Undergraduate radiology education: foundation doctors' experiences and preferences

Medical Image sharing: What do the public see when reviewing radiographs? A pilot study

INTRODUCTION

Policymakers wish to extend access to medical records, including medical imaging. Appreciating how patients might review radiographs could be key to establishing future training needs for healthcare professionals and how image sharing could be integrated into practice.

METHOD

A pilot study in the UK using a survey was distributed to adult participants via the online research platform Prolific. All subjects were without prior professional healthcare experience. Participants reviewed ten radiographs (single projection only) and were asked a two-stage question. Firstly, if the radiograph was 'normal' or 'abnormal' and secondly, if they had answered 'abnormal', to identify the abnormality from a pre-determined list featuring generic terms for pathologies.

RESULTS

Fifty participants completed the survey. A mean of 65.8 % of participants were able to correctly identify if radiographs were normal or abnormal. Results in relation to the identification of a pathology were not as positive, but still notable with a mean of 46.4 % correctly identifying abnormalities. Qualitative data demonstrated that members of the public are enthralled with reviewing radiographs and intrigued to understand their performance in identifying abnormalities.

CONCLUSION

In the pilot, members of the public could identify if a radiograph is normal or abnormal to a reasonable standard. Further detailed interpretation of images requires supportive intervention. This pilot study suggests that patients can participate in image sharing as part of their care. Image sharing may be beneficial to the therapeutic relationship, aiding patient understanding and enhancing consultations between healthcare professional and patient. Further research is indicated.

End-of-degree projects in radiology in Spanish universities

The End-of-Degree Project (TFG) is a supervised research project that medical students must carry out before graduating. This study aims to make radiology teaching staff aware of the importance of getting involved in tutoring radiology TFGs. We provide recommendations to help encourage students choose our area and carry it out. We describe the TFG regulations for the subject of medicine as well as data on TFGs carried out both in medicine in general, and more specifically in radiology between 2018 and 2022. The total number of radiology TFGs was 181, accounting for 3.3% of the 5349 TFGs carried out in medicine. There was a discrepancy between the results found on the websites, those expected according to the number of graduates and those provided by the teachers contacted. We would consider reasonable a percentage of TFGs in radiology proportional to the number of credits of this subject during the degree course and the number of lecturers in this subject.

Knowledge, Attitude, and Practice of Diagnostic Radiology Among Clinical Year Medical Students

Background Nowadays, radiology is considered one of the most important disciplines of medicine as it guides physicians to reach the proper diagnosis by using many types of medical imaging modalities, such as x-ray radiography, computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI). These modalities are used to create dynamic images of different parts of the human body, which are being used to accurately diagnose and follow up on a variety of medical conditions. Moreover, in recent decades, radiology has experienced substantial growth and transformation, establishing itself not just in diagnostics but also in the domain of medical interventions, which includes the increasingly recognized discipline of interventional radiology. Methodology A descriptive cross-sectional study was conducted at Umm Al-Qura University (UQU) in Makkah from October 2022 to April 2023. The population size of medical students from the fourth to sixth year at Umm Al-Qura University is about 820 students. Results The total number of participants was 359, but two did not fill out properly. Hence, data was analyzed for (n=357), whereas more than half of them were female, 195 (54.6%). About 133 (37%) of the students were in their sixth year, while 106 (29%) were in their fourth year. Regarding their grade point average (GPA), 209 (58%) had >3.5, and 119 (33%) had 3.0-3.5. The maximum number of females 77 (57.9%) students were in the sixth year. Regarding knowledge, 291 (81.5%) had heard about interventional radiology before, while 66 (18.5%) had never heard about interventional radiology before. Moreover, 270 (75.6%) believe that the years in radiology residency are the same as other specialties. Regarding perceived knowledge about radiology, 183 (51.3%) said it is adequate. Conclusion This study showed that medical students at Umm Al-Qura University have a positive attitude towards radiology. However, the majority of the students do not have adequate knowledge regarding radiology as well as radiation hazards. We can improve this by increasing radiology experience in our institutions. Also, courses should be designed and incorporated into the curriculum to increase the knowledge of medical students about ionizing radiation.

