Radiology Residency Programs Research Articles

Radiology resident education during the COVID-19 pandemic in the United States

The COVID-19 pandemic presented unprecedented challenges to healthcare systems, including radiology residency programs. This study aims to examine the impact of COVID-19 on radiology residency education and identify interventions implemented for future unplanned disruptions to physician training. Data collection occurred between March to April 2022 through a survey distributed to 30 radiology residency program directors from diverse geographic regions, hospital types, and practice settings. Data was collected on program characteristics, COVID-19 impact, changes in scheduling and teaching methods, and perceived effects on resident competence and well-being. All surveyed programs implemented changes to address resident teaching to accommodate social distancing. Most programs (86.7%) offered remote work/study options. A majority (66.7%) implemented alternating resident schedules. Virtual conferences and virtual view-box teaching were identified as the most utilized interventions during social distancing requirements. The majority (76.1%) of programs reported worsened resident education during the pandemic, with first-year residents the most adversely affected group. Decreased competence was noted in 40% of first-year and 36.7% of second-year residents compared to pre-pandemic cohorts. Additionally, a significant portion (73.3%) of program directors reported negative impacts on resident well-being. The COVID-19 pandemic significantly disrupted radiology residency despite mitigation efforts. While virtual teaching methods provided necessary alternatives during the pandemic, they could not fully replace traditional in-person education, as evidence by widespread reports of worsened educational outcomes. Recommendations for future preparedness include prioritizing early deployment of remote workstations, incorporating alternative teaching methods, providing increased on-site instruction for junior residents, and enhancing mental health support. These lessons can inform strategies to better prepare residency programs for future challenges and ensure the continued production of competent, resilient radiologists.

Insights From a National Survey on Gaps and Opportunities for Curriculum Improvement in Breast Imaging Education in Canadian Radiology Residency Programs

Insights From a National Survey on Gaps and Opportunities for Curriculum Improvement in Breast Imaging Education in Canadian Radiology Residency Programs

Distance Learning During the COVID-19 Lockdown and Self-Assessed Competency Development Among Radiology Residents in China: Cross-Sectional Survey.

During the COVID-19 lockdown, it was difficult for residency training programs to conduct on-site, hands-on training. Distance learning, as an alternative to in-person training, could serve as a viable option during this challenging period, but few studies have assessed its role. This study aims to investigate the impact of distance learning during the lockdown on residents' self-assessed competency development and to explore the moderating effect of poor mental health on the associations. It is hypothesized that radiology residents who were trained through distance learning during the lockdown were more likely to report higher self-assessed competency compared to those who did not receive organized, formal training. A cross-sectional survey was conducted in 2021 among all of the radiology residents in 407 radiology residency programs across 31 provinces of China. To estimate the long-term outcomes of radiology residents' training after the initial COVID-19 outbreak, this study measured 6 core competencies developed by the US Accreditation Council for Graduate Medical Education reported by radiology residents. Multiple linear regression and moderating effect analysis were conducted to examine the associations between distance learning, mental health status, and self-assessed competencies. Mental health status moderated the association between distance learning and self-assessed competency of radiology residents. A total of 2381 radiology residents (29.7% of the 8,008 nationwide) met the inclusion criteria and were included in the analysis. Among them, 71.4% (n=1699) received distance learning during the COVID-19 lockdown, and 73.2% (n=1742) reported mental health struggles ranging in severity from slight to extremely severe. Radiology residents who were trained through distance learning (β=0.35, 90% CI 0.24-0.45) were more likely to report higher self-assessed competencies. This was particularly true for the competency of "interpersonal and communication skills" (β=0.55, 90% CI 0.39-0.70). Whereas, the competency of "patient care and technical skills" (β=0.14, 90% CI 0.01-0.26) benefited the least from distance learning. Poor mental health significantly moderated the relationship between distance learning and competency (β=-0.15, 90% CI -0.27 to -0.02). Distance learning, a means of promoting enabling environments during the COVID-19 lockdown, serves its purpose and helps generally improve residents' self-assessed competencies, though different competency domains benefit unequally. The impact of mental health status calls for special attention so that distance learning can fulfill its potential.

Strategic Application in the Era of ERAS Signals: Optimizing Interview Opportunities in Radiology Residency Programs.

Strategic Application in the Era of ERAS Signals: Optimizing Interview Opportunities in Radiology Residency Programs.

Diversity in Interventional Radiology Residency Programs.

Diversity in Interventional Radiology Residency Programs.

Perceived wellness through the online lens: assessment of wellness resources in interventional radiology residency websites.

Perceived wellness through the online lens: assessment of wellness resources in interventional radiology residency websites.

A Virtual Multi-institution Pediatric Radiology Peer Teaching Conference Improves Knowledge of Educators

A Virtual Multi-institution Pediatric Radiology Peer Teaching Conference Improves Knowledge of Educators

Nationwide survey of benefits provided to radiology residents in the United States.

Nationwide survey of benefits provided to radiology residents in the United States.

Radiology Resident Perspectives on and Experiences With Labor Union Participation.

Radiology Resident Perspectives on and Experiences With Labor Union Participation.

