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.     

Curriculum in radiology for residents: what, why, how, when, and where

Developing a curriculum in chest radiology should follow the same general principles that are used when developing a curriculum in any subspecialty area of radiology. A curriculum is more than a "list of topics" with which a resident should be familiar after 4 years of training. It includes objectives and goals, content, faculty, methods, and evaluation. Numerous resources are available for those who are charged with developing a curriculum in chest radiology. In addition to faculty members in the department, whose input during development can ensure successful implementation of the curriculum, organizations (i.e., ACR, APDR, STR) already have begun to develop "model" curricula. Attending the annual meeting of the Association of American Medical Colleges is a way to meet and hear from professionals who develop and oversee curriculum development at their medical schools, and another important resource available at some medical schools is the Office of Medical Education. The faculty within such offices are uniquely qualified to assist with curriculum and faculty development, especially for those areas in which radiology faculty traditionally are less experienced, such as development of valid and reliable assessment forms and construction of behaviorally based objectives.     

The effect of radiology electives on career choice at McMaster University

Recruitment ot radiology is said to be affected by the extent to which radiologists participate in medical student teaching. At McMaster University, where radiologists make major contributions to the medical school curriculum, students appear to show little interest in radiology as a career. The characteristics, attitudes and career choices of students at McMaster who undertook elective periods in radiology between 1973 and 1976 were examined. Though students rated the elective experience very highly, none intended to become a radiologist. Half of the group wished to take up family practice, the proportion in the school as a whole being similar. This is consistent with policies of student selection and education at McMaster. Most of those choosing family practice did not change their career choice between entry to and exit from the school. Involvement of radiologists in the curriculum had no detectable positive influence on career choice.     

Why don’t female medical students choose diagnostic radiology? A review of the current literature

While the number of women entering medical schools is approaching 50% nationally, women continue to be underrepresented in a number of specialties including diagnostic radiology. While diagnostic radiology has many characteristics that might be desirable to women, such as reasonable call hours, flexible scheduling, and high salaries, women still do not choose diagnostic radiology as a career. This article examines the literature to discern possible reasons for why women are entering diagnostic radiology at a lower rate. We address trends among women in academic medicine, which resemble trends among women in diagnostic radiology, and examine the effects of gender and socialization in medical school on specialty choices among women. The current literature suggests a constellation of factors may be responsible for the gender differences in diagnostic radiology. We suggest that further research is needed to elucidate why women do not seem to be choosing diagnostic radiology as frequently as one might predict based on the lifestyle of diagnostic radiologists and the numbers of women currently entering medical school. Once these reasons are made clear, it will be possible for residency program directors and medical schools to ensure that women are making informed specialty choices, whatever those choices may be.     

Development and assessment of a radiology core curriculum in health care policy and practice

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the feasibility of implementing a core curriculum in health policy and practice for radiology residents and fellows, to determine whether such a curriculum would be considered professionally valuable by participants, and to determine if the curriculum would influence participants' careers. MATERIALS AND METHODS: A core curriculum in health policy and practice was developed, involving 19 seminars presented over 5 weeks. Twelve faculty members presented comprehensive and integrated information relevant to current and future radiology practice. Topic clusters included health care structure and payment, technology and health services, radiology practice management, and career issues. Classroom teaching was supplemented by a course syllabus and resource library. Participants were surveyed following each seminar and at the conclusion of the curriculum. RESULTS: Participants described their baseline knowledge of each topic as weak. As a result of the curriculum, self-described knowledge ratings increased considerably. Interest in curriculum topics and perception of their importance and relevance to radiology practice increased. Of respondents, 84% (26 of 31) described the curriculum as having very good or excellent educational value. All respondents indicated that the curriculum should be repeated in the future, 42% (13 of 31) indicated that the curriculum motivated them to pursue further related education, and 61% (19 of 31) developed interest in personal involvement in administrative issues and radiology organizations. CONCLUSION: A core curriculum in health policy and practice was successfully integrated into radiology training. The curriculum resulted in increased knowledge, interest, and perceived importance of medical management issues by residents and fellows and stimulated their interest in pursuing further management education and involvement in radiology administration and organizations.     

Radiologists as clinical tutors in a problem-based medical school curriculum.

