The value of a medical student radiology triage program in enhancing clinical education and skills

Impact of a Reading Room Coordinator on Efficiency of On-Call Radiology Residents

OBJECTIVES

Few level I trauma, tertiary care, academic centers have a paid, permanent reading room coordinator (RRC) to facilitate image management services during off-hour calls, to minimize interruptions to reading workflow. The purpose of this study is to investigate the effect of an RRC on the efficiency of radiology residents signing preliminary reports for emergency department (ED) and inpatient studies.

METHODS

A pre- and postintervention retrospective review was performed, using carestream PACS to retrieve imaging studies read on call during two time periods-July 1 to December 1, 2019 (pre-RRC), and July 1 to December 1, 2021 (post-RRC). Efficiency of residents signing preliminary reports was measured by turnaround time (TAT), defined as the time from when a study was marked complete by a technologist to when a preliminary report was signed by a resident, in PACS.

RESULTS

In the above time periods, residents interpreted a total of 64,406 studies on call. For ED studies, the mean TAT was 7.0 min shorter post-RRC, compared with pre-RRC (95% confidence interval [CI]: -7.8 to -6.1, (t = 15.50, degrees of freedom (df) = 31,866, P < .0001). The percentage of ED studies signed within 30 min increased from 57.7% to 65.8%, an increase of 8.1% (95% CI: 7.0% to 9.1%) after employing an RRC (χ2 = 228.11, df = 1, P < .0001). For inpatient studies, the mean TAT was 10.2 min shorter post-RRC (95% CI: -12.3 to -8.0, t = 9.22, df = 25,193, P < .0001).

CONCLUSIONS

An RRC increased radiology resident on-call workflow efficiency, facilitating care for patients in both the ED and inpatient setting.

Implementation of Medical Students as Radiology Reading Room Coordinators

OBJECTIVE

Effort has been made to minimize the burden of non-interpretive tasks (NITs), in particular by hiring and training non-radiologist support staff as reading room coordinators (RRCs). Our medical center recruited and trained senior medical students from our affiliated school of medicine to work alongside on-call radiology residents as RRCs.

METHODS

A 12-month Malpractice Carrier monetary grant was acquired to fund medical students at with the aim to reduce malpractice risk. After the first year, residents were surveyed regarding the impact of the RRCs on perceived on-call efficiency and morale. Furthermore, report turnaround times (TAT) on call shifts that were and were not accompanied by a RRC were compared.

RESULTS

89 % of residents strongly agreed that the RRC improved workflow efficiency, decreased distractions, and felt less stressed during the call shift when the RRC was on duty. 78 % strongly agreed to be more likely to contact a referring clinician when the RRC was able to help coordinate. The mean TAT in the presence of a RRC was 36.8 min, and the mean TAT in the absence of a RRC was 36.9 min DISCUSSION: After hiring medical students to assist on-call radiology residents with noninterpretive tasks, residents reported subjective indicators of program success, but average report turnaround time was unaffected. Nevertheless, we predict that this type of program will continue to grow among academic radiology departments, though additional research is required to evaluate national trends and impacts on radiologist productivity and well-being.

The "Look Ahead" Technique: A Novel Way to Engage Medical Students in the Radiology Reading Room

RATIONALE AND OBJECTIVES

Engaging medical students during a radiology course can be challenging. We sought a way to actively engage students with live cases, allow them to interact with the picture archiving and communication system workstation, and experience what it is like to be a radiologist.

MATERIALS AND METHODS

Medical students enrolled in one of three radiology courses between May 2016 and June 2017 were eligible. The "Look Ahead" technique is as follows: a preceptor identifies several nonurgent imaging studies and allows the students to view the images first and make independent observations and conclusions. When ready, the students present their findings, receive feedback, and observe the preceptor generate a final report. Students completed the postcourse survey comparing the "Look Ahead" technique with the current standard (observing a preceptor interpret imaging studies with accompanying teaching points).

RESULTS

Thirty-four (56.7%) of 60 potential respondents completed the postcourse survey. Of these 34, 24 (70.6%) reported at least one reading room case (mean 4.6) in which the technique was employed, with a mean of 2.4 unique preceptors. When compared to the current standard (0 = not to 100 = very interested/engaged/valuable/memorable), the "Look Ahead" technique was associated with increased student-reported interest (92.5 vs 75.1, p < 0.01), engagement (94.0 vs 70.3, p < 0.01), educational value (92.5 vs 73.2, p < 0.01), memorability of the case (88.5 vs 73.2, p < 0.01) and of accompanying teaching points (90.1 vs 76.7, p < 0.01).

