Radiology Education in the 21st Century: Threats and Opportunities

A model for teaching radiology to clinical specialty trainees: A pilot study in pediatric neuroradiology and neonatology

This article describes the development and assessment of a neuroimaging curriculum for neonatology fellows. The curriculum is focused on topics that are relevant to the practice of neonatology and employs contemporary teaching methods, such as flipped classroom, learner engagement, and spaced repetition. Since its implementation 2018 the curriculum has been appreciated by our trainees and demonstrated improvements in trainee knowledge.

Changes in MRI Workflow of Multiple Sclerosis after Introduction of an AI-Software: A Qualitative Study

The purpose of this study was to explore the effects of the integration of machine learning into daily radiological diagnostics, using the example of the machine learning software mdbrain® (Mediaire GmbH, Germany) in the diagnostic MRI workflow of patients with multiple sclerosis at the University Medicine Greifswald. The data were assessed through expert interviews, a comparison of analysis times with and without the machine learning software, as well as a process analysis of MRI workflows. Our results indicate a reduction in the screen-reading workload, improved decision-making regarding contrast administration, an optimized workflow, reduced examination times, and facilitated report communication with colleagues and patients. Our results call for a broader and quantitative analysis.

Medical students within the Radiology Departments: Drawback or opportunity?

University Radiology training has been carried out for years out of the Radiology Departments, where radiologists play their professional role. However, the educational needs and the leadership of the Scientific Societies make the Radiology Departments to be involved more and more in that training, though it has to be done in overloaded professional environments where medical students can be seen as a drawback. Nevertheless, radiologists must play an important role in the Radiology training of the future doctors for optimising the use of diagnostic imaging techniques and enhance the future of the specialty by bringing to our Departments those medical students who had demonstrated the most adequate personal profiles. The Radiology Department is that place to succeed by increasing the healthcare outcomes, the research results and the visibility of Radiology through a fruitful interaction between radiologists and medical students.

Radiology for anatomy educators: Success of an online, 2-day course for radiology training

Incorporation of radiology training into anatomy education from community college to health professional schools is becoming increasingly popular. However, anatomy educators generally lack training in common radiology modalities, including X-ray, CT, MRI, and ultrasound. Professional development or continuing education courses provide current and new educators the chance to gain new skills within a short timeframe. Here, a 2-day, online course for anatomy educators was created. The goals of which were for the participants: to gain basic knowledge of different radiology modalities, recognize normal radiographic images, and apply that information to common diseases or injuries in interactive case studies. Each day focused on different modalities, where Day 1 studied X-ray, CT, and MRI; and Day 2 studied Ultrasound. A 10-question pre- and post-test was taken by attendees for each day of instruction on a voluntary basis. Following the completion of the course, attendees were provided a survey to determine their perceptions on course content and knowledge acquired. Most attendees instructed undergraduates at 4-year universities, though several attendees came from community colleges and high schools. All attendees showed a significant improvement in knowledge from their pre- to post-test scores in X-ray, CT, MRI, and ultrasound following training. This was also reflected in their survey responses, where attendees felt the course was effective in increasing their knowledge and confidence in radiology. Overall, this study demonstrates the effectiveness of online continuing education courses and the need for more introductory radiology courses for anatomy educators.

AUR Radiology Resident Core Curriculum Lecture Series - A Model for Multi-Society Collaborative Virtual Education

To fulfill ACGME requirements, radiology residency programs are required to provide an educational experience that includes a core didactic curriculum for each subspecialty. Although developing and delivering such a core curriculum may not present a problem for large academic programs, it can present a significant challenge for smaller programs with limited faculty in each subspecialty area. Success of the core curriculum lectures series developed for cardiothoracic radiology by the Society of Thoracic Radiology and for musculoskeletal radiology by the International Skeletal Society in collaboration with the Society for Skeletal Radiology prompted the idea of creating a comprehensive core curriculum lecture series encompassing all subspecialties. This paper aims to describe the multi-society collaborative effort entailed in building a curated, on line resident focused core curriculum lecture series detailing the barriers encountered, effects of the COVID-19 pandemic and impact of the finished project.

