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1.
PurposeTo characterize radiation oncologist involvement in undergraduate medical education at US academic medical centers and to incorporate these findings into practical pathways for greater and broader integration of radiation oncology (RO) into medical curricula.MethodsChairpersons and residency program directors at RO departments directly affiliated with a medical school were asked to describe all the ways in which radiation oncologists in their department are involved in medical student education, excluding their elective clerkship.ResultsOf 75 eligible departments, 49 responded (response rate 65.3%). Twenty departments (40.8%) reported that at least one faculty member participates in a curricular educational session on an oncology-related topic. Twelve (24.5%) of these sessions were focused specifically on RO. Twenty-one departments (42.9%) had faculty involved with organized clinical shadowing or preceptorship programs for first- and second-year medical students. Twelve departments (24.5%) described no involvement in the formal curricula at their local or affiliated medical school. Thirteen departments (44.8%) described participation in a medical school–organized residency fair, and 12 departments (41.4%) sponsor an RO interest group. Reported novel approaches to teaching included development of multidisciplinary clerkships or educational sessions that include RO concepts, guest lectures on RO during a required clerkship, organized extracurricular experiences such as an oncology seminar series, participation in special medical student enrichment programs, and sponsorship or initiation of an RO interest group.ConclusionThe minority of RO departments are involved in formal teaching of the medical student body at large. The approaches described herein should facilitate more robust involvement of radiation oncologists in all areas of undergraduate medical education.  相似文献   

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《Brachytherapy》2022,21(1):110-119
PURPOSE/OBJECTIVE(S)Standardized simulation training geared towards interstitial brachytherapy (IS BT) for gynecologic malignancies is lacking in radiation oncology resident education. We developed and implemented a curriculum for IS BT training with (1) lecture on equipment, workflow, and guidelines, (2) hands-on ultrasound-guided IS BT workshop, and (3) treatment planning workshop.METHODS AND MATERIALThe cost in materials of each phantom was approximately $66. After a lecture, two alternating workshops were performed. The first session consisted of a hands-on ultrasound-guided IS BT workshop with one resident imaging the phantom with a transabdominal ultrasound probe and the other resident implanting the phantom with needles. A second session consisted of a hands-on treatment planning workshop using BrachyVision and an l-Q spreadsheet with the following objectives: coverage goal, meeting D2cc constraints, and minimizing V200. The primary outcome was improvement in knowledge assessed with Likert-style questions and objective knowledge-based questions (KBQs).RESULTSFour of the seven medical residents that participated in this curriculum had prior IS BT experience. Residents reported significantly improved knowledge regarding gynecologic IS BT equipment and procedure, evaluating gynecologic anatomy using ultrasound, CT simulation, contouring, and plan review (overall median pre-session subjective score 2 (1) ? (3) versus post-session score 4 (3) ? (4, p < 0.01). Residents demonstrated improvement in answering KBQs correctly from 44% correct at baseline to 88% after completion of the curriculum (p < 0.01). All residents “Agree” and “Strongly Agree” the session was an effective learning experience.CONCLUSIONSResidents participating in phantom training with an ultrasound curriculum and a treatment planning session is effective for improving knowledge and skills in IS BT for radiation oncology residents.  相似文献   

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PurposeMany US medical students lack access to radiation oncology (RO). The authors’ hypothesis was that a virtual, cross-institutional presentation introducing students to a career in RO would be valuable in exposing students to RO who are less likely to access it otherwise and would increase students’ interest in a career in RO regardless of their gender, race, or ethnicity.MethodsA 1-hour, live, virtual, extracurricular presentation was offered to deans of US medical schools lacking affiliated RO departments and/or having high enrollments of students underrepresented in medicine (UIM) and also student groups composed primarily of UIM students. Presentations were given individually to each school by a single radiation oncologist. An electronic survey captured data from participating students.ResultsOne hundred ninety-seven students from 13 institutions attended presentations; 114 students responded to the survey (response rate, 58%). Ninety-two students (81%) were aware of the specialty of RO before the presentation; however, UIM students were significantly less likely to be aware of RO than all others (69% versus 87%, P = .05). Only 19 students (17%) reported previously hearing presentations from radiation oncologist (29% among second- to fourth-year students versus 9% among first-year students, P = .01). Ninety-eight students (86%) expressed more interest in pursuing a career in RO after the presentation. There was no significant difference in interest in RO for any demographic subgroups.ConclusionsVirtual RO exposure was feasible to deliver to students less likely to be exposed otherwise and successfully stimulated interest in the specialty regardless of students’ gender, race, or ethnicity.  相似文献   

