Teaching radiology to medical students: an integrated approach

Behavioral Economics in Radiology Training: Overcoming Irrational Behavior

Behavioral economics studies how external influences subconsciously affect decision making. Everyone is subject to a range of cognitive biases, which can affect the radiology training environment and can impact resident selection, resident education, feedback, workflow, and report composition. Understanding the cognitive sources of error and patterns of deviation can help faculty and trainees better engage in an optimal learning environment. This review focuses on the role of cognitive biases as they impact multiple facets of radiology education and training environments.

Breast Imaging and Social Media: A Model Specialty for Increasing Interest and Awareness of Radiology in Pre-Medical Students

OBJECTIVE

To assess how a virtual shadowing (VS) session on breast imaging (BI), shared through social media, can increase interest and awareness of radiology in pre-medical students.

METHODS

This study was IRB exempt. A VS slide presentation on BI mentorship, didactic lecture, and deidentified image-rich, case-based learning was created. This session was advertised and presented live through an Instagram page (Pre-Health Virtual Shadowing, @virtualshadowing) geared toward pre-health students. Students were asked to complete a two-question self-assessment using a 5-point Likert scale on which 1 was "least" and 5 was "most." Question 1 read: "Please rate your overall knowledge about radiology and what a radiologist does," and question 2 read: "Please rate your interest in possibly looking into radiology as a potential career."

RESULTS

A total of 420 participants logged into the VS session; 82% (345/420) answered the pre-session survey and 48% (202/420) answered the post-session survey. Of post-survey respondents, 84% (170/202) were female and 70% (143/202) were 22 years old or younger. There was a significant difference in mean pre-session survey responses to question 1 when compared to mean post-session survey responses (2.67 vs 3.55, P < 0.001). There was also a significant difference in mean pre-session survey responses to question 2 when compared to mean post-session survey responses (3.16 vs 3.58, P < 0.001). Our VS session remains on YouTube and has 6157 views to date.

CONCLUSION

When shared through VS on social media, breast imaging can increase interest and awareness of radiology in pre-medical students.

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.

Teaching Radiology to Medical Students in Canada; a Virtual, Integrative, Clinical Approach

PURPOSE

To construct, apply, and evaluate a multidisciplinary approach in teaching radiology to Canadian medical students.

METHODS

A multidisciplinary team of radiology and other disciplines experts designed an online 5-session course that was delivered to medical students. The topics of each session were clinical cases involving different systems. The target audience was medical students of Canadian schools. Pretests and post-tests were administered before and after each session respectively. An evaluation survey was distributed at the end of the course to gauge students' perceptions of this experience.

RESULTS

An average of 425 medical students attended the live sessions. For each session, 405 students completed both the pre-tests and post-tests. In general, students scored an average of 56% higher on the post-test than on the pre-test. The final course survey was completed by 469 students. The survey results show that more than 98% of students found the course to meet or exceed their expectations. Over 80% of students agreed that the course increased their interest in radiology and about 81% agree that the topics presented were excellent and clinically important. The ratings in the final survey results also indicate that students increased their confidence in basic radiology skills after completing the course.

CONCLUSIONS

The implementation of an integrative clinical approach to teaching radiology in a virtual setting is achievable. It provides efficient use of educational resources while being accessible by a large number of students across different medical schools.

A scoping review of health professional curricula: Implications for developing integration in pharmacy

BACKGROUND

Integrated health professions curricula aim to produce graduates who are capable of meeting current and future healthcare needs. This is reflected in pharmacy education where integration is increasingly advocated by pharmacy regulators as the perceived optimal way of preparing students for registration as pharmacists. There is, however, no definition of integration. Integration can be described according to a model of horizontal, vertical or spiral integration. It can also be described by the themes used to integrate, such as a systems-based approach or by integrative teaching and learning approaches. The level of integration can also be described.