RATIONALE AND OBJECTIVES: The authors sought to evaluate the experience of radiologists teaching in a problem-based pre-clinical medical school curriculum. MATERIALS AND METHODS: The undergraduate medical school curriculum at Wake Forest University includes 2 problem-based preclinical years that integrate basic and clinical sciences. Sixteen radiology fellows served as general clinical tutors for 5-9 weeks, each guiding the work of six 2nd-year students, often in tandem with a basic science tutor. On completion of the tutoring. the radiologists and the students were surveyed by means of a questionnaire. A follow-up group interview was conducted with the radiologists. RESULTS: The response rate to the questionnaire was 81% for the radiologists and 47% for the students. On average, radiologists spent 6.1 hours weekly on preparation and tutoring and 3.5 hours in total on administration and grading. All radiologists thought tutoring was rewarding, but seven of the 13 respondents (54%) disliked assigning grades. Radiologists spent less time teaching radiology residents and performing research, but few thought their clinical work was adversely affected. Nearly half of the radiologist-tutors thought that the preliminary orientation and training provided to them by the medical school was not adequate, and nearly all of them thought that they could have been better prepared. All of the medical students improved their perceptions of radiologists after having had a radiologist as a tutor, and most thought that the radiologist-tutors performed as well as or better than tutors from other disciplines. CONCLUSION: Radiologists can be successful as general tutors in a problem-based medical school curriculum. benefiting both radiologists and students. Better orientation and training by the medical school would improve the program.     

The State of Radiologic Teaching Practice in Preclinical Medical Education: Survey of American Medical,Osteopathic, and Podiatric Schools

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.     

Clinically oriented three-year medical physics curriculum: a new design for the future

OBJECTIVE: Medical physics instruction for diagnostic radiology residency at our institution has been redesigned with an interactive and image-based approach that encourages clinical application. The new medical physics curriculum spans the first 3 years of radiology residency and is integrated with the core didactic curriculum. CONCLUSION: Salient features include clinical medical physics conferences, fundamentals of medical physics lectures, practicums, online modules, journal club, and a final review before the American Board of Radiology core examination.     

Multidisciplinary Approach in Teaching Diagnostic Radiology to Medical Students: The Development,Implementation, and Evaluation of a Virtual Educational Model

PurposeThe aim of this study was to develop, implement, and evaluate the effectiveness of an online multidisciplinary approach for teaching diagnostic radiology to medical students.MethodsAn online 10-session case-based learning course was designed and taught by a multidisciplinary team of radiologists, surgeons, and internists. Session topics included common clinical case scenarios for different systems and were hosted on a videoconferencing platform. Students from six medical schools across Texas enrolled in the course. The effectiveness of each session was evaluated using a pretest-posttest design. Students completed a final survey after the course to evaluate their experience.ResultsAn average of 108 attended the live sessions, with attendance peaking at 220. On average, 75 students completed both the pretest and posttest of each session. Posttest scores were an average of 46% higher than pretest scores. A total of 109 students completed the final survey; more than 90% of participants agreed that the program was relevant, that its multidisciplinary approach was valuable, and that it increased their knowledge of imaging as a diagnostic tool. Seventy-four percent said that the program increased their interest in radiology. Almost all participants said that the topics presented were thought to be “excellent and clinically important to learn” by most of the students (70%). Participants reported increased confidence in basic radiology skills after completion of the program.ConclusionsAn online multidisciplinary approach can be feasibly implemented to address the radiology education needs of a large number of medical students across a group of medical schools.     

Radiology curriculum for medical students: clinicians' perspectives

This study was conducted to establish clinicians' perspectives of a set of radiology curriculum topics for medical student teaching, which were held to be important by radiologists. A questionnaire was sent to clinicians in all specialties. Forty-six clinicians (51.1%) out of 90 returned the questionnaires. All curriculum topics were scored above an average of 4 (agree). The five highest ranking curriculum topics in order of importance were: developing a system for viewing chest radiographs (5.59), developing a system for viewing abdominal radiographs (5.56), developing a system for viewing bone and joint radiographs (5.33), distinguishing normal structures from abnormal in chest and abdominal radiographs (5.33) and identifying gross bone or joint abnormalities in skeletal radiographs (5.22). Correlative analysis between speciality groups showed surgical and medical specialities were significantly different in their responses of two learning outcomes: basic knowledge about the contrast media benefits and risks (P= 0.01) and ability to select the most appropriate and the most cost-effective methods of radiological investigations for clinical situations (P= 0.03). Acute specialities were not significantly different from the other two groups for these two learning outcomes. There was no statistically significant difference for other learning outcomes between the three speciality groups.     