Radiology image interpretation services in a low-resource setting: Medical doctors' experiences and the potential role of radiographers

INTRODUCTION

Medical doctors can encounter significant challenges in both the radiology image interpretation service and their ability to interpret images to promote effective patient management. This study aimed to explore the experiences of medical doctors in a low-resource setting regarding the image interpretation service received in state-funded hospitals and the potential role of radiographers.

METHODS

A qualitative approach with a descriptive phenomenology design was employed. Thirteen medical officers and medical interns, with a maximum of three years of experience, were purposively selected from three state-funded hospitals. Semi-structured interviews were conducted in English, and data analysis followed the conventional content analysis method using Atlas.ti for Windows (version 9).

RESULTS

Three main themes emerged from the data. The first theme was a poor image interpretation service which highlighted issues such as long turnaround times for image reporting and compromised patient management. The second theme was training and support deficiency which revealed the inadequacy of image interpretation training and the need for additional on-the-job support. The third theme was the inconspicuous radiographer role which showcased the potential opportunities for radiographers to aid in filling the gaps in the image interpretation system.

CONCLUSION

Medical doctors in this low-resource setting experience significant delays in radiology image interpretation, leading to compromised patient management. Their training in image interpretation is inadequate, and they often lack on-the-job support. Radiographers potentially play a role in image interpretation which may provide solutions to these contextual challenges.

IMPLICATIONS FOR PRACTICE

There is a need to review and develop a comprehensive image interpretation system that effectively supports medical doctors in image interpretation, possibly involving the collaboration of radiographers.

One-week radiology boot camp for pre-clerkship medical students: A novel format improving image interpretation and confidence

RATIONALE AND OBJECTIVES

To measure change in radiology knowledge, confidence in radiology skills, and perceptions pertaining to radiology following a one-week boot camp elective for undergraduate medical students.

MATERIALS AND METHODS

A five-day comprehensive radiology boot camp was developed including sessions on image interpretation, procedural skills, and appropriate image ordering. A multiple-choice quiz was administered before and after the elective, utilizing radiology questions from the validated AMSER STARS database. Additionally, a pre- and post-elective survey was administered assessing radiology career interest, confidence in radiology-based skills, and the potential ability of radiology-based skills to increase confidence in specialties other than radiology. Responses from the assessments were analysed using paired t-tests.

RESULTS

15 students enrolled in the course and 14 completed all assessments. The average score on the quiz increased from 50.1% to 66.0% (p<0.001). On the post-elective survey, the average student confidence score increased by more than one point on a six-point Likert scale in each of radiographic interpretation (p=0.004), ultrasound interpretation (p=0.0002), CT/MRI interpretation (p=0.02), general radiology knowledge including procedural skills (p=0.0001), and appropriate image ordering (p=0.004). Average student satisfaction with the elective was 8.1 out of 10.

CONCLUSION

A one-week radiology boot camp for pre-clerkship medical students improved radiology knowledge and confidence in radiology skills, showing potential for this format to meet the demand for increased radiology content in undergraduate training. Students indicated that confidence in radiology knowledge would increase confidence on non-radiology clerkship rotations, highlighting the importance of how a one-week radiology bootcamp can impact both future radiology and non-radiology clerkship experiences.

The current situation of Radiology training in medical studies in Spain

Radiology is now an essential part of Clinical Medicine, but undergraduate training does not reflect its importance in medical practice. In the current course, there are 46 medical schools in our country. According to the information published on the institutional websites, the study plans are very different in terms of the presence of Diagnostic Radiology and the organization of teaching. The estimated number of teaching hours in diagnostic radiology (mean ± standard deviation) is 61.3 ± 22.2 h (range from 26 h to 137 h). There is a great shortage of clinical university professors, and a generational change is essential. The current situation poses various challenges, including adapting to new teaching methods and technologies and promoting the presence of radiology in medical study plans, paying special attention to hospital practices, the Final Degree Project (FDP) and the Objective Structured Clinical Examination (OSCE).

