Emerging strategic themes for guiding change in academic radiology departments

Liberating Structures in Strategic Planning: Methods to Foster Engagement

This paper describes the innovative approach of using liberating structures to the development of the AUR 2023 strategic plan, and lessons learned in their application. The 2023 strategic plan built on the results and approach of the prior 2015 plan. Similar to the 2015 strategic plan, traditional tools such as a SWOT analysis and strategic retreat were used. In addition, the 2023 process included tools called liberating structures and was iteratively co-produced through a series of virtual meetings over 18 months. Advantages of liberating structures included increased creativity and speed in moving through meeting tasks, increased number of meaningful contributions from AUR members and increased engagement from participants during discussions and meetings. The 2023 AUR strategic plan is provided along with examples of completed goals and those under early implementation. Lessons learned from using these tools for strategic planning can be applied to other society and group meetings. Moving forward, the 2023 strategic plan will be a living document, which will be reviewed at each Board of Directors meeting and periodically adapted.

Capturing Psychologists' Work in Academic Health Settings: The Role of the Educational Value Unit (EVU)

This paper describes how psychology faculty positions in academic health centers (AHCs) have evolved to meet the changing needs in healthcare. In that context, the roles of psychologists have expanded significantly to include a wide array of clinical responsibilities, teaching and supervisory roles, administrative functions, research initiatives, and academic scholarship. Traditionally, faculty compensation plans have been calculated through the use of Relative Value Units which are primarily based on clinical service delivery, hence, incomplete when attempting to account for these growing academic responsibilities. This paper reviews the need to expand the ways in which the work provided by psychologists is appropriately identified and compensated for in AHCs. Drawing upon six models utilized in other areas of medical education, this paper describes the potential utility of incorporating Educational Value Units as a metric for capturing this expanding set of academic responsibilities and systematically incorporating them into a psychologist's job design. Recommendations for future considerations are provided.

Interactive dedicated training curriculum improves accuracy in the interpretation of MR imaging of prostate cancer

OBJECTIVE

To assess the effect of interactive dedicated training on radiology fellows' accuracy in assessing prostate cancer on MRI.

METHODS

Eleven radiology fellows, blinded to clinical and pathological data, independently interpreted preoperative prostate MRI studies, scoring the likelihood of tumour in the peripheral and transition zones and extracapsular extension. Each fellow interpreted 15 studies before dedicated training (to supply baseline interpretation accuracy) and 200 studies (10/week) after attending didactic lectures. Expert radiologists led weekly interactive tutorials comparing fellows' interpretations to pathological tumour maps. To assess interpretation accuracy, receiver operating characteristic (ROC) analysis was conducted, using pathological findings as the reference standard.

RESULTS

In identifying peripheral zone tumour, fellows' average area under the ROC curve (AUC) increased from 0.52 to 0.66 (after didactic lectures; p<0.0001) and remained at 0.66 (end of training; p<0.0001); in the transition zone, their average AUC increased from 0.49 to 0.64 (after didactic lectures; p=0.01) and to 0.68 (end of training; p=0.001). In detecting extracapsular extension, their average AUC increased from 0.50 to 0.67 (after didactic lectures; p=0.003) and to 0.81 (end of training; p<0.0001).

CONCLUSION

Interactive dedicated training significantly improved accuracy in tumour localization and especially in detecting extracapsular extension on prostate MRI.

The Academic RVU: A System for Measuring Academic Productivity

Despite the importance of teaching, research, and related activities to the mission of academic medical departments, no useful and widely agreed-on metrics exist with which to assess the value of individual faculty members' contributions in these areas. Taking the concept of the clinical relative value unit (RVU) as a model, the authors describe the development of an academic RVU (aRVU) system that assigns weights to and creates formulas for assessing productivity in publications, teaching, administrative and community service, and research. The resulting aRVU schema was implemented on a Web-based system that incorporates a number of novel tools, including a curriculum vitae manager that automatically maintains and calculates total aRVU scores and breaks out component elements for each individual and for the department as a whole. The benefits and limitations of this system are discussed, as well as the potential advantages in sharing this approach with other radiology departments and other medical disciplines. Wide acceptance and implementation would make the aRVU the appropriate counterpoint to the clinical work RVU in academic medicine.