Building for tomorrow today: opportunities and directions in radiology resident research

Academia in cardiovascular radiology: are we doing enough for the future of the subspecialty?

AIM

To explore barriers to academic activities that cardiovascular radiology-oriented radiology trainees face worldwide.

MATERIALS AND METHODS

An international call for participation in an online survey was distributed via social media and radiological societies to radiology trainees. Questions covered barriers and involvement in academic activities during radiology training. Participants interested in cardiovascular radiology were selected for analysis with appropriate statistical methods.

RESULTS

Of the 892 respondents, 120 (13.5%) reported an interest in cardiovascular imaging. The majority (63.3%, 76/120) were from Europe and 57.5% (69/120) were men. There were gender discrepancies in academic involvement and in perceived gender-related barriers (perceived gender barrier in academic work between women and men: 15/48 versus 5/69, respectively, p=0.001). The main barriers were lack of time, mentorship, and support. Most did not have protected academic time for research nor for teaching (61.7%, 74/120 and 57.5%, 69/120, respectively). Nonetheless, 40% (48/120) published as first authors, 77.5% (91/120) were involved academically in conferences, 71.7% (85/120) were positive about academic activities, 70.8% plan working in an academic setting, and 78.3% (94/120) would consider research training abroad.

CONCLUSION

Although the majority of respondents are positive about academic activities and plan to continue in the future, most do not have protected time. Lack of time, mentorship, and support were the main barriers. Fewer women declare involvement in academic work and output. There are significant perceived gender barriers to academic activities.

A roadmap of resident-led initiatives to promote research within the radiology department

RATIONAL

While radiology residents must participate in a scholarly project per Accreditation Council for Graduate Medical Education (ACGME) Program Requirements, some residency programs may lack a well-thought out, cohesive approach to research that incorporates the residents' perspective. Our objective was to improve the radiology resident research experience with resident-led initiatives.

MATERIAL AND METHODS

An annual resident research survey was created and distributed to 28 radiology residents in December 2018. Following the survey, a newly formed resident research committee developed a six-step strategic framework of resident-led initiatives to promote research and scholarly activity within the department: Reflect, Recruit, Regroup, Revive, Recognize, and Review. Outcomes of this framework were evaluated with the second annual resident research survey in December 2019.

RESULTS

Our institution identified areas of improvement on the 2019 survey after the implementation of the six-step initiatives upon comparison to the 2018 survey. A greater number of residents reported that they had adequate or somewhat adequate resources for research within the department in 2019 (95.2% [20/21]) in comparison to 2018 (70.6% [12/17]) (p = 0.03). A greater percentage of residents found available research projects engaging/interesting in 2019 (80.9% [17/21]) compared to 2018 (70.6% 12/17) (p = 0.49). The most commonly reported departmental resources needed to encourage research on the 2019 survey were dedicated research time (26.9%, 18 out of 67 total responses) and mentorship/encouragement from the faculty (19.4%, 13/67).

CONCLUSION

With a specific framework and appropriate departmental support, resident-led initiatives can improve the research experience within the radiology department from the residents' perspective.

An Institutional Academic and Research Track Curriculum for Radiology Residents: Development, Implementation, and Outcomes Assessment at 6 Years

RATIONALE AND OBJECTIVES

We report the creation of a voluntary research development curriculum for radiology residents at our institution, detailing outcomes after 6 years of existence.

MATERIALS AND METHODS

We developed a comprehensive Academic and Research Track (ART) curriculum for radiology residents in our department, including mentorship, monthly meetings, didactic curriculum, ongoing evaluation/feedback, protected academic time, and financial support. A literature review identified all indexed publications for our residency graduates from 6 years pre- (2007-2012) to 6 years post-ART (2013-2018) intervention. We also documented career outcomes (academic versus private practice). Summary statistics, Chi-square, and Poisson regression analyses were performed.

RESULTS

ART group demonstrated significantly greater publication likelihood versus pre-ART predecessors (odds ratio [OR]: 3.59, 95% confidence intervals [CI]: 1.40-9.19; risk ratios [RR]: 1.58, 95% CI: 1.19-2.11; p= 0.01), contemporaneous non-ART cohort (OR: 3.03, 95% CI: 1.12-8.33; RR: 1.45, 95% CI: 1.08-1.96; p = 0.04), and combined pre-ART plus non-ART group (OR: 3.34, 95% CI: 1.35-8.22; RR: 1.41, 95% CI: 0.87-2.29; p = 0.012). In Poisson regression, ART was a significant factor for total, first author, and senior author publications among all graduates and among the subset which remained in academics (all p-values < 0.05). Estimators were positive in all regressions, indicating a positive effect of ART for increasing numbers of publications.

