E-learning in radiology: an Italian multicentre experience

The use of technology in postgraduate medical education within radiology: a scoping review

Postgraduate radiology training has traditionally followed didactic approaches; however, complex reasoning skills and critical thinking are essential in the field of radiology. Therefore, the shortages of radiologists in Africa have necessitated the need to review the use of technology in postgraduate education to improve efficient training and service. This scoping review was conducted to map the evidence on the role of technology in postgraduate radiology education and practice. A systematic scoping review search strategy was undertaken to review material published between January 2005 and August 2020 on the use of technology in radiology education. Data from the included studies were extracted and analyzed for emerging themes and presented in response to the research question. Seven articles described studies from the African continent. The most popular technological intervention was telemedicine, and several niche areas of technology implementation were identified (blended learning, flipped learning, digital teaching files). Furthermore, the most challenging aspects relating to technology use remain fiscal and credentialing constraints. Technology plays a role in postgraduate radiology education through networks, synchronous and asynchronous applications. It has the potential to increase support to doctoral students in the African context and alleviate some stressors associated with traditional, face-to-face didactic programs.

A narrative review of e-learning in professional education of healthcare professionals in medical imaging and radiation therapy

OBJECTIVES

This literature review attempts to explore the characteristics of e-learning tools used to develop the qualifications and skills of healthcare professionals in medical imaging and radiation therapy, and to promote the effectiveness and acceptance of e-learning through highlighting the outcomes of its implementation where applicable.

KEY FINDINGS

From the literature search in the PubMed and ResearchGate databases we concluded to 21 articles, which were included in the qualitative synthesis. Acceptance of e-learning tools was confirmed. Also, e-learning can be part of healthcare professionals' blended learning. The acquisition of new or improvement of existing knowledge, the improvement of clinical skills and the increase of the self-confidence of healthcare professionals in their daily practice were recorded, as outcomes of the e-learning implementation. The importance of human-computer interaction for the comprehension of theoretical concepts and practical aspects using multimedia was also captured. No significant findings emerged among the 21 articles against the adoption of the e-learning for the training of healthcare professionals. The Internet is the channel used for synchronous and asynchronous interaction of trainees with instructors.

CONCLUSIONS

We concluded that e-learning is an attractive training method, equally or occasionally more effective than the traditional educational methods for the lifelong training of healthcare professionals in the field of medical imaging and radiation therapy. Also, many collaborative web-based applications provide the necessary means to build an e-learning program, according to the training needs of each professional team.

IMPLICATIONS FOR PRACTICE

This new knowledge corroborates the perspective of e-learning beneficial contribution to remote interaction and collaboration of healthcare professionals in medical imaging and radiation therapy. Collaborative web-based tools are already available to decision makers and stakeholders, who want to develop an e-learning program.

Development and Assessment of a Gastroscopy Electronic Learning System for Primary Learners: Randomized Controlled Trial

Background

Endoscopic examination is a popular and routine procedure for the diagnosis and treatment of gastrointestinal (GI) diseases. Skilled endoscopists are in great demand in clinical practice, but the training process for beginners to become endoscopy specialists is fairly long. Convenience and a self-paced, learner-centered approach make electronic learning (e-learning) an excellent instructional prospect.

Objective

This study aimed to develop and apply an e-learning system in gastroscopy teaching and learning and to evaluate its effectiveness and user satisfaction.

Methods

The e-learning software Gastroscope Roaming System was developed for primary learners. The system simulates the real structure of the upper gastrointestinal (UGI) tract to teach the main characteristics of gastroscopy under both normal conditions and conditions of common UGI tract diseases. A randomized controlled trial was conducted. Participants were randomly allocated to an e-learning group (EG)or a non–e-learning control group after a pretest. On completing the training, participants undertook a posttest and gastroscopy examination. In addition, the EG completed a satisfaction questionnaire.

Results

Of the 44 volunteers, 41 (93%) completed the gastroscopy learning and testing components. No significant pretest differences were found between the intervention and control groups (mean 50.86, SD 6.12 vs mean 50.76, SD 6.88; P=.96). After 1 month of learning, the EG’s posttest scores were higher (mean 83.70, SD 5.99 vs mean 78.76, SD 7.58; P=.03) and improved more (P=.01) than those of the control group, with better performance in the gastroscopy examination (mean 91.05, SD 4.58 vs mean 84.38, SD 5.19; P<.001). Overall, 85% (17/20) of the participants were satisfied with the e-learning system, and 95% (19/20) of the participants considered it successful.

