Knowledge Retention in Radiology Residents for Audience Response System Versus Traditional Hot-Seat Conference

Rewinding the Clock: Preparing the Next Generation of Radiology Residents for Oral Boards

The replacement of the ABR in-person oral examination with the DR certifying examination affected approximately 15,000 radiologists, spanning from 2013 to 2027. This decision was motivated by better aligning with the timing of other American Board of Medical Specialty (ABMS) members, more closely reflecting real-world practice of radiology and narrowing training geared towards the trainee's subspecialty preference. However, in retrospect, this change may have subtracted from the quality and value of diagnostic radiology training as a whole with the de-emphasis on competence in general radiology, communication skills, and cognitive reasoning. In this paper, the authors lay out a blueprint necessary in order to rewind the clock of how diagnostic radiology programs can prepare their trainees for the new DR oral examination. Such a change will require substantial redactions affecting all designations, including radiology faculty, education teams, departmental leadership, academic institutions, ACGME, and ABR. The authors believe that implementing these modifications will not only effectively equip radiology candidates for the new DR oral examination but will also augment the significance of radiologists as indispensable members of multidisciplinary teams. The authors also outline the challenges that could emerge from these changes and speculate on the anticipated role of AI in future oral board examinations.

Improving the Relationship Between Confidence and Competence: Implications for Diagnostic Radiology Training From the Psychology and Medical Literature

The focus of diagnostic radiology training is on creating competent professionals, whereas confidence and its calibration receive less attention. Appropriate confidence is critical for patient care both during and after training. Overconfidence can adversely affect patient care and underconfidence can create excessive costs. We reviewed the psychology and medical literature pertaining to confidence and competence to collect insights and best practices from the psychology and medical literature on confidence and apply them to radiology training. People are rarely accurate in assessments of their own competence. Among physicians, the correlation between perceived abilities and external assessments of those abilities is weak. Overconfidence is more prevalent than underconfidence, particularly at lower levels of competence. On the individual level, confidence can be calibrated to a more appropriate level through efforts to increase competence, including sub-specialization, and by gaining a better understanding of metacognitive processes. With feedback, high-fidelity simulation has the potential to improve both competence and metacognition. On the system level, systems that facilitate access to follow-up imaging, pathology, and clinical outcomes can help close the gap between perceived and actual performance. Appropriate matching of trainee confidence and competence should be a goal of radiology residency and fellowship training to help mitigate the adverse effects of both overconfidence and underconfidence during training and independent practice.