CONCLUSION

ART membership was associated with significantly increased indexed publications. A greater proportion of ART members remained in academics compared to non-ART members, but did not reach statistical significance. We detail our ART structure and curriculum, which may be used as a malleable template for other radiology departments.

Supporting Radiology Residents' Professional Development Through a Competitive Intramural Grant

Research and other scholarly activities are an important and required component of diagnostic radiology training. Several strategies, both at the departmental and the larger organizational levels, have been implemented to encourage radiology trainees to participate in these activities. In this article, we review and discuss our institution's 10-year experience in supporting the development and realization of scholarly projects through a competitive intramural grant for residents.

Building Imaging Institutes of Patient Care Outcomes: Imaging as a Nidus for Innovation in Clinical Care, Research, and Education

Traditionally, radiologists have been responsible for the protocol of imaging studies, imaging acquisition, supervision of imaging technologists, and interpretation and reporting of imaging findings. In this article, we outline how radiology needs to change and adapt to a role of providing value-based, integrated health-care delivery. We believe that the way to best serve our specialty and our patients is to undertake a fundamental paradigm shift in how we practice. We describe the need for imaging institutes centered on disease entities (eg, lung cancer, multiple sclerosis) to not only optimize clinical care and patient outcomes, but also spur the development of a new educational focus, which will increase opportunities for medical trainees and other health professionals. These institutes will also serve as unique environments for testing and implementing new technologies and for generating new ideas for research and health-care delivery. We propose that the imaging institutes focus on how imaging practices-including new innovations-improve patient care outcomes within a specific disease framework. These institutes will allow our specialty to lead patient care, provide the necessary infrastructure for state-of-the art-education of trainees, and stimulate innovative and clinically relevant research.

Promoting Collaborations Between Radiologists and Scientists

Radiology as a discipline thrives on the dynamic interplay between technological and clinical advances. Progress in almost all facets of the imaging sciences is highly dependent on complex tools sourced from physics, engineering, biology, and the clinical sciences to obtain, process, and view imaging studies. The application of these tools, however, requires broad and deep medical knowledge about disease pathophysiology and its relationship with medical imaging. This relationship between clinical medicine and imaging technology, nurtured and fostered over the past 75 years, has cultivated extraordinarily rich collaborative opportunities between basic scientists, engineers, and physicians. In this review, we attempt to provide a framework to identify both currently successful collaborative ventures and future opportunities for scientific partnership. This invited review is a product of a special working group within the Association of University Radiologists-Radiology Research Alliance.

Radiology Research Funding: Current State and Future Opportunities

Funding for research has become increasingly difficult to obtain in an environment of decreasing clinical revenue, increasing research costs, and growing competition for federal and nonfederal funding sources. This paper identifies critical requirements to build and sustain a successful radiology research program (eg, key personnel and leadership, research training and mentorship, infrastructure, institutional and departmental funding or support), reviews the current state of available funding for radiology (including federal, nonfederal, philanthropy, crowdfunding, and industry), and describes promising opportunities for future funding (eg, health services, comparative effectiveness, and patient-centered outcomes research). The funding climate, especially at the federal level, changes periodically, so it is important to have radiology-specific organizations such as the American College of Radiology and the Academy of Radiology Research serving as our key advocates. Key to obtaining any funding, no matter what the source, is a well-formulated grant proposal, so a review of opportunities specifically available to radiologists to develop and hone their grant-writing skills is provided. Effective and sustained funding for radiology research has the potential to cultivate young researchers, bolster quality research, and enhance health care. Those interested in pursuing research need to be aware of the ever-changing funding landscape, research priority areas, and the resources available to them to succeed. To succeed, radiology researchers need to think about diversification and flexibility in their interests, developing multidisciplinary and multi-institutional projects, and engaging a broader base of stakeholders that includes patients.

Teaching Critical Thinking in Graduate Medical Education: Lessons Learned in Diagnostic Radiology

The 2014 Institute of Medicine report, Graduate Medical Education that Meets the Nation's Health Needs, challenged the current graduate medical training process and encouraged new opportunities to redefine the fundamental skills and abilities of the physician workforce. This workforce should be skilled in critically evaluating the current systems to improve care delivery and health. To meet these goals, current challenges, motivations, and educational models at the medical school and graduate medical education levels related to formal training in nonclinical aspects of medicine, especially critical thinking, are reviewed. Our diagnostic radiology training program is presented as a "case study" to frame the review.