First-Year Radiology Residents Teaching Anatomy to First-Year Medical Students: A Symbiotic Relationship

ObjectivesOur institution has developed an educational program in which first-year radiology residents teach first-year medical students during gross anatomy laboratory sessions. The purpose of this study is to assess the impact of this program on medical student knowledge and perceptions of radiology, and on resident attitudes toward teaching.Materials and MethodsFirst-year resident pairs taught small groups of medical students during weekly 15-minute interactive sessions, and were evaluated on teaching skills by senior residents. A survey about attitudes toward radiology and a knowledge quiz were sent to the medical students, and a survey about attitudes toward teaching was sent to the first-year radiology residents, both pre-course and post-course.ResultsStudents’ radiology knowledge significantly increased between the pre-course and post-course survey across all categories tested (P < 0.001). Additionally, there were significant improvements in terms of students’ confidence in radiologic anatomy skills, perceived importance of radiology for medical training, familiarity with the field of radiology, and perception that radiologists are friendly (P < 0.001). Radiology residents felt more confident in their teaching proficiency (P < 0.001) by the conclusion of the course.ConclusionsResident-led small-group teaching sessions during anatomy laboratory are mutually beneficial for medical students and radiology residents. The program also allows radiology residents to be exposed early on in residency to teaching and academic medicine.     

Medical Student Performance After a Vertically Integrated Radiology Clerkship

PurposeProper selection of imaging examinations and basic image interpretation skills are essential for all physicians, yet only approximately 25% of US medical schools require clerkships in radiology. Although there is limited time in most medical school curricula to allow the addition of a required radiology clerkship, the authors developed one that is vertically integrated over a two-year period. This clerkship includes one week of contact with radiologists distributed over the M2 and M3 years, podcasts, online modules, required readings, and presentations. A standard national examination is administered at the end of the clerkship period. This clerkship was designed to address the educational needs of students while occupying minimal time in the curriculum. The purpose of this study was to determine if students completing this clerkship perform as well on a national radiology examination as students from other medical schools, regardless of their curricula.MethodsAt the end of the M3 year, these students take a computer-based radiology examination developed by the Alliance of Medical Student Educators in Radiology and used by students at multiple medical schools nationally. The mean and median scores of these students were compared with those of students at these other institutions.ResultsThe mean and median scores of the students were 74% and 74% (standard deviation, 7.5%) compared with 74% and 50% (standard deviation, 8.4%) at other institutions.ConclusionsStudents completing this vertically integrated radiology clerkship had test scores comparable with those of students at other medical schools.     

Blending online techniques with traditional face to face teaching methods to deliver final year undergraduate radiology learning content

Aim

To review the initial experience of blending a variety of online educational techniques with traditional face to face or contact-based teaching methods to deliver final year undergraduate radiology content at a UK Medical School.

Materials and methods

The Brighton and Sussex Medical School opened in 2003 and offers a 5-year undergraduate programme, with the final 5 spent in several regional centres. Year 5 involves several core clinical specialities with onsite radiology teaching provided at regional centres in the form of small-group tutorials, imaging seminars and also a one-day course. An online educational module was introduced in 2007 to facilitate equitable delivery of the year 5 curriculum between the regional centres and to support students on placement. This module had a strong radiological emphasis, with a combination of imaging integrated into clinical cases to reflect everyday practice and also dedicated radiology cases. For the second cohort of year 5 students in 2008 two additional online media-rich initiatives were introduced, to complement the online module, comprising imaging tutorials and an online case discussion room.

Results

In the first year for the 2007/2008 cohort, 490 cases were written, edited and delivered via the Medical School managed learning environment as part of the online module. 253 cases contained a form of image media, of which 195 cases had a radiological component with a total of 325 radiology images. Important aspects of radiology practice (e.g. consent, patient safety, contrast toxicity, ionising radiation) were also covered. There were 274,000 student hits on cases the first year, with students completing a mean of 169 cases each. High levels of student satisfaction were recorded in relation to the online module and also additional online radiology teaching initiatives.

Conclusion

Online educational techniques can be effectively blended with other forms of teaching to allow successful undergraduate delivery of radiology. Efficient IT links and good image quality are essential ingredients for successful student/clinician engagement.     

The Short and the Long of It: Transitioning to a Blended Longitudinal Curriculum in Radiology

PurposeThe 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.MethodsIn 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 question 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.ResultsAmong 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.ConclusionsTransitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.     

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.     