OBJECTIVE

This scoping review aimed to explore health professions education literature to inform the optimal design of integrated pharmacy curricula. This review asks: what is meant by integration in health professions curricula?

METHODS

The Arksey and O'Malley scoping review framework was utilised. Ovid MEDLINE, EMBASE, Scopus, Web of Science and ERIC were searched. Models of integration, themes for integration, integrative teaching and learning approaches, and level of integration were defined and supported data extraction.

RESULTS

There were 9696 records screened and of these 137 were included. The majority of studies (n = 88) described horizontal integration. Systems-based teaching (n = 56) was the most common theme reported. Various integrative teaching and learning approaches were described, including experiential (n = 43), case-based (n = 42) and problem-based (n = 38) learning. The majority of the curricula could be classified as levels 5-7 on Harden's ladder (n = 102). Perception outcomes were reported for 81 studies, and only 3 reported outcomes beyond perception. Reported outcomes were generally positive and included knowledge gains and increased motivation.

CONCLUSIONS

There is a need for integration to be explicitly defined by curriculum developers and researchers. Attention should be given to describing the model, theme, teaching and learning approach and level of integration. There remains a lack of evidence for integration.

Designing a Comprehensive Undergraduate Medical Education Radiology Curriculum Using the 5C's of Radiology Education Framework

The 5C's of Radiology Education is a tool created from a recent qualitative study designed to explore how radiology exposures impact medical student opinions and perceptions of radiology and radiologists. It outlines the factors that the medical students identified as important for their radiology education. These factors are curriculum, coaching, collaborating, career, and commitment. The purpose of this paper is to provide a review of the literature of undergraduate medical education both broadly and more specifically to radiology education using the 5C's of Radiology Education framework.

Radiology education: a radiology curriculum for all medical students?

Diagnostic errors in radiology are frequent and can cause severe patient harm. Despite large performance differences between radiologists and non-radiology physicians, the latter often interpret medical images because electronic health records make images available throughout the hospital. Some people argue that non-radiologists should not diagnose medical images at all, and that medical school should focus on teaching ordering skills instead of image interpretation skills. We agree that teaching ordering skills is crucial as most physicians will need to order medical images in their professional life. However, we argue that the availability of medical images is so ubiquitous that it is important that non-radiologists are also trained in the basics of medical image interpretation and, additionally in recognizing when radiological consultancy should be sought. In acute situations, basic image interpretations skills can be life-saving. We plead for a radiology curriculum for all medical students. This should include the interpretation of common abnormalities on chest and skeletal radiographs and a basic distinction of normal from abnormal images. Furthermore, substantial attention should be given to the correct ordering of radiological images. Finally, it is critical that students are trained in deciding when to consult a radiologist.

Radiology Exposure in the Undergraduate Curriculum: A Medical Student Perspective on Quality and Opportunities for Positive Change

Purpose

This article is a continuation of a qualitative study designed to explore how radiology exposures can impact medical student opinions and perceptions of radiology and radiologists. We focused on: 1) conducting a radiology exposure inventory from the perspective of the medical student; 2) student evaluation of the quality of the radiology exposures and suggestions for positive change; and 3) development of a framework to address the needs of medical students as it relates to radiology education in the undergraduate medical curriculum.

Methods

Research methodology and design for this qualitative study were described in detail in a previous article by Visscher et al [1] .

Results

Participants included 28 medical students; 18 were in medical school years 1 and 2 (preclerkship), and 10 were in years 3 and 4 (clerkship). Specific to the focus of this article, the data revealed 3 major findings: 1) multiple exposures to radiology exist, and they are received and valued differently depending on the medical student's stage of professional development; 2) medical students value radiology education and want their radiology exposure to be comprehensive and high quality; 3) Medical students have constructive suggestions for improving the quality of both formal and informal radiology exposures.

