Computer-assisted radiology resident rotation scheduling

The author developed a method for computer-assisted scheduling of resident rotations in which the chief resident determines the most desirable set of rotations for each resident, disregarding specific month assignments except as required or requested, and the computer generates the schedule by assigning months to rotations. The computer uses an efficient search algorithm to find a schedule that satisfies all requirements. The method satisfies training goals, staffing needs, and residents' desires more effectively than manual scheduling. Although fixed staffing levels for every rotation are required, flexibility is achieved through "dummy" assignments of rotations to residents.     

Computer-assisted radiology

New digital imaging modalities and more sophisticated image processing systems will have a profound effect on those areas of medicine concerned with imaging. This mainly means computer-assisted radiology (CAR) and implies a transition from analog film systems to digital imaging systems, integration of digital imaging modalities through picture archiving and communication systems (PACS) and the graduated employment of image-oriented medical work stations (MWS) for computer-assisted representation, communication, diagnosis, and therapy planning.     

Computer-assisted instruction in radiology

We developed an interactive computer system to support various educational uses. The system allowed numerous instructors to create lessons or tests in a flexible, personalized fashion. As a pilot project, the system was used to develop and administer a computer-driven final examination in a didactic radiology course for second-year medical students. It was our objective to change the examination into an enjoyable experience that would also bring about long-term learning gains. The computer added immediate feedback to the testing situation.     

The resident’s call: Challenging case deftly handled by a radiology resident evaluating placement of a nasogastric tube

Nasogastric tube placement, a seemingly harmless procedure, has been documented as a source of iatrogenic complications such as aspiration, gastric and bronchial puncture, and aortoesophageal fistula formation. Additionally, malposition involving the distal esophagus, skull, and respiratory tract has been reported. This case report describes the placement of a nasogastric tube which exited the patient’s stomach and abdomen via a percutaneous endoscopic gastrostomy tube tract to lie external and lateral to the patient’s flank. A brief review of the literature that discusses the malpositions, radiographic appearances, and complications of nasogastric tube placement is included.     

Selecting radiology resident candidates

Radiology resident candidate selection has become a burdensome, subjective, and somewhat arbitrary process. Because the luxury of many well-qualified candidates exists, there is an obligation to select them as honestly, equitably, and objectively as possible. Two years were spent in revising and modifying the resident selection process to make it more uniform and more efficacious. An application scoring form was devised to extract uniform pertinent information from the original application form. Candidates could then be ranked according to a numerical score derived from the form. This allowed easy selection of top candidates to be interviewed. A new interviewing scoring form was developed to include desirable characteristics of resident candidate performance. This form was also devised in such a way as to be easily scored and to allow selection of the top 20 to 25 candidates. These candidates were then ranked by participating faculty members while reviewing their application score forms and their interview forms. Positions for the residency training program were offered according to the ranking. The usefulness of both new forms was evaluated and confirmed by correlating form scores with faculty ranking of academic performance of current residents in the training program.     

Assessing radiology resident reporting skills

PURPOSE: To develop an Objective Structured Clinical Examination for assessing the reporting skills of radiology residents. MATERIALS AND METHODS: The approach used in this study derives from performance-based assessment, that is, tests in which actual performance of a skill is observed and measured. For this task, 29 radiology residents and five faculty members (n = 34) independently dictated reports regarding a set of 20 cases with radiographs in 1 hour. The task was performed in a controlled environment. Data were analyzed by using analysis of variance and tests for linear trends, with the expectation of increasing performance with increasing experience. RESULTS: Significant relationships were observed between subjects' experience and the mean number of cases completed (F = 4.46, P =.006), the mean number of well-specified impressions (F = 5.84, P =.001), and the mean number of urgent or discrepant findings noted (F = 3.67, P =.015). Results also demonstrated a clear linear trend of increasing performance with increasing experience with each variable (P =.002, <.001, and.002, respectively, for t tests with polynomial contrasts). CONCLUSION: The significant linear trends indicate that reporting skills increase with increasing experience in the program. This finding supports the validity of the measurement. The Objective Structured Clinical Examination provides a means of assessing radiology resident reporting skills.     

Evaluating resident training in radiology

Evaluation plays a key role in both the educational process and in its results. The evaluation established in the regulations for the Spanish residency system (MIR) is a two-step process that aims to teach. These steps are: a) continuous evaluation by the tutor and specialists at the training unit and b) an annual review by the evaluating committee. The resident's handbook and evaluation sheets from the rotations are the tools used for this task. Other techniques for evaluation, such as 360-degree feedback, examinations (conventional, case-based, and/or Objective Structured Clinical Examination [OSCE]), checklists, reviewing reports, or public presentation, can also complement or enhance the official evaluation. This article aims to provide information about the evaluation process and to open new possibilities to make evaluation more objective.     

Evaluation of radiology resident cognitive performance

Using radiographs and slides in three formats, we objectively tested the cognitive performance of 16 residents during an 8-month period. One format tested individual residents with radiographs and required only that a list of findings be provided within a week. For the second method, radiographs were projected to a small group of residents and a single diagnosis for each of ten cases was required. The third format required a larger group of competing residents to view projected slides of ten loosely defined but thematically connected cases and develop one diagnosis. Two of the test formats correlated significantly with a Spearmen rank, r = .50 or better (P less than .025) with a ranking based upon total score on the American College of Radiology Inservice Examination. All three test formats had a Spearmen rank r = .50 or better (P less than .05) when compared with pooled ranking performed by the staff radiologists.     

Teaching radiology resident didactics using videoconferencing development of a videoconferencing network to increase the efficiency of radiology resident training

There is a major evolution in radiology perhaps most clearly evidenced by the advent of all digital, filmless imaging. Advanced imaging devices coupled with readers that permit real-time interpretation fit well into the videoconferencing paradigm. The study by Durfee et al. (11) demonstrated that the availability of the picture archiving and communication system (PACS) was likely to increase the use of electronic teaching devices throughout radiology departments. The acquisition of teaching files has become an entirely different process than it was just 5 or 6 years ago. No longer will it be necessary to spend hours searching for films and organizing them in a tedious process in order to incorporate them into lectures. An additional benefit is increased security. It is now possible to store multiple copies of a teaching file in several geographically separate areas. The expression surfing the file room for good teaching cases will now likely be changed to “surfing the PACS” (12 and 13). It has been asserted that the paradigm shift to an all-digital environment will bring about substantial changes in what is required to provide radiology residents with an optimal education (14). The RLN videoconferencing format is in an ideal position to play an important role in effecting those changes that are moving radiology into its revolutionary future.This project grew out of the changing needs, time commitments, and technological innovations that are commonplace in academic radiology programs. Although there are some elements of the RLN that are unique, for the most part the system is replicable by programs where residents rotate away from their home institution and there is an opportunity for collaboration. The videoconference incorporates a number of skills important to the radiologist of the future by promoting exposure to and expertise in the filmless world that will continue to increase as the program matures.