Cardiac imaging training in radiology residency programs: a survey of radiology chief residents

Integrated cardio-thoracic imaging curriculum for residents: Design, implementation, and analysis of test and evaluation results

As the field of cardiac imaging has demonstrated exceptional growth over the past several decades, radiology departments and residency programs have struggled to integrate cardiac imaging instruction into training curricula.

PURPOSE

To create an integrated cardio-thoracic teaching and lecture curriculum and resident rotation in accordance with AGGME and Society of Thoracic Radiology (STR) guidelines.

MATERIALS AND METHODS

Consecutive PGY-2 to PGY-4 residents (n = 14) rotating through our Cardiothoracic Imaging (CTI) section from 1/1/2021 to 04/18/2022 were give pre- and post- rotation tests of knowledge and feedback evaluations. Attending feedback of the curriculum was obtained at 3-months and 9-months post curriculum implementation. A Wilcxon test was used to evaluate differences in improvement between pre- and post- rotation resident feedback scores, test scores for thoracic and cardiac test questions in addition to attending feedback scores at 3 and 9-months post curriculum implementation.

RESULTS

The overall post-rotation scores in addition to thoracic only and cardiac only scores improved, with the difference between improved versus stable or decreased scores being statistically significant overall (P = 0.039) and for cardiac scores (P = 0.003), but not for thoracic scores (P = 0.22). The overall (P = 0.002), thoracic (P = 0.027), and cardiac (P = 0.026) resident feedback scores were significantly improved post-rotation. Similarly, the overall attending feedback scores significantly improved over time (P = 0.021).

CONCLUSION

An integrated Cardio-thoracic Imaging teaching curriculum was well received by both residents and attendings with significant improvement in post rotation feedback scores by both groups. Moreover, residents demonstrated improved scores on knowledge tests post rotation.

Challenges and opportunities to delivering cardiac imaging training: a national survey by the Italian college of cardiac radiology

BACKGROUND

Delivering consistent levels of training in cardiac imaging to radiologist is of pivotal importance because of the increasing clinical indications to coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR). Our study sought to capture the heterogeneity of cardiac imaging training programs and to explore residents' vision on cardiac imaging both in the present and in the future.

METHODS

Two web-based surveys were created. The first was administered to all chief residents from the 42 University Hospitals within Italy, aiming to explore the local educational offer in cardiac imaging. The second was administered via social media to all Italian residents, including questions about their overall vision regarding cardiac imaging.

RESULTS

42/42 University Hospitals responded to the first survey and 235 residents to the second. There was at least a 64-slice CT scanner and a 1.5 T MR scanner per center. In the majority of sites, the weekly routine consisted of more than 10 CCTA and more than 5 CMR. Approximately, half of the centers used advanced CCTA and CMR techniques. The majority of the interviewed resident (94%) perceived cardiac imaging training to be moderately to very important, while requirement for external educational resources was advocated in 25% of the cases.

CONCLUSION

Our survey highlighted a significant awareness of radiology residents regarding the importance of cardiac imaging in their training curriculum. All centers met the technical requirements for cardiac imaging, limiting its use to basic applications in around half of cases. Implementation of an educational network might be the key for supporting the growth of this subspecialty field.

Identification of Coronary Artery Calcification and Diagnosis of Coronary Artery Disease by Abdominal CT: A Resident Education Continuous Quality Improvement Project

RATIONALE AND OBJECTIVES

Coronary artery calcium (CAC) scoring is an excellent imaging tool for subclinical atherosclerosis detection and risk stratification. We hypothesize that although CAC has been underreported in the past on computed tomography (CT) scans of the abdomen, specialized resident educational intervention can improve on this underreporting.

MATERIALS AND METHODS

Beginning July 2009, a dedicated radiology resident cardiac imaging rotation and curriculum was initiated. A retrospective review of the first 500 abdominal CT reports from January 2009, 2011, and 2013 was performed including studies originally interpreted by a resident and primary attending physician interpretations. Each scan was reevaluated for presence or absence of CAC and coronary artery disease (CAD) by a cardiovascular CT expert reader. These data were then correlated to determine if the presence of CAC had been properly reported initially. The results of the three time periods were compared to assess for improved rates of CAC and CAD reporting after initiation of a resident cardiac imaging curriculum.

RESULTS

Statistically significant improvements in the reporting of CAC and CAD on CT scans of the abdomen occurred after the initiation of formal resident cardiac imaging training which included two rotations (4 weeks each) of dedicated cardiac CT and cardiac magnetic resonance imaging interpretation during the resident's second, third, or fourth radiology training years. The improvement was persistent and increased over time, improving from 1% to 72% after 2 years and to 90% after 4 years.

CONCLUSIONS

This single-center retrospective analysis shows association between implementation of formal cardiac imaging training into radiology resident education and improved CAC detection and CAD reporting on abdominal CT scans.

Results of the 2012 survey of the American Association of Academic Chief Residents in Radiology

RATIONALE AND OBJECTIVE

Every year, the American Association of Academic Chief Residents in Radiology conducts a survey of the chief residents in accredited radiology training programs in North America. The survey serves as a tool for gathering information, sharing ideas, and voicing opinions.

MATERIALS AND METHODS

An online survey was made available to the chief residents from 187 training programs in North America. Questions were presented in multiple-choice and free response formats, designed to address many issues ranging from program structure to on-call policies, changes for the new board examination format and fellowships, and the effects of health care reform on radiology practices. The results of the survey were tabulated and responses to the repeated questions were compared with those from earlier surveys dating to 2003.

RESULTS

Among those surveyed, 185 individual responses representing 135 unique programs were completed, yielding a 73% response rate. Thirty-eight percent of programs responded from the northeast and 17% of programs responded from the southeast. Nineteen percent of responses were from central United States, 14% of responses were from western United States, and 12% of responses were from Canada.

CONCLUSIONS

There is an increasing number of programs, which cover more hospitals, during the past decade. There are more programs providing ultrasound and magnetic resonance services after hours, with an associated increase in after-hours attending physician coverage. Many changes are being made for the future board examination format. Health care reform is affecting how residents are preparing themselves for their future practices.