Conclusions

Performing a radiology exposure inventory from a medical student perspective is a useful way to explore how students receive and value radiology instruction. Medical students want a more comprehensive radiology education that can be summarized using the 5 C's of Radiology Education framework. The 5 C's (curriculum, coaching, collaborating, career and commitment) reflect medical students' desires to learn content that will support them in clinical practice, be supported in their professional development, and have the necessary information to make informed career decisions.

A Vertically Integrated Online Radiology Curriculum Developed as a Cognitive Apprenticeship: Impact on Student Performance and Learning

RATIONALE AND OBJECTIVES

The principles of Collins' cognitive apprenticeship model were used to design a radiology curriculum in which medical students practice radiological skills using online case-based modules. The modules are embedded within clinical third-year clerkships, and students are provided with personalized feedback from the instructors. We describe the development of the vertical online radiology curriculum and evaluate its impact on student achievement and learning process using a mixed method approach.

MATERIALS AND METHODS

The curriculum was developed over a 2-year period. Student participation was voluntary in the first year and mandatory in the second year. For quantitative curriculum evaluation, student metrics for voluntary versus mandatory groups were assessed using independent sample t tests and variable entry method regression analysis. For qualitative analysis, responses from a survey of students about the value of the curriculum were organized into defined themes using consensus coding.

RESULTS

Mandatory participation significantly improved (p = .001) the mean radiology examination score (82 %) compared to the voluntary group (73%), suggesting that mandatory participation had a beneficial effect on student performance. Potential preexisting differences in underlying general academic performance were accounted for by including mean basic science grades as the first variable in the regression model. The significant increase in R(2) from .16 to .28 when number of radiology cases completed was added to the original model, and the greater value of the standardized beta for this variable, suggest that the curriculum made a significant contribution to students' radiology examination scores beyond their baseline academic performance. Five dominant themes about curricular characteristics that enhanced student learning and beneficial outcomes emerged from consensus coding. These themes were (1) self-paced design, (2) receiving feedback from faculty, (3) clinical relevance of cases, (4) gaining confidence in interpreting radiological images, and (5) transfer of conceptual knowledge to actual practice.

CONCLUSIONS

The vertically integrated online radiology curriculum can positively impact student performance and learning process in the context of the cognitive apprenticeship model.

Radiology Undergraduate and Resident Curricula: A Narrative Review of the Literature

OBJECTIVE

The purpose of this study was to examine the literature regarding radiology curricula for both undergraduates and residents.

METHODS

A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references.

RESULTS

Of the 4716 unique abstracts reviewed by the author, 142 were found to be relevant to the purpose of this study. Undergraduate radiology education, radiology curriculum, and radiology pedagogy vary widely between disciplines and between colleges within disciplines. Formal radiology education is not taught at all medical programs and little radiology training is incorporated into non-radiology residencies. This results in some medical graduates not being taught how to interpret basic radiology images and not learning contraindications and indications for ordering diagnostic imaging tests. There are no definitive studies examining how to incorporate radiology into the curriculum, how to teach radiology to either undergraduates or residents, or how to assess this clinical competency.

CONCLUSIONS

This review shows that radiology education is perceived to be important in undergraduate and residency programs. However, some programs do not include radiology training, thus graduates from those programs do not learn radiology essentials.

Expectations of Medical Student Neuroradiology Education: A Survey of Practicing Neuroradiologists and Neurologists