Percepciones de estudiantes de Medicina sobre el impacto de la inteligencia artificial en radiología

ObjectivesTo analyze medical students’ perceptions of the impact of artificial intelligence in radiology.Material and methodsA structured questionnaire comprising 28 items organized into six sections was distributed to students of medicine in Spain in December 2019.ResultsA total of 341 students responded. Of these, 27 (7.9%) included radiology among their three main choices for specialization, and 51.9% considered that they clearly understood what artificial intelligence is. The overall rate of correct answers to the objective true-or-false questions about artificial intelligence was 70.7%. Whereas 75.9% expressed their disagreement with the hypothesis that artificial intelligence would replace radiologists, only 41.9% disagreed with the hypothesis that the demand for radiologists would decrease in the future. Only 36.7% expressed concerns about the role of artificial intelligence related to choosing radiology as a specialty. A greater proportion of students in the early years of medical school agreed with statements that radiologists accept artificial-intelligence-related technological changes and work with the industry to apply them as well as with statements about the need to include basic training about artificial intelligence in the medical school curriculum.ConclusionsThe students surveyed are aware of the impact of artificial intelligence in daily life, but not of the current debate about its potential applications in radiology. In general, they think that artificial intelligence will revolutionize radiology without having an alarming effect on the employability of radiologists. The students surveyed think that it is necessary to provide basic training about artificial intelligence in undergraduate medical school programs.     

Global Radiology Training Prevalence Among Radiology Residency Programs

ObjectiveGlobal Radiology aims to enhance access to medical imaging services and education, worldwide. To date, few reports have evaluated Global Radiology Training (GRT) in radiology residency programs. Here, we examined how radiology residency programs perceive and incorporate GRT into their curriculum, and how this information is promoted online.MethodsTwo methods were used to examine the current state of GRT. First, radiology residency program directors (identified via the Association of Program Directors in Radiology) were surveyed on topics including: Electives, institutional partnerships, resident and faculty involvement, inquiry by prospective residents, and barriers to implementation. Second, radiology residency program websites (n = 193) were examined for existing GRT on the programs’ publicly available webpages.ResultsThere were 62 survey responses (response rate of 19%). Thirty-eight percent (24/62) of residency programs offered a Global Radiology elective to their residents within the past academic year and 27% (17/62) of programs have active affiliations with medical institutions outside of the United States. Eighty-four percent of program directors (52/62) received questions from residency applicants regarding opportunities to participate in Global Radiology. Furthermore, only 13% (26/193) of all radiology residency programs listed at least one GRT elective on their webpage.DiscussionGRT in radiology residency is more widely available than previously reported and has been underrepresented on residency program websites. In the present survey, the majority of radiology residency program directors reported that radiology is an important component of Global Health, one-third of whom have already incorporated the subject into their curriculum. However, most common barriers to GRT include, perceived lack of time in the curriculum and lack of faculty interest. The high prevalence of inquiry from residency program applicants about GRT suggests that it may be a notable factor for applicants during the ranking process. Programs build up GRT may choose to share related information seeking to may choose to emphasize work in Global Radiology on their program webpages.     

Implementation of a new undergraduate radiology curriculum: experience at the University of British Columbia.

OBJECTIVES: The purpose of this study was to review and revise the undergraduate radiology curriculum at the University of British Columbia to improve radiology education to medical students and to meet the needs of a medical program with province-wide distribution. METHODS: We identified the radiology content of the curriculum from the Curriculum Management and Information Tool online database, from personal interviews with curriculum heads, and from published information. Undergraduates' and recent graduates' opinions were solicited by means of surveys. Information on radiology curricula at medical schools across Canada was gathered from email surveys and personal contacts with members of the Canadian Heads of Academic Radiology (CHAR). RESULTS: Review of our curriculum indicated that lack of a unified syllabus resulted in redundant content, gaps in knowledge, and lack of continuity in the curriculum. Results from the survey of programs across Canada indicated that most schools also lacked a formal radiology curriculum for medical students. By adapting the guidelines from the Association of Medical Student Education in Radiology, we revised our undergraduate radiology curriculum to emphasize integration and self-learning. The modified curriculum includes a combination of instructional technology, focused lectures in preclinical years, and in-context seminars in clerkship rotations. CONCLUSION: Most medical schools in Canada do not have a formal radiology curriculum for medical students. A structured curriculum is required to improve the quality of radiology teaching for medical students.     