Conclusions

E-learning is an effective educational strategy for primary learners to acquire skills in gastroscopy examination and endoscopic imaging of the GI tract.

Trial Registration

Chinese Clinical Trial Registry ChiCTR-IOR-17013091; http://www.chictr.org.cn/showproj.aspx?proj=22142

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.

Student and recent graduate perspectives on radiological imaging instruction during basic anatomy courses

Recently, faculty at Pritzker School of Medicine, The University of Chicago, have made efforts to improve the depth of radiological anatomy knowledge that students have, but no insights exist as to student and resident opinions of how clinically helpful deep anatomical understanding is. A single-institution survey of second- and fourth-year medical students and postgraduate year 1-4 residents from 11 specialties, composed of five-point Likert questions, sample examination questions, and narrative response questions, was distributed in 2015. One hundred seventy-seven of the 466 potential respondents replied (71 residents and 106 students), response rate 38.0%. No nonresponse bias was present in two separate analyses. Respondents generally favored a superficial "identification" question as more relevant to clinical practice, which was positively associated with increasing clinical experience ρ = 0.357, P < 0.001 by point-biserial correlation. Students and residents most commonly used self-directed methods to learn medical imaging during their medical anatomy courses (72.6 and 57.7%, respectively). Small group education was least commonly used by students and residents (45.3 and 39.4%, respectively), but most commonly recommended (62.3 and 69%, respectively). A total of 56.6 and 64.8% of students and residents, respectively, reported that having multiple learning methods was "quite" or "extremely" important. Respondents with more clinical experience were more likely to report that a superficial identification question was more clinically relevant than a question testing deeper radiological anatomy knowledge. Small group learning was preferred among students and residents but was the least commonly employed method of instruction. Both findings contrast starkly with current radiological anatomy instructional understanding and practices. Anat Sci Educ 11: 25-31. © 2017 American Association of Anatomists.

Radiology education in Europe: Analysis of results from 22 European countries

AIM

To assess the state of radiology education across Europe by means of a survey study.

METHODS

A comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo (January-April 2016). Survey questions include length of medical school and residency training; availability of fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize data.

RESULTS

Radiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55% (12 out of 22) European countries. Subspecialty fellowship training is offered in 55% (12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22 (41%) European countries have research requirements during residency. The types of certifying exam show variation where 64% (14 out of 22) European countries require both written and oral boards, 23% (5 out of 22) require oral examinations only, and 5% (1 out of 22) require written examinations only. A degree in medical physics is offered in 59% (13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are required.

CONCLUSION

Comparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide.

A large survey among European trainees in clinical microbiology and infectious disease on training systems and training adequacy: identifying the gaps and suggesting improvements

The purpose of this investigation was to perform a survey among European clinical microbiology (CM) and infectious disease (ID) trainees on training satisfaction, training tools, and competency assessment. An online, anonymous survey in the English language was carried out between April and July 2015. There were 25 questions: seven in a 5-point Likert scale (1: worst scenario, 5: best scenario) and the remainder as closed multiple-choice questions in five areas (satisfaction, adequacy, system, mentorship, and evaluation of training). Included were 419 respondents (215 CM, 159 ID, and 45 combined CM/ID) from 31 European countries [mean age (standard deviation) 32.4 (5.3) years, 65.9 % women]. Regarding satisfaction on the training scheme, CM and ID scored 3.6 (0.9) and 3.2 (1.0), respectively. These scores varied between countries, ranging from 2.5 (1.0) for Italian ID to 4.3 (0.8) for Danish CM trainees. The majority of respondents considered training in management and health economics inadequate and e-learning and continuing medical education programs insufficient. Many trainees (65.3 % of CM and 62.9 % of ID) would like to have more opportunities to spend a part of their training abroad and expected their mentor to be more involved in helping with future career plans (63.5 % of CM and 53.4 % of ID) and practical skills (53.0 % of CM and 61.2 % of ID). Two-thirds of the respondents across the specialties agreed that a European exam should be developed, but half of them thought it should not be made mandatory. This survey shows high heterogeneity in training conditions in European countries, identifies perceived gaps in training, and suggests areas for improvements.