The purpose of this study is to evaluate which neuroradiological diseases neuroradiologists and neurologists believe medical students should be exposed to during their neuroradiology rotation. Members of the American Society of Neuroradiology (ASNR) and the American Academy of Neurology (AAN) were surveyed. Respondents were presented 32 diseases with neuroimaging findings and asked which ones medical students should be exposed to during a neuroradiology rotation. Using a 50% response threshold per disease entity, results were tabulated into 3 groups: diagnoses that (1) more than 50% of neuroradiologists and neurologists felt medical students should see radiologically by rotation completion, (2) less than 50% of respondents in both the groups felt were important, and (3) both the groups disagree are important. Both the groups thought medical students should be exposed to imaging of intraparenchymal hemorrhage (ASNR = 80.4% vs AAN = 84.3%; P = 0.346) and subarachnoid hemorrhage (ASNR = 74% vs AAN = 78%; P = 0.394). Both the groups (>50%) thought subdural hematoma, acute ischemic stroke, epidural hematoma, and spinal cord compression are important. Conditions such as spine fractures, nonacute stroke, arteriovenous malformation, and ear-nose-throat pathology showed varied results between both the groups. Varying degrees of similarity and differences exist between the expectations of neuroradiologists and neurologists regarding medical student neuroradiology education, presenting a positive opportunity for greater consensus, dialogue, and joint curriculum formation.

Redesign and implementation of the radiology clerkship: from traditional to longitudinal and integrative

PURPOSE

The authors discuss the evolution and application of 3 radiology teaching methods-a fundamentals-of-imaging course, a combined clinical-radiology case conference, and a radiology objective structured clinical examination-to medical education at the Brigham and Women's Hospital site of Harvard Medical School.

METHODS

The evolution of the medical student radiology teaching program from content needs assessment to blueprint creation, through implementation, is outlined.

RESULTS

The 3 components of the teaching program are described. The changes in format in response to feedback and challenges faced in deploying this new curriculum are detailed. Results from student surveys and the radiology objective structured clinical examination scores from recent years are also presented.

CONCLUSIONS

As radiology assumes an increasingly central role in patient care and diagnosis, the need for effective integration of radiology teaching into medical education becomes more critical. The concepts presented here have been deemed to be successful by students and faculty members and may be applicable to other institutions.

Fourth-year medical student opinions and basic knowledge regarding the field of radiology

RATIONALE AND OBJECTIVES

This study evaluates the opinions and knowledge of fourth-year US medical students regarding radiology and analyzes the influence of a required or nonrequired radiology rotation as a reflection of the effectiveness of radiology medical student education.

METHODS AND MATERIALS

Our institutional review board granted exempt status. An invitation e-mail was sent to 137 US medical schools. Upon receiving approval a second email was sent containing our voluntary anonymous online survey hyperlink to forward to their fourth-year class. Survey topics included demographics, radiology educational experiences, attitudes toward the field, and basic radiology knowledge. Responses were collected between August 4 and September 26, 2011.

RESULTS

A total of 444 fourth-year medical students from 37 medical schools participated: 89% planned to enter a nonradiology specialty, 10.8% were required to take a dedicated radiology rotation, 34.9% completed one, 77% planned to complete one by graduation, 88.4% thought radiology often changes patient care or is at least as important as physical exam, 91.4% underestimated the cancer risk of an abdomen and pelvis computed tomography by at least one order of magnitude, and 72.9% by at least two orders. Seventy-seven percent had never heard of the American College of Radiology (ACR) Appropriateness Criteria. Respondents underestimated the potential risks of magnetic resonance imaging (MRI); with 58.3% aware intravenous gadolinium can cause nephrogenic systemic fibrosis and 79.4% aware of potential injury from metallic projectiles. 40.4% indicated that non-radiologist clinicians in specific medical specialties interpret their respective imaging studies at least as accurately as corresponding subspecialty radiologists. Other results include student opinions regarding teleradiology, radiologist lifestyle, and compensation.

CONCLUSIONS

Fourth-year medical students recognize the importance of radiology but are poorly informed regarding radiation safety, MRI safety, and ACR Appropriateness Criteria, despite 34.9% having a dedicated rotation. This highlights the need for adoption of the Alliance of Medical Student Educators in Radiology curriculum.

The Utilisation of Radiology for the Teaching of Anatomy in Canadian Medical Schools

Objective

To determine the utilisation of diagnostic imaging (radiology) as a department and/or imaging medium in the teaching of anatomy at the Canadian undergraduate medical education level.

