criterion B compares the nature, quantity, and quality of resources (time, staffing, materials, budget) provided to the intervention and control conditions, and asks whether additional resources in the intervention arm are (a) balanced in the control arm, or (b) explicitly the treatment variable being tested. This paper defines the intervention as a collaborative model that includes substantial additional radiologist participation (joint lectures, weekly conferences, and radiologist-involved ward rounds). That added expert time is not described as a separate, optional enhancement; rather, it is the central feature of the interdisciplinary teaching package being evaluated against conventional single-discipline teaching. The paper does not quantify total instructional time in each arm, so it is unclear whether the intervention increased time-on-task or replaced existing activities. However, under the ERCT decision logic, when the added resource is the core treatment (here, structured radiologist-surgeon collaboration), the study can still satisfy criterion B because the resource difference is integral to what is being tested. Final sentence: Criterion B is met because the additional radiologist input is explicitly integral to the intervention being tested rather than an unacknowledged resource imbalance.

• Level 3 Criteria

  • R

    Reproduced

    • No independent replication is reported in the paper, and no independently published replication of this specific trial was identified in an external literature search.
    • "Future studies should explore the scalability of the collaborative teaching model in different settings and with larger sample sizes, adopting multi-center designs [23]."
    • Relevant Quotes: 1) "Future studies should explore the scalability of the collaborative teaching model in different settings and with larger sample sizes, adopting multi-center designs [23]." (Discussion, Limitations and future directions) Detailed Analysis: ERCT criterion R requires independent replication by a different research team, in a different context, published in a peer- reviewed outlet. The paper itself does not claim prior replications; instead, it explicitly calls for future multi-center studies, which suggests replication/scaling evidence is not yet established in the literature as presented by the authors. Internet searching (performed 2026-03-04) for independent replications referencing this paper/DOI and for closely matched "radiologist-surgeon partnership" collaborative teaching RCTs did not identify a peer-reviewed study that clearly replicated this specific intervention and design by an independent team. Final sentence: Criterion R is not met because independent replication evidence for this specific trial was not found.
  • A

    All-subject Exams

    • Because the study does not use standardized exam-based assessments, ERCT criterion A is automatically not met; in addition, outcomes focus on vascular training competencies rather than standardized exams across all core subjects.
    • "The accuracy of residents’ CT image interpretations was evaluated using 5 randomly selected CT cases, each representing distinct vascular pathologies (e.g., aortic aneurysms, aortic dissections, arteriosclerotic occlusions)."
    • Relevant Quotes: 1) "The accuracy of residents’ CT image interpretations was evaluated using 5 randomly selected CT cases, each representing distinct vascular pathologies (e.g., aortic aneurysms, aortic dissections, arteriosclerotic occlusions)." (Materials and methods, Outcome measures) 2) "Case Selection: Diagnostic accuracy was assessed using 25 standardized cases(including 5 acute/chronic limb ischemia, 5 aortic aneurysms, 5 aortic dissections, 5 visceral artery diseases, and 5 venous disorders) that included clinical histories, physical examination findings, and imaging data." (Materials and methods, Outcome measures) Detailed Analysis: ERCT criterion A requires standardized, exam-based assessments covering all main subjects (and it additionally requires that criterion E is met). In this paper, the assessment approach is case-based and competency-focused (CT interpretation, diagnostic reasoning, treatment planning, communication), rather than using a recognized standardized exam framework. Since criterion E is not met, criterion A is automatically not met under the ERCT rules. Independently, the outcomes are specialized clinical competencies rather than "all core subject" exams. Final sentence: Criterion A is not met because criterion E is not met and the paper does not assess standardized exams across all main subjects.
  • G

    Graduation Tracking

    • The study reports a short follow-up and provides no tracking to a graduation or program-completion endpoint; no follow-up papers by the same authors reporting graduation tracking were identified.
    • "Second, the short follow-up period prevents us from assessing the long-term impact of the intervention on residents’ competence and patient outcomes."
    • Relevant Quotes: 1) "Second, the short follow-up period prevents us from assessing the long-term impact of the intervention on residents’ competence and patient outcomes." (Discussion, Limitations and future directions) Detailed Analysis: ERCT criterion G requires follow-up tracking until graduation (i.e., until completion of the relevant educational stage). The paper explicitly notes that follow-up is short and that long-term impact was not assessed, which implies participants were not tracked to a completion/graduation endpoint. Because criterion Y is met, criterion G is eligible to be met, but it still requires evidence of graduation/program-completion tracking. An external search (performed 2026-03-04) for subsequent publications by the same authors following the same cohort through residency completion or other graduation-like endpoints did not identify any such follow-up papers. Final sentence: Criterion G is not met because neither the paper nor identified follow-up publications track participants through graduation/program completion.
  • P

    Pre-Registered

    • The paper provides no registry identifier or dated statement showing that a protocol was pre-registered before data collection.
    • Relevant Quotes: (No pre-registration statement, registry ID, or registration date is reported in the paper.) Detailed Analysis: ERCT criterion P requires a publicly accessible pre-registration record (with an identifier) and timing that clearly predates enrollment/data collection. The paper provides ethics approval information (IRB No.2024−429) and informed consent procedures, but it does not mention trial registration, a pre-registered analysis plan, OSF, ClinicalTrials. gov, ISRCTN, the Chinese Clinical Trial Registry, or any other pre-registration platform. Without an explicit registry ID and date, pre-registration cannot be verified. Final sentence: Criterion P is not met because no protocol pre-registration information is provided.