Abstract
BACKGROUND: Incidental lung nodules (ILNs) are increasingly detected through imaging, posing clinical and psychological challenges for healthcare providers, especially when local guidelines are lacking. This study assessed knowledge and fear related to ILNs among interns, residents, and general practitioners (GPs) in Palestine. METHODS: A cross-sectional study was conducted using an online questionnaire distributed via social media platforms to interns, residents, and GPs across Palestine. The validated tool assessed demographics, knowledge, emotional responses, clinical practices, and perceived barriers regarding ILNs. SPSS version 25 was used for statistical analysis. RESULTS: The mean age was 26 (± 3.22) years; 53% were female. A majority of the participants (54%) were interns, and 83% had two or fewer years of professional experience. While 68% of participants reported being aware of ILN management guidelines, only 6% rated their understanding of these guidelines as excellent, and more than half (51%) indicated that they did not utilize any guidelines. The median knowledge score was 4 out of 7 [IQR: 2]. Female participants and those who received training in Palestine achieved significantly higher scores (p = 0.012 and p < 0.001, respectively). Common management strategies included reviewing previous imaging (44%) and referring patients to specialists (30%). The primary barriers to effective ILN management were identified as insufficient training (62%) and limited clinical exposure (50.3%). CONCLUSION: This study reveals significant deficiencies in knowledge and confidence regarding ILNs among early-career clinicians in Palestine. The findings underscore the need for targeted educational interventions, the development of local guidelines, and increased clinical exposure to enhance competence and alleviate anxiety in managing incidental findings. Addressing these gaps is crucial for ensuring accurate diagnosis, appropriate follow-up, and improved patient outcomes.