Methods

The study objectives were achieved through the use of a questionnaire and a literature review. The anatomy department head at each English-based Canadian Medical School was contacted, and the individual most responsible for anatomy teaching in the medical school curriculum was identified. This individual was subsequently asked to complete a questionnaire that evaluated the involvement of radiology for anatomy teaching in their curriculum.

Results

The use and integration of radiology is a common practice in the teaching of anatomy in Canadian undergraduate medicine. Although the methods and extent of its use varied among institutions, every English-based Canadian medical school, except one, was using diagnostic imaging material in their instruction of anatomy. Furthermore, half of the institutions had a radiologist as a faculty member of their anatomy department to help teach and to use imaging to its full potential.

Discussion

This audit of anatomy departments suggests that diagnostic imaging has an important role to play in anatomy teaching in Canadian English-speaking medical schools.

Results of a survey by the European Society of Radiology (ESR): undergraduate radiology education in Europe-influences of a modern teaching approach

Objectives

The purpose of the present study is to determine in what way a conventional versus a modern medical curriculum influences teaching delivery in formal radiology education.

Methods

A web-based questionnaire was distributed by the ESR to radiology teaching staff from 93 European teaching institutions.

Results

Early exposure to radiology in pre-clinical years is typically reported in institutions with a modern curriculum. The average number of teaching hours related to radiology is similar in both curriculum types (60 h). Radiology in modern curricula is mainly taught by radiologists, radiology trainees (50%), radiographers (20%) or clinicians (17%). Mandatory clerkships are pertinent to modern curricula (55% vs. 41% conventional curriculum), which start in the first (13% vs. 4% conventional curriculum) or second year of the training (9% vs. 2% conventional curriculum). The common core in both curricula consists of radiology examinations, to work with radiology teaching files, to attend radiology conferences, and to participate in multidisciplinary meetings.

Conclusion

The influence of a modern curriculum on the formal radiology teaching is visible in terms of earlier exposure to radiology, involvement of a wider range of staff grades and range of profession involved in teaching, and radiology clerkships with more active and integrated tasks.

Main Message

• This study looks at differences in the nature of formal radiology teaching.

A Pilot Study

Point-of-care sonography is a valuable tool used in medical practice. A free health clinic was the venue for the authors’ approach to hands-on training for medical and nursing students. Students were surveyed before and after the event regarding their experience and their ability to successfully perform six targeted sonographic skills. The primary outcome was the change presurvey to postsurvey in the students’ assessment of their ability to perform scans on patients and identify the anatomic structures in the six skill areas. An experienced sonographer monitored each scan and confirmed skill application. One hundred nineteen sonograms were performed. Most students (23/29) did not report competence in any of the six assessed skills prior to the study. On average, students developed competence in three of six skill areas. Before the study, 3 of 29 students (10%) reported being able to perform scans on patients and identify the major anatomic structures. After the study, 20 of 28 students (71%) reported that they could perform scans and identify these structures. This change was significant ( P < .0001, χ2).

The long-term impact of preclinical education on medical students' opinions about radiology

RATIONALE AND OBJECTIVES

It has been previously shown that integrating radiology teaching into the first year of medical education has an immediate positive effect on medical students' attitudes toward the practice of radiology. The purpose of this study is to determine whether these changes in attitude persist through the clinical years of training and whether preclinical exposure to radiology has a long-term effect on medical students' opinions about radiology and radiologists.

MATERIALS AND METHODS

The first-year medical curriculum at the University of Pittsburgh School of Medicine was revised between the 2003 and 2004 academic years, with 2.5 hours of additional radiology lectures integrated into the existing preclinical coursework. Additionally, radiology consult sessions were integrated into problem-based learning sessions. An initial survey was administered in the preclinical years of training to assess first-year medical students' attitudes toward radiology before and after the changes to the curriculum. A follow-up survey was administered before graduation to determine whether the changes in attitude revealed in the first survey persisted throughout the remaining years of training, and to assess students' opinions about negative radiologist stereotypes. Students who had undergone the revised curriculum were compared to students who had undergone the traditional curriculum.

