378TF Interactive Curriculum for Learning Pediatric Emergency Medicine Radiology

Abstract

Radiology studies can significantly influence management in the emergency department. We noted that our pediatric emergency medicine (PEM) fellows often wait for a radiologist’s interpretation instead of reviewing their patients’ images. Our needs assessment revealed that 2 main factors limited the fellows’ comfort with interpreting their own images: 1) lack of exposure to reading x-rays and CTs (pediatric-trained fellows) and 2) lack of confidence reading pediatric images (emergency medicine-trained fellows). The purpose of this instructional curriculum is to provide PEM fellows with structured training in the interpretation of pediatric-specific emergency radiology. By the end of the year, PEM fellows will have gained experience reading a variety of pediatric-specific radiologic modalities and be comfortable interpreting most radiologic studies while on shift. The primary audience for this curriculum is PEM fellows. During the course of their fellowship, trainees will participate in a year-long, repeating curriculum of monthly, 90-minute sessions focused on the interpretation of radiological modalities and images commonly encountered during their shifts. Sessions include: Chest X-ray, Head CT, Abdominal X-ray, Upper extremity X-ray, Lower extremity X-ray, Abdomen/Pelvis CTs, Spine X-ray and CTs, Abdominal/Pelvic Ultrasound (US), Other US (soft tissue, ocular), MRI (focus on brain and extremity), “Other” (Meckel’s scan, panorex), and a “Knowledge Bowl” game session. Some sessions will utilize still images (radiographs), while others will be video-based (CTs, MRI, US), allowing the trainee to interact with the images much like they would on-shift. To maximize engagement of our advanced trainees and take advantage of our small group of fellows, an active educational strategy will be used, in which fellows take turns reading images with interposed teaching provided by the facilitator. Images will be used from real cases on shift, or where no personal cases are known, from generally available high-quality radiology libraries (eg, Radiopaedia). Fellows will be expected to read images with the group and provide teaching to other fellows on their interpretation, in order to increase their retention of the material. The end of the year “Knowledge Bowl” will be used to test the participants’ skills in quickly interpreting important radiology in a fun manner. Fellows’ on-shift performance will be evaluated by PEM faculty course facilitators. Fellows will provide formative feedback about the course during monthly feedback sessions and our annual program evaluation meeting, and summative feedback on an end-of-the-year electronic survey. This feedback will be used to refine the curriculum in successive cycles. To our knowledge, there is no other intensive, pediatric-specific radiology curriculum that has been developed for teaching PEM fellows. Our goal is to ensure that our PEM fellows, when finished with the course, have a grasp of pediatric-specific radiology, are comfortable interpreting their own images while on shift, and are able to teach key points to less advanced trainees.