Pedagogical Approaches to Diagnostic Imaging Education: A Narrative Review of the Literature

Exploring the integration of artificial intelligence in radiology education: A scoping review

BACKGROUND

The integration of Artificial Intelligence (AI) into radiology education presents a transformative opportunity to enhance learning and practice within the field. This scoping review aims to systematically explore and map the current landscape of AI integration in radiology education.

METHODS

The review process involved systematically searching four databases, including MEDLINE (Ovid), Embase (Ovid), PsychINFO (Ovid), and Scopus. Inclusion criteria focused on research that addresses the use of AI technologies in radiology education, including but not limited to, AI-assisted learning platforms, simulation tools, and automated assessment systems. This scoping review was registered on Open Science Framework using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) extension to scoping review.

RESULTS

Of the 1081 search results, 9 studies met the inclusion criteria. Key findings indicate a diverse range of AI applications in radiology education, from personalized curriculum generation and diagnostic support tools to automated evaluation systems. The review highlights both the potential benefits, such as enhanced diagnostic accuracy, and the challenges, including technical limitations.

CONCLUSION

The integration of AI into radiology education, which has significant potential to enhance outcomes and professional practice, requires overcoming existing challenges and ensuring that AI complements rather than replaces traditional methods, with future research needed on longitudinal studies to evaluate its long-term impact.

Large Language Models as Tools to Generate Radiology Board-Style Multiple-Choice Questions

RATIONALE AND OBJECTIVES

To determine the potential of large language models (LLMs) to be used as tools by radiology educators to create radiology board-style multiple choice questions (MCQs), answers, and rationales.

METHODS

Two LLMs (Llama 2 and GPT-4) were used to develop 104 MCQs based on the American Board of Radiology exam blueprint. Two board-certified radiologists assessed each MCQ using a 10-point Likert scale across five criteria-clarity, relevance, suitability for a board exam based on level of difficulty, quality of distractors, and adequacy of rationale. For comparison, MCQs from prior American College of Radiology (ACR) Diagnostic Radiology In-Training (DXIT) exams were also assessed using these criteria, with radiologists blinded to the question source.

RESULTS

Mean scores (±standard deviation) for clarity, relevance, suitability, quality of distractors, and adequacy of rationale were 8.7 (±1.4), 9.2 (±1.3), 9.0 (±1.2), 8.4 (±1.9), and 7.2 (±2.2), respectively, for Llama 2; 9.9 (±0.4), 9.9 (±0.5), 9.9 (±0.4), 9.8 (±0.5), and 9.9 (±0.3), respectively, for GPT-4; and 9.9 (±0.3), 9.9 (±0.2), 9.9 (±0.2), 9.9 (±0.4), and 9.8 (±0.6), respectively, for ACR DXIT items (p < 0.001 for Llama 2 vs. ACR DXIT across all criteria; no statistically significant difference for GPT-4 vs. ACR DXIT). The accuracy of model-generated answers was 69% for Llama 2 and 100% for GPT-4.

CONCLUSION

A state-of-the art LLM such as GPT-4 may be used to develop radiology board-style MCQs and rationales to enhance exam preparation materials and expand exam banks, and may allow radiology educators to further use MCQs as teaching and learning tools.

Education Descriptive Reports: How to Publish Pragmatic Studies in Education

OBJECTIVE

The purpose of this article is to describe the contents of an education descriptive report and to provide a useful publication format for educators in the health professions.

DISCUSSION

The education descriptive report is a pragmatic, empirical study that can contribute to the literature. Education descriptive reports describe an event or situation in an education setting, the resulting outcomes, and what new information can be learned. These reports may use quantitative, qualitative, or mixed methods and may be from organizational, academic, instructional, programmatic, or other educational perspectives.

CONCLUSION

The education descriptive report gives educators in the health professions a mechanism to introduce their scholarly efforts and observations in education environments in a manner that is consistent with the academic literature. This article describes the structure of an education descriptive report and includes a helpful template for academic authors to develop their own report so they may publish observational, reflective, and hypothesis-generating articles.

Instructional Strategies to Enhance Dermoscopic Image Interpretation Education: a Review of the Literature

Introduction

In image interpretation education, many educators have shifted away from traditional methods that involve passive instruction and fragmented learning to interactive ones that promote active engagement and integrated knowledge. By training pattern recognition skills in an effective manner, these interactive approaches provide a promising direction for dermoscopy education.

Objectives

A narrative review of the literature was performed to probe emerging directions in medical image interpretation education that may support dermoscopy education. This article represents the second of a two-part review series.