A combination of traditional learning and e-learning can be more effective on radiological interpretation skills in medical students: a pre- and post-intervention study

BACKGROUND

The ability to interpret an X-Ray is a vital skill for graduating medical students which guides clinicians towards accurate diagnosis and treatment of the patient. However, research has suggested that radiological interpretation skills are less than satisfactory in not only medical students, but also in residents and consultants.

METHODS

This study investigated the effectiveness of e-learning for the development of X-ray interpretation skills in pre-clinical medical students. Competencies in clinical X-Ray interpretation were assessed by comparison of pre- and post-intervention scores and one year follow up assessment, where the e-learning course was the 'intervention'.

RESULTS

Our results demonstrate improved knowledge and skills in X-ray interpretation in students. Assessment of the post training students showed significantly higher scores than the scores of control group of students undertaking the same assessment at the same time.

CONCLUSIONS

The development of the Internet and advances in multimedia technologies has paved the way for computer-assisted education. As more rural clinical schools are established the electronic delivery of radiology teaching through websites will become a necessity. The use of e-learning to deliver radiology tuition to medical students represents an exciting alternative and is an effective method of developing competency in radiological interpretation for medical students.

How Turkish radiology residents access information related to their profession in this social media and smartphone era

Purpose

To evaluate the frequency of mobile technology and social media usage among radiology residents and their access to professional information.

Materials and methods

A questionnaire consisting of 24 questions prepared using Google Drive was sent via e-mail to 550 radiology residents throughout the country. Of the 176 participating residents, 74 completed the survey via the internet, and 102 completed it at three different national radiology meetings. Response rates and its relationship with responses given to different questions were assessed.

Results

Hundred two male and 74 female residents participated in the survey. 141 (81.3%) residents thought that they had appropriate internet access in their department. The number of residents using a smartphone was 153 (86.9%). The android operating system (70, 45.8%) was the preferred operating system of respondants. Only 24 (15.7%) of the smartphone users thought that there were enough radiology related applications. “Radiology assistant” (18.9%), “Radiopedia” (7.8%) and “Radiographics” (7.8%) were the most utilized applications. Of the smartphone users, 87(56.9%) stated that they used cell phones in order to find radiological information, and the most used web pages were Google (165, 93.8%), Radiopaedia.org (129, 73.3%), Radiologyassistant.nl (135, 76.7%), and Pubmed (114, 64.8%). Social media usages were as follows: None (10, 5.7%), Facebook (139, 79%), Twitter (55, 31.3%), Google + (51, 29%) and YouTube (44, 25%).

Conclusion

While smartphone usage rates among the residents were high, the use of radiology specific applications was not common. Social media usage was very common among residents.

Development and assessment of an e-learning course on breast imaging for radiographers: a stratified randomized controlled trial

BACKGROUND

Mammography is considered the best imaging technique for breast cancer screening, and the radiographer plays an important role in its performance. Therefore, continuing education is critical to improving the performance of these professionals and thus providing better health care services.

OBJECTIVE

Our goal was to develop an e-learning course on breast imaging for radiographers, assessing its efficacy, effectiveness, and user satisfaction.

METHODS

A stratified randomized controlled trial was performed with radiographers and radiology students who already had mammography training, using pre- and post-knowledge tests, and satisfaction questionnaires. The primary outcome was the improvement in test results (percentage of correct answers), using intention-to-treat and per-protocol analysis.

RESULTS

A total of 54 participants were assigned to the intervention (20 students plus 34 radiographers) with 53 controls (19+34). The intervention was completed by 40 participants (11+29), with 4 (2+2) discontinued interventions, and 10 (7+3) lost to follow-up. Differences in the primary outcome were found between intervention and control: 21 versus 4 percentage points (pp), P<.001. Stratified analysis showed effect in radiographers (23 pp vs 4 pp; P=.004) but was unclear in students (18 pp vs 5 pp; P=.098). Nonetheless, differences in students' posttest results were found (88% vs 63%; P=.003), which were absent in pretest (63% vs 63%; P=.106). The per-protocol analysis showed a higher effect (26 pp vs 2 pp; P<.001), both in students (25 pp vs 3 pp; P=.004) and radiographers (27 pp vs 2 pp; P<.001). Overall, 85% were satisfied with the course, and 88% considered it successful.

CONCLUSIONS

This e-learning course is effective, especially for radiographers, which highlights the need for continuing education.