Diagnostic imaging in undergraduate medical education: an expanding role

Radiologists have been involved in anatomy instruction for medical students for decades. However, recent technical advances in radiology, such as multiplanar imaging, "virtual endoscopy", functional and molecular imaging, and spectroscopy, offer new ways in which to use imaging for teaching basic sciences to medical students. The broad dissemination of picture archiving and communications systems is making such images readily available to medical schools, providing new opportunities for the incorporation of diagnostic imaging into the undergraduate medical curriculum. Current reforms in the medical curriculum and the establishment of new medical schools in the UK further underline the prospects for an expanding role for imaging in medical education. This article reviews the methods by which diagnostic imaging can be used to support the learning of anatomy and other basic sciences.     

Development of a Competency-Based Radiology Clerkship Using Categorical and Statistical Analysis of Assessment

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.     

First-year medical students' attitudes toward radiology.

To explore the perspectives of entering medical students, a questionnaire was completed anonymously by 171 students in September of their first year of medical school. The authors investigated their attitudes toward radiology relative to other specialties and their perspective concerning which factors would influence their eventual choice of a specialty. Upon entering medical school, 33.3% of the students indicated that they had chosen a specialty, and 7.4% of these students had selected radiology. Radiology was perceived as a well-paid specialty with a pleasant lifestyle. These are factors that were perceived as very important regarding influence on eventual choice of specialty. However, radiology was believed to have an undesirably low level of patient contact and was perceived as not being intellectually exciting. We plan to follow this group of students prospectively through medical school to see whether their attitudes change toward radiology as a career.     

Utilization of a Virtual Information Session to Increase Engagement With Prospective Applicants in the Setting of COVID-19

PurposeThis study aimed to assess the efficacy of a virtual information session hosted by a diagnostic radiology residency program at addressing applicant concerns about the 2020-2021 interview cycle and highlighting key aspects of the residency program.MethodsParticipants were recruited to attend the virtual information session over a 2-week period via social media and communication with medical school radiology interest groups. Attendees were able to submit questions or topics of interest prior to the session. The virtual information session was hosted by trainees and faculty from a radiology residency. Data regarding the demographics of the attendees and the efficacy of the session were obtained through interactive live polling during the virtual session and a voluntary anonymous postsession survey.ResultsA total of 171 attendees participated in the virtual information session. Of the attendees, 42% learned about the session from Twitter and 72% were fourth-year medical students applying for residency. Among topics addressed during the session, attendees indicated that they were most interested in learning about “Application strategies during COVID-19” during an in-session poll. On the post-session survey, 96% of attendees reported being more knowledgeable about the residency program culture and the breadth of research and educational opportunities.ConclusionGiven the virtual nature of the 2020-2021 residency application cycle, utilization of web-based platforms for recruitment will be essential. Virtual information sessions can be effective at providing insight into aspects of a residency program that are typically gained during the in-person interview experience.     

Radiology Clerkship Requirements in Canada and the United States: Current State and Impact on Residency Application

PurposeAn unmet need for radiology education exists even in this era of medical school curricular renewal. The authors examined the radiology clerkship requirements in Canadian and US medical schools to interpret radiology residency applicant trends.MethodsThe curricula of Canadian and US medical schools were reviewed for radiology rotation requirements. The radiology residency applicant trends for 2010 to 2019 were analyzed using linear regression. The number of radiology electives taken by matched radiology applicants was examined. Regression analysis was performed to assess the impact of radiology rotation requirements on residency application.ResultsOnly 1 of 17 Canadian medical schools required a radiology rotation despite major curricular renewal at the majority of medical schools. Approximately 20% of US medical schools required radiology rotations, without a significant change from 2011 to 2018, whereas the duration of required radiology rotations increased significantly. The numbers of total and first-choice radiology applicants showed significant decreases from 2010 to 2019 in Canada but not in the United States. Nearly all matched radiology applicants took electives in radiology, the majority of whom took three or more electives. Both the presence and duration of radiology rotation requirements showed significant, positive relationships with the number of radiology applicants.ConclusionsOnly a minority of medical schools in North America have radiology clerkship requirements, both the presence and duration of which significantly affect students’ choice of radiology as a career. Radiology clerkship requirements can be a solution to meet the expanding demand for diagnostic imaging in modern medicine.     

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.