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A shortage of radiation oncologists has been a problem in both Canada and the United States of America. The fundamental step to rectify this situation is the recruitment of interested medical students. A mail-in survey was sent to 214 third- and fourth-year medical students at the University of British Columbia to evaluate attitudes to and the level of understanding of radiation oncology. The response rate was 59%. Seventy-five percent of the students were planning postgraduate training in clinically orientated specialties with good lifestyle and availability of job opportunities. However, only 18% of the respondents considered radiation oncology as a possible specialty. This survey suggests that this lack of interest is the result of misconceptions about training in the practice of radiotherapy. To better inform the medical students, teaching clinics providing them with direct contact with radiation oncologists and their patients, are invaluable. In order to generate the correct image of the specialty and the types of patients encountered, teaching in an ambulatory care setting is not to be neglected. Distribution of information pamphlets describing the radiation oncology program and the nature of radiation oncology practice is also suggested as an efficient means of informing medical students.  相似文献   

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《Brachytherapy》2020,19(6):725-731
PurposeBrachytherapy is critical for the curative treatment of locally advanced cervical cancer. Although brachytherapy use is declining in the United States (U.S.), novel interstitial or intracavitary applicators and advances in image guidance for applicator placement and treatment planning have allowed for tumor dose escalation while reducing normal tissue toxicity. Recent survey data have suggested insufficient brachytherapy training for radiation oncology trainees in the United States. This study aimed to address these gaps by developing and piloting a simulation-based education (SBE) workshop for MR-guided cervical cancer brachytherapy.Methods and MaterialsAn SBE workshop was developed for graduate medical education (GME) trainees focusing on MR-guided brachytherapy for cervical cancer. Four hands-on stations, simulating aspects of the procedure, were led by a team of gynecological brachytherapy experts. The learners were radiation oncology residents and fellows in a U.S. GME training program. The primary outcome was feasibility, assessed by completion of the workshop within the time constraints of the curriculum. Learners completed preworkshop and postworkshop surveys to provide information on efficacy.ResultsThe workshop was successfully completed in a 1-h block of GME didactic time. Ten trainees completed all four stations, and all completed preworkshop and postworkshop surveys, which showed improvements in knowledge and technical proficiency. Feedback was positive, and trainees requested additional learning opportunities.ConclusionsThis study showed that GME-focused SBE in MR-guided cervical cancer brachytherapy was feasible. SBE provided a nonclinical environment in which to practice aspects of MR-guided brachytherapy. Ongoing work includes collaboration with other U.S. institutions. Future studies should focus on international adaptation.  相似文献   

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《Brachytherapy》2020,19(6):787-793
PurposeEducation and training on prostate brachytherapy for radiation oncology and medical physics residents in the United States is inadequate, resulting in fewer competent radiation oncology personnel to perform implants, and is a factor in the subsequent decline of an important, potentially curative cancer treatment modality for patients with cancer. The American Brachytherapy Society (ABS) leadership has recognized the need to establish a sustainable medical simulation low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy workshop program that includes physician–physicist teams to rapidly translate knowledge to establish high-quality brachytherapy programs.MethodsThe ABS, in partnership with industry and academia, has held three radiation oncology team–based LDR/HDR workshops composed of physician–physicist teams in Chicago in 2017, in Houston in 2018, and in Denver in 2019. The predefined key metric of success is the number of attendees who returned to their respective institutions and were actively performing brachytherapy within 6 months of the prostate brachytherapy workshop.ResultsOf the 111 physician/physicist teams participating in the Chicago, Houston, and Denver prostate brachytherapy workshops, 87 (78%) were actively performing prostate brachytherapy (51 [59%] HDR and 65 [75%] LDR).ConclusionsThe ABS prostate brachytherapy LDR/HDR simulation workshop has provided a successful education and training structure for medical simulation of the critical procedural steps in quality assurance to shorten the learning curve for delivering consistently high-quality brachytherapy implants for patients with prostate cancer. An ABS initiative, intended to bend the negative slope of the brachytherapy curve, is currently underway to train 300 new competent brachytherapy teams over the next 10 years.  相似文献   