Methods

To promote innovation in dermoscopy education, the International Skin Imaging Collaborative (ISIC) assembled an Education Working Group that comprises international dermoscopy experts and educational scientists. Based on a preliminary literature review and their experiences as educators, the group developed and refined a list of innovative approaches through multiple rounds of discussion and feedback. For each approach, literature searches were performed for relevant articles.

Results

Through a consensus-based approach, the group identified a number of theory-based approaches, as discussed in the first part of this series. The group also acknowledged the role of motivation, metacognition, and early failures in optimizing the learning process. Other promising teaching tools included gamification, social media, and perceptual and adaptive learning modules (PALMs).

Conclusions

Over the years, many dermoscopy educators may have intuitively adopted these instructional strategies in response to learner feedback, personal observations, and changes in the learning environment. For dermoscopy training, PALMs may be especially valuable in that they provide immediate feedback and adapt the training schedule to the individual's performance.

Use of Radiography for New Patients Presenting to a Chiropractic Teaching Clinic: A Cross-sectional Analysis

OBJECTIVE

The aim of this study was to identify the number and type of indications for radiographs ordered in a chiropractic teaching clinic in Malaysia.

METHODS

A cross-sectional retrospective analysis was conducted using the medical health records of new patients who presented to the International Medical University Bukit Jalil teaching clinic for chiropractic care between August 2018 and July 2019. Data about sociodemographic characteristics, region of presenting complaint, radiography ordering rates, and referral indications were collected. We compared indications reported in the patient records with those listed in the International Medical University Chiropractic Clinical Manual. We conducted χ² and logistic regression analysis to identify the association between radiography indications and the number of radiographs ordered.

RESULTS

Data were collected for 1451 patients (741 [51.1%] women and 700 [48.9%] men). The most common body region for the presenting complaint was the lumbar/pelvic region (39.0%), and the overall radiograph use rate was 2.7%, with the highest number of radiographs for the lumbar spine.

CONCLUSION

For the patient files sampled in this study, the overall radiograph order rate in the International Medical University Bukit Jalil Chiropractic teaching clinic was 2.7%.

A Single Static Breast Model Education of Ultrasound Skill in Final Year Medical Students of Burapha University

Background:

Ultrasound (US) is widely used among physicians. There has been no standardized curriculum in US for undergraduate medical students. This study aimed to assess the US image acquisition skill of final year medical students after adding 2 weeks dedicated radiology rotation.

Methods:

At our institution, there are two hospital affiliations. Two-week radiology rotation was added for the final-year students of one affiliation. These students had a chance to do the US in real-life clinical settings proctored by radiologists. At the end of the academic year, US image acquisition skill was assessed by objective structured clinical examination (OSCE) in students from both affiliations.

Results:

From 48-final-year medical students, 28 students finished the 2 week radiology rotation. OSCE mean score of the students who received radiology rotation was significantly higher than other groups with a score of 65.5 compared to 53.3, respectively (P = 0.006). The student background characteristics had no relationship with the OSCE score (P = 0.565).

Conclusion:

Results showed that exposure through a dedicated radiology rotation in only 2 weeks is helpful to improve the US skill of the medical students regardless of their background performances. Exposure to live patients is essential for students' experiences. OSCE can be used as a standardized assessment tool.

Radiology-Pathology Conference: Reviving the Art of Oral Case Presentation in Residency

RATIONALE AND OBJECTIVES

To improve resident oral case communication and preparatory skills by providing residents an opportunity to prepare for and conduct a new interdisciplinary Radiology-Pathology (Rad-Path) conference series.

MATERIALS AND METHODS

To assess whether conference goals were being achieved, we surveyed trainees and attendings in the radiology and pathology departments. Percentages were examined for each variable. Mann-Whitney U test for ordinal variable significance was applied to determine statistical significance between radiology trainee and attending survey responses.

RESULTS

Most surveyed radiology trainees (57.1%) strongly agreed or agreed with: "I wish I felt more comfortable with oral presentations." Sixty-five percent of radiology attendings (34 of 52) either agreed or strongly agreed that the residents should be more comfortable with oral case presentations. Of resident Rad-Path conference presenters, 69% (9 of 13) either agreed or strongly agreed that the conference improved their confidence and/or ability to present case information orally. Of responders who attended at least one Rad-Path conference in person, 83% of residents (19/23) and 61% (17/28) of attendings agreed or strongly agreed that the conference improved their ability to formulate a differential diagnosis. Using the Mann-Whitney U test, no significant difference was found between radiology trainees and attendings' responses.

CONCLUSIONS

Our Rad-Path correlation conference was specifically designed and structured to provide residents with focused experience in formal oral case preparation and presentation. We consider our conference a success, with 69% of resident presenters reporting that the Rad-Path conference improved their confidence and/or ability to present case information orally.