Effect of a communication lecture tutorial on breast imaging trainees' confidence with challenging breast imaging patient interactions

Patient Communication Innovations in Breast Imaging

Effective patient communication is paramount in breast radiology, where standardized reporting and patient-centered care practices have long been established. This communication profoundly affects patient experience, well-being, and adherence to medical advice. Breast radiologists play a pivotal role in conveying diagnostic findings and addressing patient concerns, particularly in the context of cancer diagnoses. Technological advances in radiology reporting, patient access to electronic medical records, and the demand for immediate information access have reshaped radiologists' communication practices. Innovative approaches, including image-rich reports, visual timelines, and video radiology reports, have been used in various institutions to enhance patient comprehension and engagement.

Breast Imaging Fellowship Training in the United States: A National Survey of Fellowship Program Directors

OBJECTIVE

To provide an updated characterization of breast imaging fellowship programs in the United States to identify opportunities for improvement and standardization.

METHODS

An anonymous survey was e-mailed to program directors of breast imaging fellowship programs listed on the Society of Breast Imaging website. The survey was open from April 23, 2021, through May 27, 2021. The survey was deemed exempt by the IRB.

RESULTS

Forty-seven of 80 (59%) program directors responded, of which 36/47 (77%) represented programs dedicated 100% to breast imaging, and 11/47 (23%) represented programs dedicated 50%-75% to breast imaging. Common elements to most programs include tumor boards (47/47, 100%), journal clubs (39/47, 83%), case-based teaching sessions (35/47, 74%), didactic lectures (40/47, 85%), and participation in radiology-pathology conferences (29/47, 62%). Mammography Quality and Standards Act audit training (22/47, 47%), mammography quality control training (22/47, 47%), and formal communication training (19/47, 40%) were less common. Most programs provide exposure to wire (42/47, 89%) and wire-free localization procedures (45/47, 96%), but exposure to contrast-enhanced mammography (13/47, 28%) and molecular breast imaging (4/47, 9%) was limited. A small majority of programs (25/47, 53%) do not require weekday call; however, more (31/47, 66%) have weekend call responsibilities. Many programs (29/47, 62%) offer at least 3 weeks of elective time, which may be clinical or nonclinical.

CONCLUSION

Breast imaging fellowship programs vary in curricula, modality exposure, and academic policies. The results of this survey can help guide further efforts to standardize and optimize fellowship training.

State of Communication Training During the Breast Imaging Fellowship Year

OBJECTIVE

The purpose of this study was to survey breast imaging fellowship programs nationally on the state of communication skills training during fellowship training.

METHODS

In this IRB-exempt study, fellowship program director members of the Society of Breast Imaging (SBI) were anonymously surveyed on current provision and types of communication skills training in their fellowship curricula.

RESULTS

A six-question survey was sent to all 95 SBI member fellowship program directors with a response rate of 56% (53/95). Although direct fellow patient-centered communication interactions are practiced across all respondent training programs, formal communication skills training was offered in a minority of programs with 32% (17/53) providing formal communication in the form of a didactic lecture and 17% (9/53) engaging fellows in a simulation communication skills workshop. Of the 53 programs, 12 (22%) reported no formal communication skills training of any kind, while a majority (44/53, 83%) of programs provide regular feedback based on observed fellow-patient communication interactions.

CONCLUSION

Despite nearly uniform practice of engaging breast imaging fellows in direct patient-centered interaction at the onset of the fellowship training year, the majority of fellowship programs do not provide any formal communication skills training curricula at any point during fellowship training. To equip future breast radiologists with the skills to provide value in an increasingly patient-centered field, dedicated formal communication curricula ought to be incorporated consistently into breast imaging fellowship training programs.

The American College of Radiology/Society of Breast Imaging Updated Fellowship Training Curriculum for Breast Imaging

Since the publication of the most recent breast imaging resident and fellowship curriculum in 2013, there have been widespread changes to the field of breast imaging. Screen-film mammography has been nearly completely replaced, and there has been widespread adoption of breast MRI and digital breast tomosynthesis. Fellowship training programs are increasingly one year in length, which accommodates the rapidly evolving subspecialized field of breast imaging. Recent surveys have identified deficits in nonclinical training related to patient communication and practice audits. This updated fellowship curriculum focuses on four discrete skill sets: clinical, noninterpretive, collaborative, and scholarly. Updates to the clinical curriculum include familiarity with new and emerging imaging technologies and biopsy techniques, as well as a more comprehensive understanding of breast pathology and appropriate follow-up and/or treatment recommendations. There is an increased focus on noninterpretive skills related to the practice audit and quality control. A formal communication curriculum tailored toward discussions with patients is highly recommended. The collaborative value of multidisciplinary care and the benefits of mentorship are emphasized. Finally, scholarly activities including both the opportunity for teaching and research, as well as dedicated lectures and journal clubs, will establish a platform for lifelong learning. This updated curriculum, which has been approved by the Executive Committee of the American College of Radiology and the Society of Breast Imaging Board of Directors, is designed to develop well-rounded fellowship graduates who are positioned to be breast imaging leaders within their future practices.

Lessons learned during the COVID-19 pandemic: a single institution radiology chief resident experience

Coronavirus Disease 2019 (COVID-19) has posed incredible new challenges for radiology residency programs, including resident training under tenuous and uncertain conditions, barriers to communication, deployment-induced anxiety, and social isolation. Chief residents and program leadership play a critical role in guiding radiology residents through these unprecedented times. Best practices and creative approaches experienced in a single institution's residency program located in New York City are shared in an effort to encourage other programs struggling with similar obstacles to prioritize resident education and wellness.

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COVID-19 has posed incredible challenges for radiology residency programs.

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Lessons learned by radiology chief residents from a NYC institution are shared.

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The importance of communication, preparation, leadership, education and wellness in a radiology residency are discussed.