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.

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.

The Short and the Long of It: Transitioning to a Blended Longitudinal Curriculum in Radiology

PURPOSE

The aim of this study was to demonstrate that the transition from a stand-alone radiology clerkship block to a longitudinally integrated radiology curriculum leverages newer teaching tools favored by today's learners.

METHODS

In 2013 and 2014, medical students attended a dedicated 1-week radiology clerkship course. In 2015, the block clerkship model for radiology transitioned to a vertically integrated curriculum. By 2019, radiology content was integrated into many of the health illness and disease course blocks. Pre- and postcourse multiple-choice questions tests as well as anonymous surveys were administered for both clerkship and integrated curriculum blocks. The student survey questions assessed perceptions regarding interpretation skills, imaging modality knowledge, and radiologists' roles.

RESULTS

Among 197 total students in the clerkship block, surveys were completed by 170 respondents, yielding a response rate of 86.3%. Among 106 students in the longitudinal course, surveys were completed by 71 respondents, yielding a response rate of 67%. For both clerkship and longitudinally integrated courses, the average number of correct responses after completion of the courses was significantly greater than the average number of correct precourse responses. Compared with students in the clerkship block curriculum, students in the longitudinal curriculum demonstrated a significantly greater frequency of agreement in response to survey questions regarding significant exposure to radiology, feeling comfortable interpreting CT images, and being familiar with how to use the ACR Appropriateness Criteria.

CONCLUSIONS

Transitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.

Web-Based Radiology Learning Module Design: The Author Perspective

RATIONALE AND OBJECTIVES

Over recent years, e-learning has become an integral component of radiology education. While demands for innovative, interactive e-learning resources have increased, the availability of viable solutions have not kept pace. As a result, many educators are authoring their own e-learning content. This study describes the six-year experience of faculty clinician educators and residents who participated in this authoring process.

MATERIALS AND METHODS

From 2014 to 2020, 62 radiology faculty and residents created a total of 89 peer reviewed web-based learning modules. Authors were given instructions and materials to support their design process. Following completion of their module(s), authors were asked to complete an anonymous and voluntary survey on their perspective.

RESULTS

Hundred percent of survey respondents reported that they enjoyed creating their module and 97.8% would recommend the experience to others. Reported educational value of authoring a learning module was 4.18 per 5, with 65% of resident authors reporting that they felt more likely to retain the information they learned through authoring a module rather than reading a chapter on the same topic. A total of 77.3% of respondents reported that the experience would make them more likely to teach medical students in the future.

CONCLUSION

With the appropriate resources and support, radiology faculty and residents succeed in authorship of innovative e-learning modules for medical student learners. In addition to enhancing subject matter knowledge and satisfying Accreditation Council for Graduate Medical Education requirements for teaching and scholarly activity, authorship provides mentoring opportunities and cultivates interest in medical student education.

Panoramic Dental Reconstruction for Faster Detection of Dental Pathology on Medical Non-dental CT Scans: a Proof of Concept from CT Neck Soft Tissue

Even though teeth are often included in the field of view for a variety of medical CT studies, dental pathology is often missed by radiologists. Given the myriad morbidity and occasional mortality associated with sequelae of dental pathology, an important goal is to decrease these false negatives. However, given the ever-increasing volume of cases studies that radiologists have to read and the number of structures and diseases they have to evaluate, it is important not to place undue time restraints on the radiologist to this end. We hypothesized that generating panoramic dental radiographs from non-dental CT scans can permit identification of key diseases, while not adding much time to interpretation. The key advantage of panoramic dental radiographs is that they display the plane of the teeth in two dimensions, thereby facilitating fast and accurate assessment. We found that interpreting panoramic radiographic reconstructions compared to the full CT volumes reduced time-to-diagnosis of key dental pathology on average by roughly a factor of four. This expedition was statistically significant, and the average time-to-diagnosis for panoramic reconstructions was on the order of seconds, without a loss in accuracy compared to full CT. As such, we posit that panoramic reconstruction can serve as a one-slice additional series in any CT image stack that includes the teeth in its field of view.