"Seeing is believing": myth or maxim? Mimics of pathology on paediatric chest imaging studies

Appreciating the importance of correct interpretation of radiological studies, the need for space for further education and experience, and the recognition that interpretative errors often occur, we present below a case series highlighting situations where all may not be as it first appears.

Trauma radiology teaching for foundation doctors working within the Scottish Trauma Network improves radiology requests and patient safety: a multidepartmental quality improvement project

The importance of radiology in trauma management is particularly relevant today as Scotland develops its Scottish Trauma Network. Trauma and radiology are scarcely covered in the 2016 and 2021 Foundation Programme Curriculum. Trauma is a significant and endemic public health challenge, while radiology is ever growing in use as a diagnostic and interventional tool. Currently, the majority of radiological investigation requests in trauma are made by foundation doctors. Accordingly, there is an urgent need to ensure foundation doctors are adequately trained in trauma radiology. This prospective, multidepartmental quality improvement project at a single major trauma centre primarily analysed the impact of trauma radiology teaching on the quality of foundation doctors' radiology requests according to Ionising Radiation Medical Exposure Regulations (IRMER) criteria. As a secondary outcome, the impact of teaching on patient safety was also evaluated. 50 foundation doctors across three departments dealing with trauma patients had their trauma radiology requests analysed before and after the intervention of trauma-focused radiology teaching. Results showed cancelled and altered radiology requests decreased from 20% to 5% and from 25% to 10%, respectively, with a p value of 0.01. This translated to fewer delays in trauma patients receiving radiological investigations. The foundation curriculum would benefit from the introduction of trauma radiology teaching for its foundation doctors, in parallel to the demands of a growing national trauma network. Education globally improves radiology request quality by raising awareness and respect of IRMER criteria and ultimately leads to positive changes for patient safety.

Knowing the ABCs: teaching the principles of radiology to medical students in Turkey

BACKGROUND

Radiology education in Turkey is mainly taught during clinical years of medical school and often lacks main principles. Exposure to the fundamentals of radiology at an early stage of medical education may drastically help students generate a better understanding of radiology and expand their interest in the specialty. With the Principles of Radiology Course that we provided, pre- and post-session tests, and assessment survey at the end of the course, we aimed to evaluate the effectiveness of such an online course among Turkish medical students.

METHODS

A total of nine online sessions on imaging modalities principles was developed by radiology professors. Each session was given through Zoom by radiologists from different U.S.-institutions to Turkish medical students from state (n = 33) and private (n = 8) universities. Pretests and post-tests were given to participants via Qualtrics before and after each session, respectively. Paired two-sample t-tests were conducted to detect the variance and p=-.05 was used as the significance level. An evaluation survey was distributed at the end of the course to collect their feedback through SurveyMonkey.

RESULTS

A total of 1,438 predominantly Turkish (99.32%) medical students engaged with this course. An average of 506 students completed both pre-test and post-test. There was a statistically significant (p < .001) increase in the scores in post-test (mean[range]:7.58[5.21-8.53]) relative to pre-test (mean[range]:5.10[3.52-8.53]). Four hundred and thirty-nine participants (F/M:63.33%/35.54%) completed the end-of-course survey. A total of 71% and 69.70% of the participants strongly agreed that the course would be useful in their clinical practice and had increased their understanding of radiology. They also reported that their level of confidence in the subjects had increased 68% and reached a weighted average of 3.09/4. The survey revealed that 396 (90.21%) of the participants strongly or somewhat agree that introductory principles and concepts should be presented in earlier years of medical education. Compared to in-person education, 358 (81.55%) found the course extremely or very convenient.

CONCLUSION

Online lecture series consisting of the principles of the radiological imaging modalities can be offered to Turkish medical students to enhance their grasp of the various imaging modalities and their correct clinical application.