Evaluation of use of e-Learning in undergraduate radiology education: A review

PurposeThe aim of this review is to investigate the evaluative outcomes present in the literature according to Kirkpatrick's learning model and to examine the nature and characteristics of the e-Learning interventions in radiology education at undergraduate level.Materials and methodsFour databases (PubMed, MEDLINE, Embase, Eric) are searched for publications related to the application of e-Learning in undergraduate radiology education. The search strategy is a combination of e-Learning and Mesh and non Mesh radiology and undergraduate related terms. These search strategies are established in relation to experts of respective domains. The full text of thirty pertinent articles is reviewed. Author's country and study location data is extracted to identify the most active regions and year's are extracted to know the existing trend. Data regarding radiology subfields and undergraduate year of radiology education is extracted along with e-Learning technologies to identify the most prevalent or suitable technologies or tools with respect to radiology contents. Kirkpatricks learning evaluation model is used to categorize the evaluative outcomes reported in the identified studies.ResultsThe results of this analysis reveal emergence of highly interactive games, audience response systems and designing of wide range of customized tools according to learner needs assessment in radiology education at undergraduate level. All these initiatives are leading toward highly interactive self directed learning environments to support the idea of life-long independent learners. Moreover, majority of the studies in literature regarding e-Learning in radiology at undergraduate level are based on participant satisfaction followed by participant results or outcomes either before or after an intervention or both. There was no research particularly demonstrating performance change in clinical practice or patient outcome as they may be difficult to measure in medical education. Thus clinical competences and performances are highly affected by pretentious learning environments.     

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 in Medical Education: A Pediatric Radiology Elective as a Template for Other Radiology Courses

PurposeTraditionally, the pediatric radiology elective for medical students and pediatric residents constituted a morning teaching session focused mainly on radiography and fluoroscopy. A more structured elective was desired to broaden the exposure to more imaging modalities, create a more uniform educational experience, and include assessment tools.MethodsIn 2012, an introductory e-mail and formal syllabus, including required reading assignments, were sent to participants before the start date. A rotating weekly schedule was expanded to include cross-sectional imaging (ultrasound, CT, MR) and nuclear medicine. The schedule could accommodate specific goals of the pediatric resident or medical student, as requested. Starting in 2013, an online pre-test and post-test were developed, as well as an online end-of-rotation survey specific to the pediatric radiology elective. Taking the Image Gently pledge was required. A scavenger hunt tool, cue cards, and electronic modules were added.ResultsPre-test and post-test scores, averaged over 2 years, showed improvement in radiology knowledge, with scores increasing by 27% for medical students and 21% for pediatric residents. Surveys at the end of the elective were overwhelmingly positive, with constructive criticism and complimentary comments.ConclusionsWe have successfully created an elective experience in radiology that dedicates time to education while preserving the workflow of radiologists. We have developed tools to provide a customized experience with many self-directed learning opportunities. Our tools and techniques are easily translatable to a general or adult radiology elective.     

Development and Evaluation of a Competency-Based Anatomy Rotation for Diagnostic Radiology Residents During Internship Year: A Canadian Experience

Rationale and Aim

As medical schools reduce the hours of anatomy teaching, residents in anatomy-intensive residency programs like radiology must independently acquire the anatomy knowledge needed to achieve competency. The purpose of this study was to develop and evaluate a 4-week competency-based self-directed anatomy rotation for junior residents.

The State of Medical Student Teaching of Interventional Radiology: Implications for the Future

IntroductionThe formation of integrated interventional radiology (IR) residency programs has changed the training paradigm. This change mandates the need to provide adequate exposure to allow students to explore IR as a career option and to allow programs to sufficiently evaluate students. This study aims to highlight the availability of medical student education in IR and proposes a basic framework for clinical rotations.Materials and MethodsThe Liaison Committee on Medical Education (LCME) website was utilized to generate a list of accredited medical schools in the United States. School websites and course listings were searched for availability of IR and diagnostic radiology rotations. The curricula of several well-established IR rotations were examined to identify and categorize course content.ResultsIn all, 140 LCME-accredited medical schools had course information available. Of those schools, 70.5% offered an IR rotation; 84.6% were only available to senior medical students and only 2% were offered for preclinical students; and 8.1% of courses were listed as subinternships. Well-established IR clerkships included a variety of clinical settings, including preprocedure evaluation, experience performing procedures, postprocedure management, and discharge planning.ConclusionMedical student exposure to IR is crucial to the success of integrated IR residency programs. Current research shows few institutions with formal IR subinternship rotations. Although 70.5% of institutions have some form of nonstandardized IR course, 84.6% are available only to fourth-year students, and 2% are offered to preclinical students. This suggests there is a significant opportunity for additional formal exposure to IR through increasing availability of IR rotations and exposure during the clinical and preclinical years.     