CONCLUSION

The "Look Ahead" technique is a meaningful and engaging teaching method, which students find "interesting," "valuable," and "memorable."

Constructing an experiential education model in undergraduate radiology education by the utilization of the picture archiving and communication system (PACS)

BACKGROUND

Medical education in China is in a transitional period, from passive learning models to experiential education. We modified an experiential education method for radiology education. The aim of this study is to evaluate the effect of this method on undergraduate radiology education.

METHOD

With the help of the picture archiving and communication system (PACS) and RadiAnt DICOM Viewer, we modified an experiential education method that simulates similar working conditions for undergraduate medical students to formulate radiology diagnosis similar to clinical radiologists. A total of 101 students were allocated into either the experiential education group or the control group. The final examination scores and a 5-point Likert scale self-assessment questionnaire of radiologic skills were collected from all the students as an objective assessment and a subjective assessment respectively. A questionnaire was also used to assess the satisfaction with the experiential model in the experiential education group. Mann-Whitney U test was used to compare the ranked data, and t-tests were used to compare the numeric data.

RESULTS

The experiential education group demonstrated significantly higher scores (7.4 ± 1.3) compared to the control group (6.7 ± 1.5, p < 0.05) in the question type "description and diagnosis". The self-assessment questionnaire indicated that the experiential education was related to increased familiarity with the diagnosis thinking principle and the sequences and reconstruction methods of computer tomography (CT) imaging, which also strengthen participants' self-confidence to perform future clinical work (p < 0.05). The self-assessment questionnaire in the experiential education group showed that the majority of students were satisfied with the organization (82.5%), interactivity (85%) and quality (85%) of the learning activity. Most students found this model of learning to be helpful for studying radiology (85%) and for understanding anatomy (90%).

CONCLUSION

Compared with the traditional radiology education approach, the experiential education method showed greater efficacy in improving students' analysis and diagnostic skills and their self-confidence.

An Internet-Based Radiology Course in Medical School: Comparison of Academic Performance of Students on Campus Versus Those With Absenteeism Due to Residency Interviews

BACKGROUND

Imaging and its optimal use are imperative to the practice of medicine, yet many students don't receive a formal education in radiology. Concurrently, students look for ways to take time away from medical school for residency interviewing. Web-based instruction provides an opportunity to combine these imperatives using online modalities.

OBJECTIVE

A largely Web-based course in radiology during the 4th year of medical school was evaluated both for its acceptance to students who needed to be away from campus for interviews, and its effectiveness on a nationally administered standardized test.

METHODS

All students were placed into a structured program utilizing online videos, online modules, online textbook assignments, and live interactive online lectures. Over half of the course could be completed away from campus. The Alliance of Medical Student Educators in Radiology test exam bank was used as a final exam to evaluate medical knowledge.

RESULTS

Positive student feedback included the freedom to travel for interviews, hands-on ultrasound training, interactive teaching sessions, and quality Web-based learning modules. Negative feedback included taking quizzes in-person, a perceived outdated online textbook, and physically shadowing hospital technicians. Most students elected to take the course during the interview months of October through January. The Alliance of Medical Student Educators in Radiology final exam results (70.5%) were not significantly different than the national cohort (70%) who took the course in-person. Test scores from students taking the course during interview travel months were not significantly different from students who took the course before (P=.30) or after (P=.34) the interview season.

CONCLUSIONS

Students desire to learn radiology and often choose to do so when they need to be away from campus during the fall of their 4th year of study to accomplish their residency interviews. Web-based education in radiology allows students' interview traveling and radiology course objectives to be successfully met without adversely affecting the outcomes on a nationally normed examination in radiology. A curriculum that includes online content and live Web-based teleconference access to faculty can accomplish both imperatives.

The Current State of Radiology Call Assistant Triage Programs Among US Radiology Residency Programs

RATIONALE AND OBJECTIVES

Given increasing volume and workflow interruptions in radiology, we sought to identify and characterize radiology call assistant triage (RCAT) programs among US radiology residency programs.

MATERIALS AND METHODS

A survey was created using Qualtrics survey software and emailed to all members of the Association of Program Directors in Radiology listserv. A total of 296 active members belong to this listserv, including program directors and assistant program directors. The survey included questions about the existence and specifics of a call triage assistant program.