Expanding our concept of simulation in radiology: a "Radiology Requesting" session for undergraduate medical students

Objectives

Whilst radiology is central to the modern practice of medicine, graduating doctors often feel unprepared for radiology in practice. Traditional radiological education focuses on image interpretation. Key areas which are undertaught include communication skills relating to the radiology department. We sought to design teaching to fill this important gap.

Methods

We developed a small group session using in situ simulation to enable final and penultimate year medical students to develop radiology-related communication and reasoning skills. Students were given realistic cases, and then challenged to gather further information and decide on appropriate radiology before having the opportunity to call a consultant radiologist on a hospital phone and simulate requesting the appropriate imaging with high fidelity. We evaluated the impact of the teaching through before-and-after Likert scales asking students about their confidence with various aspects of requesting imaging, and qualitatively through open-ended short answer questionnaires.

Results

The session was delivered to 99 students over 24 sessions. Self-reported confidence in discussing imaging increased from an average of 1.7/5 to 3.4/5 as a result of the teaching (p < 0.001) and students perceived that they had developed key skills in identifying and communicating relevant information.

Conclusions

The success of this innovative session suggests that it could form a key part of future undergraduate radiology education, and that the method could be applied in other areas to broaden the application of simulation.

Advances in knowledge

This study highlights a gap in undergraduate medical education. It describes and demonstrates the effectiveness of an intervention to fill this gap.

Attracting the next generation of radiologists: a statement by the European Society of Radiology (ESR)

With demand increasing each year for diagnostic imaging and imaging guided interventions, it is important for the radiology workforce to expand in line with need. National and international societies such as the European Society of Radiology have an important role to play in showcasing the diversity of radiology, and highlighting the key role radiologists have in patient care and clinical decision-making to attract the next generation of radiologists. Medical students are an important group to engage with early. Meaningful exposure of undergraduates to radiology with an integrated programme and clinical placements in radiology is essential. Elective courses and dedicated 1-year Bachelor or Masters imaging programmes provide medical students with an opportunity for more in-depth study of radiology practice. Undergraduate radiology societies improve opportunities for engagement and mentorship. Innovations in imaging such as augmented-reality simulation and artificial intelligence and image-guided intervention also offer exciting training opportunities. Through these opportunities, students can gain insight into the wide variety of career opportunities in radiology.

Acing the Fundamentals of Radiology: An Online Series for Medical Students and Interns

PURPOSE

The current undergraduate radiology education predominantly integrates radiology with other disciplines during preclerkship years and is often taught by nonradiologists. Early exposure to radiology and profound understanding of scientific fundamentals of imaging modalities and techniques are essential for a better understanding and interest in the specialty. Furthermore, the COVID-19 pandemic-related impact on in-person medical education aggravated the need for alternative virtual teaching initiatives to provide essential knowledge to medical students.

METHODS

The authors designed an online 7-session course on the principles of imaging modalities for medical students and fresh graduates in the United States and abroad. The course was delivered online and taught by radiologists from different US institutions. Pretests and posttests were delivered before and after each session, respectively, to assess change in knowledge. At the end of the course, a survey was distributed among students to collect their assessment and feedback.