Surveying Fourth-Year Medical Students Regarding the Choice of Diagnostic Radiology as a Specialty

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.     

Impact of Early Radiology Research Experiences on Medical Student Perceptions of Radiology and Research

Rationale and objectivesTo promote opportunities for medical students to gain early exposure to radiology and research, our institution has initiated programs which fund summer radiology research projects for rising second-year medical students. This study assesses the impact of these faculty-mentored summer research experiences on medical student perceptions of radiology and research, in terms of both knowledge and interest.Materials and methodsA voluntary, anonymous survey was administered to students both before and after the summer research period. Both the pre-program survey and post-program survey included 7-point Likert-scale questions (1 = strongly disagree; 7 = strongly agree) to evaluate students’ perceptions about research and students’ perceptions about radiology as a specialty. Faculty mentors were sent an analogous post-program survey that included an evaluation of their student's research skills.ResultsThe surveys were completed by 9 of 11 students and 10 of 11 mentors. Students’ perceived knowledge of radiology as a specialty improved (P = 0.02) between the pre-program survey and post-program survey. Similarly, there was an increase in students’ perceived knowledge of research skills (P = 0.02) between the pre-program survey and post-program survey, with student ratings of research skills consistent with those of mentors. High student interest in both radiology and research was maintained over the course of the program.ConclusionOur pilot study suggests that summer research experiences can improve knowledge of radiology and research among medical students. Continued evaluation of this annual program will allow us to enhance the benefit to medical students and thereby bolster interest in academic radiology.     

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.     

The Challenge With Clinical Radiology Electives: Student and Faculty Perspectives Identify Areas for Improvement

PurposeTo determine medical students' and radiologists’ attitude toward radiology electives at a distributed medical school and identify specific areas for improvement.MethodsDuring a single academic year, both students and faculty preceptors were surveyed anonymously following a senior radiology elective. The survey was based on an established theoretical framework for studying the educational environment which takes into account domains: (1) goal orientation, (2) organization/regulation, and (3) relationships. Mann-Whitney tests were performed to determine if there was any difference between the overall satisfaction of students and preceptors, responses from the different elective sites and students’ ratings of the domains. Statistical significance was set at P < .05. Thematic analysis was performed on the narrative comments to identify specific challenges.ResultsThe response rate was 82.0% for students (95/116) and 19.5% (31/159) for radiologists. There was no difference in responses based on elective site. Overall, the elective was viewed positively by both groups however students rated their experience as significantly better than their preceptors (P = .0012). Students viewed the relationships domain more positively than both the other two (goal orientation, P = .0001; organization/regulation, P = .0038). Thematic analysis identified that the student challenges were lack of autonomy, structured teaching, and preceptor continuity and the preceptor challenges were ambiguous learning objectives/expectations and insufficient resources.ConclusionsThe radiology elective challenges identified in this study provide educators with specific areas to target when updating radiology electives. A better elective experience may improve students' radiology knowledge and attitude towards the specialty as well as radiologists’ interest in teaching.     

Artificial Intelligence and Radiology: A Social Media Perspective

ObjectiveTo use Twitter to characterize public perspectives regarding artificial intelligence (AI) and radiology.Methods and materialsTwitter was searched for all tweets containing the terms “artificial intelligence” and “radiology” from November 2016 to October 2017. Users posting the tweets, tweet content, and linked websites were categorized.ResultsSix hundred and five tweets were identified. These were from 407 unique users (most commonly industry-related individuals [22.6%]; radiologists only 9.3%) and linked to 216 unique websites. 42.5% of users were from the United States. The tweets mentioned machine/deep learning in 17.2%, industry in 14.0%, a medical society/conference in 13.4%, and a university in 9.8%. 6.3% mentioned a specific clinical application, most commonly oncology and lung/tuberculosis. 24.6% of tweets had a favorable stance regarding the impact of AI on radiology, 75.4% neutral, and none were unfavorable. 88.0% of linked websites leaned toward AI being positive for the field of radiology; none leaned toward AI being negative for the field. 51.9% of linked websites specifically mentioned improved efficiency for radiology with AI. 35.2% of websites described challenges for implementing AI in radiology. Of the 47.2% of websites that mentioned the issue of AI replacing radiologists, 77.5% leaned against AI replacing radiologists, 13.7% had a neutral view, and 8.8% leaned toward AI replacing radiologists.ConclusionThese observations provide an overview of the social media discussions regarding AI in radiology. While noting challenges, the discussions were overwhelmingly positive toward the transformative impact of AI on radiology and leaned against AI replacing radiologists. Greater radiologist engagement in this online social media dialog is encouraged.     