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Purpose/ObjectiveRadiation oncology trainees frequently learn to contour through clinical experience and lectures. A hands-on contouring module was developed to teach delineation of the postoperative prostate clinical target volume (CTV) and improve contouring accuracy.MethodsMedical students independently contoured a prostate fossa CTV before and after receiving educational materials and live instruction detailing the RTOG approach to contouring this CTV. Metrics for volume overlap and surface distance (Dice similarity coefficient, Hausdorff distance (HD), and mean distance) determined discordance between student and consensus contours. An evaluation assessed perception of session efficacy (1 = “not at all” to 5 = “extremely”; reported as median[interquartile range]). Non-parametric statistical tests were used.ResultsTwenty-four students at two institutions completed the module, and 21 completed the evaluation (88% response). The content was rated as “quite” important (4[3.5-5]).The module improved comfort contouring a prostate fossa (pre 1[1-2] vs. post 4[3-4], p<.01), ability to find references (pre 2[1-3] vs. post 4[3.5-4], p<0.01), knowledge of CT prostate/pelvis anatomy (pre 2[1.5-3] vs. post 3[3-4], p<.01), and ability to use contouring software tools (pre 2[2-3.5] vs. post 3[3-4], p=.01). After intervention, mean DSC increased (0.29 to 0.68, p<0.01) and HD and mean distance both decreased, respectively (42.8 to 30.0, p<.01; 11.5 to 1.9, p<.01).ConclusionsA hands-on module to teach CTV delineation to medical students was developed and implemented. Student and expert contours exhibited near “excellent agreement” (as defined in the literature) after intervention. Additional modules to teach target delineation to all educational levels can be developed using this model.  相似文献   

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《Radiography》2022,28(1):222-231
ObjectiveThe COVID-19 pandemic has changed traditional ways to provide pre-registration medical radiation science (MRS) (medical imaging and radiation therapy) education. This literature review explores the published pre-registration MRS education curriculum adaptations implemented in response to the pandemic and effects of the adaptations on stakeholders.Key findingsEleven articles were identified through a systematic literature search. The included articles covered the pre-registration MRS curriculum adaptations implemented in response to the pandemic in 12 countries of five continents. Through changing content delivery and assessment modes from face-to-face to online, non-practical classes and academic assessments could continue without significant interruptions. However, cancellation/postponement of practical classes and clinical placements was common during COVID-19 lockdown. Simulated learning was used by some institutions to replace some practical classes and placements. Among the stakeholders of MRS education (students, academics and clinical educators), the students were most affected. The main impacts were negative psychological effects and learning experiences. For the academics, they had common concerns about online learning quality and assessment integrity.ConclusionThis review of the early publications in the first year of the pandemic provides an illustration of the MRS curriculum adaptations implemented in five continents covering both English and non-English speaking countries and their effects on the stakeholders as yet. It is expected that more articles on this area will be published over time and hence allowing a more comprehensive review in the future.Implications for practiceThe included articles show provision of wellbeing support, good planning of online content delivery based on sound pedagogical approaches, implementation of computer-based simulation tools suitable for home-based learning environment and use of authentic online assessments would address the impacts on the students and academics.  相似文献   