Radiology Mentoring Program for Early Career Faculty-Implementation and Outcomes

OBJECTIVE

To implement a mentoring program for early career faculty in an academic radiology department and to assess its impact on career development.

METHODS

A formal departmental mentoring program for early career faculty (instructors) who were paired with senior radiologists outside of their division was implemented. The program provided structured one-on-one mentoring, creation of a mentoring network, and opportunities for peer mentoring. A survey was conducted before and 1 year after initiation of the program. Historical data on promotion over 5 years before the implementation of the program was used to determine the impact on the rate of promotion. The study was exempt from institutional review board approval.

RESULTS

Before and 1 year after implementation of the mentoring program, 57% versus 86% of instructors were satisfied with their mentor (P = .04); 43% versus 90% felt that by encouraging mentorship, the department valued their professional development (P = .001); 38% versus 86% felt that the department created an environment that promoted feedback and sharing of information (P = .002); and 43% versus 76% felt that faculty strove to support each other (P = .03). Since implementation of the program, 43% of instructors received grant funding, 50% received other awards, and 10 instructors were promoted to assistant professor, compared with an average of 4.2/y over the past 5 years. Of those, three were underrepresented minorities in medicine versus none in the previous 5 years.

CONCLUSIONS

A mentoring program helped to advance the careers of early career and minority radiology faculty and helped create an atmosphere of more openness and support in the department.

Radiological 'SATs' monitor: The use of 'study ascribable times' to assess the impact of clinical workload on resident training in a resource-limited setting

INTRODUCTION

Globally, increasing clinical demands threaten postgraduate radiology training programmes. Time-based assessment of clinical workload is optimal in the academic environment, where an estimated 30% of consultant time should ideally be devoted to non-reporting activities. There has been limited analysis of the academic radiologist workload in low- and middle-income countries.

METHODS

Departmental staffing and clinical statistics were reviewed for 2008 and 2017. The Royal Australian and New Zealand College of Radiologists 'study ascribable times' (RANZCR-SATs) for primary consultant reporting were used with the Royal College of Radiologists (RCR) 2012 guidelines for secondary review of resident reports, to estimate the total consultant-hours required for each year's clinical workload. Analyses were stratified by type of investigation (plain-film vs. special) and expressed as a proportion of the total annual available consultant working hours.

RESULTS

Reporting all investigations required 90% and 100%, while reporting special investigations alone, demanded 53% and 69% of annual consultant working hours in 2008 and 2017, respectively. Between 2008 and 2017, the proportion of consultant time available for plain-film reporting decreased from 17% to 1%, while preserving 30% for non-reporting activities.

CONCLUSION

A time-based analysis of the academic radiologist's clinical workload, utilizing the RANZCR-SATs and RCR 2012 guidelines for primary and secondary reporting, respectively, provides a reasonably accurate reflection of the service pressures in resource-constrained environments and has potential international applicability.

Mentorship in academic radiology: why it matters

Mentorship plays a critical role in the success of academic radiologists. Faculty members with mentors have better career opportunities, publish more papers, receive more research grants, and have greater overall career satisfaction. However, with the increasing focus on clinical productivity, pressure on turn-around times, and the difficult funding climate, effective mentoring in academic radiology can be challenging. The high prevalence of “burnout” among radiologists makes mentorship even more important. This article reviews benefits and challenges of mentorship in academic radiology, discusses how to institute a faculty mentoring program, examines different types of mentoring, and reviews challenges related to diversity and inclusion.