RESULTS

There were statistically significant differences between the two graduating classes in terms of interest in, and perceptions of, the field of radiology. At graduation, students exposed to the revised preclinical curriculum with a greater exposure to radiology had a greater interest in radiology as a discipline and were more likely to have taken senior electives in radiology. These graduating students were also less likely to agree with negative stereotypes about radiologists.

CONCLUSIONS

Dedicated medical student teaching from an academic radiologist during the first year of medical school has a positive, long-lasting effect on medical students' attitudes toward radiology. The prevalence of negative stereotypes about radiologists among graduating medical students can be reduced by appropriate teaching of radiology in the preclinical years of medical school.

The needs of an educator

A medical educator has needs that are specific to educators and needs that are common to all medical faculty members. An educator needs time to perform educational duties; space to carry out educational activities; and money to buy time, space, and other resources. Just as important as time, space, and money are to the success of an educator is having an infrastructure that supports the educator and the educational mission. Such an infrastructure includes a system that provides educational leadership opportunities, institutional support for medical education, opportunities and funding for medical education research, students, feedback from students and peers, faculty development and mentoring, national societal support for education, and an institutional agenda that values education to the degree that it values patient care and investigative research.

Linear versus web-style layout of computer tutorials for medical student learning of radiograph interpretation

RATIONALE AND OBJECTIVE

We sought to determine which is more effective in increasing skill in radiograph interpretation: a linear (PowerPoint-style) computer tutorial that locks the student into a fixed path through the material or a branched (Web-style) version that allows random access.

MATERIALS AND METHODS

We prepared a computer tutorial for learning how to interpret cervical spine radiographs. The tutorial has 66 screens including radiographs or graphics on almost every page and five unknown radiographs for the student to interpret. One version (linear) presents the material in a linear sequence with the unknown radiographs heading up "chapters" detailing an important aspect of the task. In the second (branched) version, the same 66 screens were accessed through hyperlinks in a frame beside the unknown radiographs. One hundred thirty-nine medical students at two sites participated in a randomized single-blinded controlled experiment. They interpreted cervical spine images as a pretest and then completed one of the two tutorial versions. Afterward, they did the same examination as a post-test.

RESULTS

The tutorial was successful, in both layouts, in improving the subjects' ability to interpret cervical spine radiograph images (effect size 2.1; 95% confidence interval 1.7-2.5). However, the layout did not make a difference to their gain in ability. Students in the linear group completed the tutorial in 17% less time (P < .001) but were slightly less likely to rate the tutorial as "valuable."

CONCLUSION

For these novice learners, computer tutorial layout does not affect knowledge gain. Students may be more satisfied with the linear layout, but in time-pressured situations, the Web-style layout may be preferable because it is more efficient.

Errors in radiographic interpretation made by veterinary students

As a means of identifying student weaknesses in radiographic interpretation that could be used as foci for teaching, a cohort of 96 students joining the final-year radiology rotation were randomly allocated to one of three radiographic interpretation quizzes, each based on radiographs of small-animal patients together with the signalment and a brief, relevant history. Students' quiz scores were analyzed by multiple logistic regression, using an outcome variable with the score for each item as numerator and maximum possible mark as denominator. Students' median quiz score was 49% of the maximum (range 23-80%). Students were more likely to gain a mark for items based on abnormal radiographs than for those based on normal radiographs (odds ratio 3.4, p < 0.001). Skeletal radiographs were associated with lower scores (OR 0.75, p = 0.03). The fewest marks were awarded for interpretation of a radiograph of a normal canine stifle and interpretation of a radiograph of a normal canine pelvis; these items were misinterpreted as abnormal by 86% and 80% of the students, respectively. Students' tendency to over-interpret normal radiographs may reflect a lack of knowledge of radiographic anatomy or an unrealistically high expectation that the radiographs are abnormal.