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PurposeThe purpose was to create and analyze a competency-based model of educating medical students in a radiology clerkship that can be used to guide curricular reform.MethodsDuring the 2019 to 2020 academic year, 326 fourth-year medical students were enrolled in a 2-week required clerkship. An online testing platform, ExamSoft (Dallas, Texas), was used to test pre- and postinstruction knowledge on “must see” diagnoses, as outlined in the National Medical Student Curriculum in Radiology. Assessment analysis was used to compare the frequency with which the correct diagnosis was identified on the pretest to that on the posttest. At the end of the academic year, in addition to statistical analysis, categorical analysis was used to classify the degree of this change to uncover topics that students found most challenging.ResultsFor 23 of the 27 topics (85%), there was a significant improvement in diagnostic accuracy after instruction in the test curriculum. Categorical analysis further demonstrated that the clerkship had a high impact in teaching 13 of the 27 topics (48%), had a lower impact for 6 topics (22%), and identified the remaining 8 topics (30%) as gaps in teaching and learning.ConclusionsFor medical students, our instructional program significantly increased competency for most critical radiologic diagnoses. Categorical analysis adds value beyond statistical analysis and allows dynamic tailoring of teaching to address gaps in student learning.  相似文献   

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PURPOSEThe number of female medical students has increased significantly in the last decade due to increased gender diversity. However, the number of female doctors going into interventional radiology (IR) does not reflect this trend on an international scale.METHODSA standardized set of questions was created looking into medical students’ demographics, awareness of IR, their general opinion, and whether they would consider IR as a potential career path. One-hundred female medical students from the United Kingdom, Germany, Poland, Spain, and New Zealand were approached either directly or via an online survey platform. The students ranged from first to final year study of Medicine and were between 18 and 30 years of age.RESULTSThe majority of medical students (68%) were unaware of what IR is and 98% denied having teaching about IR in their university. Influential factors to choosing IR were more exposure to IR in medical school (15%), more options to allow family life (15%), direct training pathway to IR rather than via diagnostic radiology (13%), options of private practice (13%), and understanding more about radiation protection during pregnancy (12%).CONCLUSIONA lack of awareness about what IR is and misconceptions, particularly regarding radiation exposure during pregnancy, play an important role in discouraging entry into IR. Additionally, some of the concerns raised were directed at IR training pathway. Female IR consultants should also take leadership initiative to act as role models. More lectures and direct clinical exposure are paramount to their understanding of IR.

Over the past decades, the number of female medical students has gradually increased equalizing the gender gap. The Royal College of Physicians suggest that more than 60% of new medical students in 2009 were female (1). This was increased by ten-fold in comparison to the late 20th century when medicine was a male dominated career (1). However, the number of female doctors going into interventional radiology (IR) training schemes or female IR consultants does not reflect this trend on an international scale. When compared with other specialties such as general surgery and vascular surgery, entrance of women into IR was substantially lower in proportion (2, 3). Even though female consultant radiologists make 35% of the IR workforce in the UK, it was estimated that only 10% of interventional radiology consultants were female (4, 5).Many factors have been perceived to contribute to this discrepancy. These include radiation exposure concerns (particularly those relating to pregnancy), the frequency of being on call, the lack of female role models, and an overwhelmingly male dominant culture in IR (3, 5). Methods to attract females into IR include early exposure to the specialty, preferably at the medical student stage to increase interest and address any misconceptions of the perceived work life imbalance and radiation exposure (5). The aim of our study was to evaluate and understand female medical students’ perception of the obstacles preventing them from entering this career path.  相似文献   

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PurposeIn an effort to better characterize the extent and impact of residency expansion and job placement, the authors conducted a multilevel survey of radiation oncologists exploring the current state of the radiation oncology employment market.MethodsA multilevel survey was conducted using the Qualtrics platform in the spring of 2017. Survey participants were categorized into five groups within radiation oncology: (1) chairpersons, (2) program directors, (3) new practitioners (at least 1 year out of residency), (4) new residency graduates (radiation oncology postgraduate year 5 graduates with new jobs), and (5) medical students. The Wilcoxon-Mann-Whitney test was used to compare Likert scale scores.ResultsA total of 752 participants were surveyed, with an overall response rate among all five groups of 31% and 92% of those completing the entire survey. Chairpersons were more likely to consider expanding their residency programs compared with program directors. Fellowship remained low on the job search, with less than 10% of new graduates and new practitioners interested in fellowship positions. Job satisfaction was high with 85% of new graduates, and 78% of new practitioners moderately to very satisfied with their future or current employment. The vast majority of both new practitioners (85%) and new graduates (81%) was moderately to very satisfied with their location of practice.ConclusionsResident job satisfaction remains high, whereas interest in radiation oncology fellowships remains low. Conflicting perception regarding the job market and residency expansion could have downstream impacts, such as deterring potential applicants.  相似文献   