Assessment of knowledge about,attitudes toward,and awareness of a forensic medicine course among medical students at the University of Dammam

AimThis study assesses the knowledge about, awareness of, and attitudes toward forensic medicine and the forensic medicine undergraduate course among medical students at the University of Dammam in Dammam, Saudi Arabia.MethodWe conducted a cross-sectional study of 143 fourth-year students. We used a structured, self-administered questionnaire containing 10 items relating to forensic medicine to assess the knowledge about, awareness of, and attitudes toward forensic medicine and the forensic medicine undergraduate course.ResultsThe results showed inadequate knowledge about, poor attitudes toward, and limited awareness of the importance of the forensic medicine course among medical students. Media had an effect on the students as they are a major source of forensic science information among medical students.ConclusionThe forensic medicine undergraduate course is important for medical students. We recommended that it be taught at the undergraduate level because it is the only academic source for forensic medicine that physicians may encounter in their careers. Teaching how to conduct an autopsy is important and has a positive role in medical education, and the forensic medicine curriculum must include instruction on autopsies, both from theoretical and practical perspectives. Medical institutes must take responsibility to increase awareness about the effect of media on medical education.     

Awareness of radiation protection and dose levels of imaging procedures among medical students,radiography students,and radiology residents at an academic hospital: Results of a comprehensive survey

PurposeTo evaluate the awareness of radiation protection issues and the knowledge of dose levels of imaging procedures among medical students, radiology residents, and radiography students at an academic hospital.Material and methodsA total of 159 young doctors and students (including 60 radiology residents, 56 medical students, and 43 radiography students) were issued a questionnaire consisting of 16 multiple choice questions divided into three separated sections (i.e., demographic data, awareness about radiation protection issues, and knowledge about radiation dose levels of common radiological examinations).ResultsMedical students claimed to have at least a good knowledge of radiation protection issues more frequently than radiology residents and radiography students (94.4% vs 55% and 35.7%, respectively; P < 0.05), with no cases of perceived excellent knowledge among radiography students. However, the actual knowledge of essential radiation protection topics such as regulations, patient and tissue susceptibility to radiation damage, professional radiation risk and dose optimisation, as well as of radiation doses delivered by common radiological procedures was significantly worse among medical students than radiology residents and radiography students (P < 0.05). Those latter significantly outperformed radiology residents as to knowledge of radiation protection issues (P < 0.01). Overall, less than 50% of survey respondents correctly answered all questions of the survey.ConclusionsRadiology residents, radiography students and medical students have a limited awareness about radiation protection, with a specific gap of knowledge concerning real radiation doses of daily radiological examinations. Both undergraduate and postgraduate teaching needs to be effectively implemented with radiation safety courses.     

Radiology as seen by medical students

Purpose

To determine the impact of exposing medical students to medical imaging during the first year of the second cycle of medical school (DCEM1) on their perception of this medical specialty and the acquisition of its basic concepts.

Materials and methods

All students in the 2007-2008 graduation class entering into the first year of the second cycle of medical school were anonymously enrolled into this project that included pre-rotation and post-rotation questionnaires, theory classes followed by clinical rotations with clearly predetermined objectives.

Results

A total of 108 students were enrolled, with 70% being females. The parents of the students had a medical or paramedical profession in 46.3% of cases. Before the rotation, 61.6% of students perceived a difference between a hospital-based practice and private practice. Fifty-two percent of students had a clear idea of their professional future prior to the rotation. Five students (4.7%) believed prior to the rotation that it might have an impact on their professional future, versus 63% after the rotation (P < 0.0001). The students whose parents work in the medical or paramedical field do not have a better defined idea of their professional future; on the other hand, they have more interest for radiology (73.6% with high or very high interest versus 52.8%, P = 0.03). After the rotation, there was a significant increase in the number of students with high or very high interest for radiology (77.8% versus 66.7%, P = 0.023). A student noted that he would redirect his career to radiology. There was also a significant increase in the number of students perceiving a difference between a hospital-based practice and private practice (82.2% versus 61.6%, P = 0.003). With regards to radiology knowledge before and after the rotation, there was a significant increase of mean scores (P < 0.001). Eighty-eight percent of students were satisfied or very satisfied with the radiology rotation. Overall, the students believe that 70% of the objectives were achieved. The only criticism from the students was that the clinical instructors were overworked.

Conclusion

Early exposure of medical students to radiology increases their level of interest for the specialty and increases the perception of differences between a hospital-based practice and private practice. The overall knowledge of students about radiology was improved, but the workload of clinical instructors impaired the quality of the rotation.