RESULTS

A total of 162 students and interns initially enrolled in the program by completing a sign-up interest form. An average of 65 participants attended each live session, with the highest attendance being 93 live attendees. An average of 44 attendees completed both the pretest and posttest for each session. There was a statistically significant increase in posttest scores compared with pretest scores (P < 0.01) for each session; on average, the posttest scores were 48% higher than the pretest scores. A total of 84 participants answered the end-of-course survey. A total of 11% of the respondents described themselves as first year, 17% as second year, 18% as third year, 21% as fourth year, and 33% as "other." Attendees were enrolled in medical schools across 21 different countries with 35% of the respondents studying medicine in the United States. More than 76% of the respondents stated that they "strongly agree" that the program increased their understanding of radiology, increased their interest in radiology, and would be useful in their clinical practice in the future. Eighty-three percent of the respondents stated that they "strongly agree" that "this course was a worthwhile experience." Particularly, more than 84% of the respondents stated that among the most important components in enhancing their understanding of radiology were "the interpretation of normal imaging" and "interpretation of clinical cases." Ninety-two percent of the respondents stated that "the amount of effort to complete the requirements for this program was just right." Participants were also asked to rate each of the 8 sessions using the following scale: poor = 1 point, fair = 2, good = 3, and excellent = 4. The average rating for all 8 sessions was 3.61 points (SD = 0.55), which translates to 96% of the sessions being rated good or excellent. Eighty percent of the participants reported that the topics presented in the program were "excellent and clinically important to learn," and 20% of the participants reported that the topics presented were "good and somewhat important to learn." The participants were asked to evaluate their confidence regarding basic radiology skills before and after the program using the following scale: not confident at all = 1 point, somewhat confident = 2, moderately confident = 3, and very confident = 4. Figure 2 summarizes the responses of the participants.

CONCLUSIONS

An online course to teach the fundamentals of imaging modalities could be delivered through a webinar format to medical students and interns in several countries to address the potential gaps in radiology education, therefore increasing their understanding of the different imaging modalities and their proper use in medicine.

Practice-Based Learning Using Smart Class: A Competency-Based Model in Undergraduate Radiology Education

RATIONALE AND OBJECTIVES

A need for adequate and early exposure to radiology practice is rising in undergraduate students, taking competency development as the orientation. We aimed to develop a competency-based model of practice-based learning for undergraduate radiology education.

MATERIALS AND METHODS

The model of practice-based learning was constructed upon an e-learning smart class environment, with case-based learning and simulators for competency development. To assess the model effectiveness, a randomized controlled experiment was performed, where 57 third-year medical students received the model (Smart-Class group) and another 57 received traditional teaching (Traditional group). Seven quizzes, a final exam, and a survey were performed in both groups.

RESULTS

Smart-Class group achieved higher mean score in the quizzes (r = -0.4, p < 0.001) and application subscore in the final exam (r = -0.3, p = 0.005) compared to Traditional group. Smart-Class group also gave higher ratings in students' perceptions concerning promotion of learning interests, radiology skills, and diagnostic reasoning (r = -0.2 to -0.3, p = 0.001-0.034).

CONCLUSION

Practice-based learning using smart class improved students' application ability and satisfactions in undergraduate radiology education, suggesting it a practical model for early exposure to radiology practice and competency development for undergraduate medical students.

Feasibility of a paediatric radiology escape room for undergraduate education

OBJECTIVES

To develop a paediatric radiology themed escape room session for undergraduate education and secondly, to determine participant satisfaction and improvement in knowledge.

METHODS

A paediatric radiology escape room with accompanying tutorial was developed around key learning objectives set within the RCR and ESR undergraduate curriculum. Students were recruited from two different universities and undertook the escape room themed teaching. An 8-question single best answer (SBA) test was completed before, immediately after and at 2 weeks post-teaching to determine participant improvement and retention of knowledge. The general feedback was also collected.

RESULTS

The escape room sessions were held three times, for 19 students (6-7 students per session). All groups completed the escape room in ≤ 20 min. Students enjoyed the experience, assigning an average satisfaction score of 9.4/10 (range 7-10). The majority (17/19, 89.5%) preferred this method of teaching to a lecture-based tutorial alone, although all said they found the tutorial component useful. For the SBA test, there was an average increase in 3.6 marks (range 1-6 marks) per participant between before and after the escape room. This improved knowledge was mostly sustained after 2 weeks, with an average increase of 3.4 marks difference (range 1 to 6) per participant compared to before the teaching.

CONCLUSIONS

A paediatric radiology themed escape room is a feasible teaching method, enjoyed by participants and associated with an increase in radiological knowledge. Further work with larger sample size and direct comparison with other traditional teaching methods is required.