Preclinical Medical Student Training in Radiology: The Effect of Early Exposure

OBJECTIVE

The purpose of this study was to determine whether an integrated radiology curriculum in the first year of medical school changes medical students' attitudes toward radiology or affects their knowledge of radiologic principles.

SUBJECTS AND METHODS

The first-year medical curriculum of a medical school was revised between the 2003 and 2004 academic years to introduce more didactic radiology teaching. Dedicated radiology lectures were introduced, and radiology consult sessions became integral to problem-based learning sessions. A survey was administered between the first and second years of training to assess first-year medical students' attitudes toward radiology and their knowledge of basic radiologic principles. Students who had undertaken the revised curriculum (class of 2008) were compared with students who had undertaken the traditional curriculum (class of 2007). Survey responses were compared with Mann-Whitney rank sum tests.

RESULTS

Students exposed to the new curriculum stated that they were more familiar with radiology as a specialty and believed that radiology had greater importance to the overall practice of medicine. They stated that they were more likely to select radiology as a clinical elective, and more of them were considering radiology as a career option. The students who had been exposed to radiology performed better on the test of basic radiologic knowledge. All results were statistically significant.

CONCLUSION

Exposing students to radiology in the first year of medical school improves their impression of radiology as a specialty and increases their interest in radiology as a career. Follow-up surveys will determine whether this effect persists through the clinical years of training and improves the overall impression of radiology within the medical community.

Reinventing the apprenticeship: the hot seat in the digital era

RATIONALE AND OBJECTIVES

Describe new interactive digital teaching methods for medical student education in radiology and evaluate student responses.

MATERIALS AND METHODS

Third- and fourth-year medical students on radiology clerkship were taught using either film-based "hot seat" format, digital "hot seat," or didactic slide-based format. Digital hot seat included direct projection of full-resolution images and use of digital tablet for annotation. Students completed surveys commenting on each method.

RESULTS

Before 2003-2004, comments were available from general course surveys. Only positive responses were made regarding digital hot seat format. Dedicated surveys of teaching methods since July 2003 (23 students) showed 100% gave high ratings to digital hot seat methods (1 or 2 on a scale from 1 to 5), citing easier visibility of findings and ability to draw on images as positive features. Fifty-two percent rated film hot seat method <3, with limited visibility as the main complaint. Didactic slide teaching was rated <3 by 74%. Eighty-three percent chose digital hot seat as their favorite format overall.

CONCLUSIONS

Students overwhelmingly favor digital hot seat teaching over film-based or didactic slide presentations. Digital hot seat methods preserve the best features of case-based interactive teaching while improving visibility of findings.

2003 AUR Joseph E. And Nancy O. Whitley Award. Developing tomorrow's academic radiologists: a 3-month residency elective in education

RATIONALE AND OBJECTIVES

The shortage of academic radiologists reveals an urgent need to attract more residents into academic careers. A great deal of attention has been focused on research, but few programmatic initiatives have addressed the development of the next generation of radiology educators. The purpose of this study was to develop and test a new 3-month residency elective in education.

MATERIALS AND METHODS

A large academic radiology department developed a 3-month education elective, during which two residents would be relieved of clinical duties and focus full-time on tasks related to their development as educators, including the completion of a major educational project.

RESULTS

Two residents, in their 3rd year and 4th year of residency, respectively, proposed to collaborate in developing a Web-delivered tutorial for the department's senior medical student clerkship. At the end of 3 months, their radiology tutorial was introduced. In its 1st month, it received a mean rating of 4.3 on a five-point scale. The residents stated that the elective had enabled them to develop important skills in instructional technology, put into practice their enhanced understanding of learning psychology, and substantially strengthened their overall commitment to academic careers.

CONCLUSION

It is vital that residency programs focus on developing the next generation of radiology educators. This ongoing education elective represents one successful model.