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BACKGROUND AND PURPOSE:While standard guidelines assist in target delineation for head and neck radiation therapy planning, the complex anatomy, varying patterns of spread, unusual or advanced presentations, and high risk of treatment-related toxicities produce continuous interpretive challenges. In 2007, we instituted weekly treatment planning quality assurance rounds as a joint enterprise of head and neck radiation oncology and neuroradiology. Here we describe its impact on head and neck radiation therapy target delineation.MATERIALS AND METHODS:For 7 months, treatment planning quality assurance included 80 cases of definitive (48%) or postoperative (52%) head and neck radiation therapy. The planning CT and associated target volumes were reviewed in comparison with diagnostic imaging studies. Alterations were catalogued.RESULTS:Of the 80 cases, 44 (55%) were altered, and of these, 61% had clinically significant changes resulting in exclusion or inclusion of a distinct area or structure. Reasons for alteration included the following: gross or extant tumor, 26/44 (59%); elective or postoperative coverage, 25/44 (57%); lymph nodes, 13/44 (30%); bone, 7/44 (16%); skull base, 7/44 (16%); normal organs, 5/44 (11%); perineural, 3/44 (7%); distant metastasis, 2/44 (5%); and eye, 1/44 (2%). Gross tumor changes ranged from 0.5% to 133.64%, with a median change in volume of 5.95 mm3 (7.86%). Volumes were more likely to be increased (73%) than decreased (27%).CONCLUSIONS:A collaborative approach to head and neck treatment planning quality assurance has an impact. Cases likely to have challenging patterns of infiltrative, intracranial, nodal, orbital, or perineural spread warrant intensive imaging-based review in collaboration with a diagnostic neuroradiologist.

Retrospective and prospective studies demonstrate increased efficacy from multidisciplinary physician interaction,1,2 and team-based approaches to patient care are routine within radiation oncology. However, the process of radiation therapy target delineation remains an essentially solitary activity, and the impact of collaborative peer review is a contested issue. One survey suggested that major alterations from this type of process were rare, occurring in <6% of head and neck (HN) plans, though the extent of alterations was noted to be dependent on the reviewing peer''s subsite experience level.3The weakness of these studies as applied to HN cancer stems from a tendency to underestimate the specialized nature of anatomically defined HN radiation therapy and its unique interdependence with neuroradiology. Head and neck malignancies comprise a heterogeneous group of neoplasms characterized by complex local and regional anatomy, varying patterns of spread, and frequent occurrence of unusual and/or advanced presentations. Acquiring proficiency in the interpretation of HN imaging is difficult due to the subtlety of the characteristics that may suggest benign or malignant disease and distinguishing them from normal or inflamed tissue. Because management frequently consists of staged, multimodal combinations of surgery, systemic therapy, and/or radiation therapy, the interpretation of sequential image sets is exceptionally challenging, particularly the discrimination of posttreatment changes from residual disease.4 Previous studies have found that after re-interpretation by a specialist head and neck neuroradiologist, changes in staging or management occur in 38%–56% of cases.5,6Beginning in 2007, diagnostic neuroradiology participation was included as part of weekly HN treatment planning quality assurance (TPQA) rounds at our institution. The format includes diagnostic imaging review for new and follow-up patients, as well as the highly prioritized review of proposed radiation therapy target volumes and normal organ delineations, which are peer-reviewed by HN radiation oncology and neuroradiology physicians. As of June 2010, electronic documentation was prepared pre- and post-TPQA. This study characterizes the impact of diagnostic neuroradiology involvement on the radiation therapy planning process.  相似文献   