RESULTS

Data were obtained from 88 active members of the Association of Program Directors in Radiology (30% response rate). Of those, 20 programs (23%) have an RCAT program. Triage assistant staffing includes nonmedical or clerical staff (60%), medical students (30%), first-year radiology residents (5%), and technologists (5%). All respondents with RCAT programs report satisfaction with their program and plan to continue. A significant majority (75%) have no plans to change, whereas the remaining 25% are considering program expansion and pay increases. Among residency programs without RCAT programs, none reported termination of their triage program. The most common reasons for not having triage assistants include cost, lack of awareness, differing opinions on utility, and the presence of 24/7 attending coverage.

CONCLUSION

Twenty US radiology residency programs report having an RCAT program. All report satisfaction with their program despite different staffing models. RCAT programs may represent an effective measure in limiting interruptions and potentially decreasing interpretative errors made by residents on call.

The Close Exposure to Radiology Program: Educational Benefits to Medical Students

BACKGROUND

Radiology clerkships during medical school provide a suboptimal training experience in the Chinese medical doctor training program. Staff radiologists are heavily occupied with clinic tasks which decreases teaching quality. The close exposure to radiology program (CERP) is a novel pathway designed to improve teaching quality, yet students' expectations of the potential benefits of such a program and their willingness to join CERP still have not been investigated among Chinese medical students.

METHODS

A survey was conducted among medical students of both sexes with various majors and at different levels of training. The students were asked to identify the potential benefits of CERP as well as to indicate if they were willing to join CERP.

RESULTS

Of the 1,600 surveys distributed to medical students, 1,394 were returned and analyzed. Most of the returned surveys were from males (1,268, 91%), and most respondents had not had a radiology clerkship experience (1,376, 99%). Most responding students were in a 5-year training program (94%) and in their third grade of training (41%). More than 60% of the surveyed students acknowledged each of the 5 benefits listed on the survey, although no statistically significant differences were seen between sexes, training grades, those with and without prior radiology experience, program length, or majors in how the questions were answered. Students most willing to participate in CERP were those enrolled in a 5-year training program (71%) and those who had previous radiology clerkship experience (89%). Students least willing to join CERP were majoring in somatology medicine (54%) and medical psychology (55%), and only 45% of students in 8-year programs indicated a willingness to join CERP. Chi-square tests indicated that the willingness to join CERP was not associated with sex (χ²_{(df = 1393)} = 128.6, P=1.00), training program (χ²_{(df = 1393)} = 111.3, P=1.00), training grade (χ²_{(df = 1393)} = 266.1, P=1.00), major (χ²_{(df = 1393)} = 456.1, P=1.00), or previous experience with radiology (χ²_{(df = 1393)} = 142.2, P=1.00).

CONCLUSION

Medical students enrolled at Fourth Military Medical University developed an awareness of the potential benefits of CERP; however, this awareness did not correlate with their willingness to join CERP.

Results of the 2014 survey of the American Alliance of Academic Chief Residents in Radiology

RATIONALE AND OBJECTIVES

The American Alliance of Academic Chief Residents in Radiology (A³CR²) conducts an annual survey of chief residents in accredited radiology programs in North America. The survey serves as a tool for observing trends and disseminating ideas among radiology programs.

MATERIALS AND METHODS

An online survey conducted through the SurveyMonkey Web site was distributed to chief residents from 187 Accreditation Council on Graduate Medical Education (ACGME)-accredited radiology training programs. A variety of multiple-choice and free-response questions were designed to gather information about residency program details, benefits, chief resident responsibilities, call, preparations for the recent American Board of Radiology Core Examination, implementation of selectives (mini-fellowships), fellowships, health care economics and the job market, and ACGME milestones.

RESULTS

Among those surveyed, 212 unique responses from 136 programs were provided, yielding a 73% response rate. Data were compared to historical data from prior surveys dating back through 2002.

CONCLUSIONS

Programs are increasingly providing 24-hour sonographer coverage, full day routine services on weekends, and 24-hour attending radiologist coverage. The new American Board of Radiology examination format and schedule has driven many changes, including when chief residents serve, board preparation and review, and how the final year of residency training is structured. Despite facing many changes, there is slightly more optimism among chief residents regarding their future job prospects.