With the development of cross-sectional imaging\ntechniques and transformation to digital reading of radiological\nimaging, e-learning might be a promising tool in undergraduate\nradiology education. In this systematic review of the\nliterature, we evaluate the emergence of image interaction\npossibilities in radiology e-learning programs and evidence\nfor effects of radiology e-learning on learning outcomes and\nperspectives of medical students and teachers. A systematic\nsearch in PubMed, EMBASE, Cochrane, ERIC, and PsycInfo\nwas performed. Articles were screened by two authors and\nincluded when they concerned the evaluation of radiological\ne-learning tools for undergraduate medical students. Nineteen\narticles were included. Seven studies evaluated e-learning programs\nwith image interaction possibilities. Students perceived\ne-learning with image interaction possibilities to be a useful\naddition to learning with hard copy images and to be effective\nfor learning 3D anatomy. Both e-learning programs with and\nwithout image interaction possibilities were found to improve\nradiological knowledge and skills. In general, students found\ne-learning programs easy to use, rated image quality high, and\nfound the difficulty level of the courses appropriate. Furthermore,\nthey felt that their knowledge and understanding of\nradiology improved by using e-learning. In conclusion, the\naddition of radiology e-learning in undergraduate medical\neducation can improve radiological knowledge and image\ninterpretation skills. Differences between the effect of\ne-learning with and without image interpretation possibilities\non learning outcomes are unknown and should be subject to\nfuture research.
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