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ObjectivesTo assess and raise medical student interest in interventional radiology (IR); and to evaluate student response across gender, level of training, and surgical vs nonsurgical specialty interest.Materials and MethodsAll Ohio medical students were invited to an IR Symposium held by a large academic medical center in central Ohio. The program encompassed didactic lectures, hands-on simulation models, and a networking luncheon with faculty, trainees, and industry partners. All attendees completed an anonymous, 5-point Likert scaled survey preattending and postattending the event to assess their awareness of IR as a specialty, understanding of the current training pathways, and level of interest.ResultsA total of 46 participants (M:F 60%:40%, MS1—53%, MS2—36%, and MS3—11%) attended the symposium. The cohort demonstrated increased interest in pursuing a career in IR following the symposium (4.12 vs 3.70, P < 0.001). Students with an interest in a nonsurgical specialty showed an increased interest in IR (4.20 vs 3.68, P < 0.001), whereas surgically oriented students did not demonstrate a significant increase (4.00 vs 3.71, P = 0.375). No statistically significant differences were noted across gender or level of training. The symposium experience significantly increased understanding of the IR training pathways (4.51 vs 2.94, P < 0.001). Students rated lectures (57%) and endovascular simulators (41%) as the most useful experiences.ConclusionsThis study demonstrated the role of symposia in improving medical student awareness of IR and training pathways. Findings were validated across gender and training level, and identified the subset of students with nonsurgical interests as most responsive to such intervention and potential recruitment.  相似文献   

17.
PurposeThis study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools.MethodsAn online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey.ResultsOf 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology.ConclusionsThis survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught.  相似文献   

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PurposeThe aim of this study was to survey fourth-year medical students, both those choosing and those not choosing diagnostic radiology as their specialty, regarding factors influencing their choice of specialty and their perceptions of radiology.MethodsA voluntary anonymous online survey hyperlink was sent to 141 US medical schools for distribution to fourth-year students. Topics included demographics, radiology education, specialty choice and influencing factors, and opinions of radiology.ResultsA representative sampling (7%) of 2015 fourth-year medical students (n = 1,219; 51% men, 49% women) participated: 7% were applying in radiology and 93% were not. For respondents applying in radiology, the most important factor was intellectual challenge. For respondents applying in nonradiology specialties, degree of patient contact was the most important factor in the decision not to choose radiology; job market was not listed as a top-three factor. Women were less likely than men to apply in radiology (P < .001), with radiology selected by 11.8% of men (56 of 476) and only 2.8% of women (13 of 459). Respondents self-identifying as Asian had a significantly higher (P = .015) likelihood of selecting radiology (19 of 156 [12.2%]) than all other races combined (44 of 723 [6.1%]). Respondents at medical schools with required dedicated medical imaging rotations were more likely to choose radiology as a specialty, but most schools still do not require the clerkship (82%).ConclusionsThe reasons fourth-year medical students choose, or do not choose, diagnostic radiology as a specialty are multifactorial, but noncontrollable factors, such as the job market, proved less compelling than controllable factors, such as taking a radiology rotation.  相似文献   

20.

Objectives

How do students experience and perceive the innovative undergraduate radiology curriculum at Ghent University, and what explains differences in student perception?

Methods

A survey was presented to the 2008 cohort of students enrolled in the undergraduate medical curriculum at Ghent University. The survey focused on their experiences and perceptions in relation to the innovative undergraduate radiology teaching.

Results and conclusion

The present research results point at a favorable perception of the innovative radiology curriculum components. The study points - both during pre-clinical and clinical years - at the appreciation for curriculum components that combine traditional curriculum components (ex-cathedra lessons with syllabus) with distance learning components such as E-learning and E-testing. In clinical years - as expected - students switch to the application of knowledge and skills and therefore heavily appreciate practice linked curriculum components.  相似文献   

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