Upskilling or deskilling? Measurable role of an AI-supported training for radiology residents: a lesson from the pandemic

ObjectivesThis article aims to evaluate the use and effects of an artificial intelligence system supporting a critical diagnostic task during radiology resident training, addressing a research gap in this field.Materials and methodsWe involved eight residents evaluating 150 CXRs in three scenarios: no AI, on-demand AI, and integrated-AI. The considered task was the assessment of a multi-regional severity score of lung compromise in patients affected by COVID-19. The chosen artificial intelligence tool, fully integrated in the RIS/PACS, demonstrated superior performance in scoring compared to the average radiologist. Using quantitative metrics and questionnaires, we measured the ‘upskilling’ effects of using AI support and residents’ resilience to ‘deskilling,’ i.e., their ability to overcome AI errors.ResultsResidents required AI in 70% of cases when left free to choose. AI support significantly reduced severity score errors and increased inter-rater agreement by 22%. Residents were resilient to AI errors above an acceptability threshold. Questionnaires indicated high tool usefulness, reliability, and explainability, with a preference for collaborative AI scenarios.ConclusionWith this work, we gathered quantitative and qualitative evidence of the beneficial use of a high-performance AI tool that is well integrated into the diagnostic workflow as a training aid for radiology residents.Critical relevance statementBalancing educational benefits and deskilling risks is essential to exploit AI systems as effective learning tools in radiology residency programs. Our work highlights metrics for evaluating these aspects.Key PointsInsights into AI tools’ effects in radiology resident training are lacking.Metrics were defined to observe residents using an AI tool in different settings.This approach is advisable for evaluating AI tools in radiology training.Graphical

Radiology resident competency in orthopedic trauma detection in simulated on-call scenarios.

To evaluate radiology residents' ability to accurately identify three specific types of orthopedic trauma using radiographic imaging within a simulated on-call environment. We utilized the Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM) to assess residents' preparedness for independent radiology call. The simulation included 65 cases, with three focusing on orthopedic trauma: sacral ala, femoral neck, and pediatric tibial/Toddler's fractures. Faculty graded residents' responses using a standardized 10-point rubric and categorized errors as observational (failing to identify key findings) or interpretive (incorrect conclusions despite correct identification of findings). 321 residents evaluated sacral ala fracture radiographs and received an average score of 1.29/10, with 8.71 points lost to observational errors. Only 6% produced effective reports (scores ≥ 7), while 80% made critical errors (scores < 2). For femoral neck fracture CT images (n = 316 residents), the average score was 2.48/10, with 6.71 points lost to observational errors. 25% produced effective reports, and 66% made critical errors. Pediatric tibial/Toddler's fracture radiographs (n = 197 residents) yielded an average score of 2.94/10, with 6.60 points lost to observational errors. 29% generated effective reports, while 71% made critical errors. Radiology residents demonstrated significant difficulty in identifying these orthopedic trauma cases, with errors primarily attributed to observational deficiencies. These findings suggest a need for targeted educational interventions in radiology residency programs to improve the identification of these fractures.

Effectiveness of Social Media in Promoting Diversity, Equity, and Inclusion in Radiology Residency Programs.

Effectiveness of Social Media in Promoting Diversity, Equity, and Inclusion in Radiology Residency Programs.

Take your PIC (Program Improvement Committee): The benefits of a resident-run initiative to improve graduate medical education.

Take your PIC (Program Improvement Committee): The benefits of a resident-run initiative to improve graduate medical education.

Correlation between adult trauma center status and radiology resident performance on trauma cases in the WIDI SIM exam.

To assess whether adult trauma center status influences radiology resident performance on trauma cases in the Emergent/Critical Care Imaging SIMulation (WIDI SIM) exam. This retrospective study analyzed 29,290 WIDI SIM exam scores from 110 adult trauma cases across 55 radiology residency programs. Residents were categorized by training level-R1 (n = 17,801), R2 (n = 9,136), R3 (n = 1,826), R4 (n = 527)-and by their program's adult trauma center designation: Level 1 (n = 20,121), Level 2 (n = 1,870), Level 3 (n = 1,029), Level 4 (n = 487), and no trauma designation (n = 5,834). A Generalized Linear Mixed Model with a negative binomial distribution was used to evaluate the effect of trauma center status on resident performance, adjusting for resident level, imaging modality, and case specialty. After adjusting for confounding variables, there was no statistically significant difference in resident scores based on adult trauma center status (p > 0.05 for all trauma levels compared to no trauma designation). Resident level significantly influenced performance, with higher-level residents scoring better than R1 residents (p < 0.001 for R2-R4). Imaging modality and case specialty also significantly affected scores. Residents performed better on MR, US, and XR modalities compared to CT (p ≤ 0.002), and scored lower on chest, cardiovascular, musculoskeletal, and neuro cases compared to abdominopelvic cases (p < 0.001). Adult trauma center status did not significantly impact radiology resident performance on trauma cases in the WIDI SIM exam. Resident training level, imaging modality, and case specialty were significant factors influencing performance. These findings suggest that resident education and exposure to diverse imaging modalities and specialties are more critical determinants of diagnostic accuracy than the trauma center designation of their training program.

Development of an online authentic radiology viewing and reporting platform to test the skills of radiology trainees in Low- and Middle-Income Countries

Abstract Background Diagnostic radiology residents in low- and middle-income countries (LMICs) may have to provide significant contributions to the clinical workload before the completion of their residency training. Because of time constraints inherent to the delivery of acute care, some of the most clinically impactful diagnostic radiology errors arise from the use of Computed Tomography (CT) in the management of acutely ill patients. As a result, it is paramount to ensure that radiology trainees reach adequate skill levels prior to assuming independent on-call responsibilities. We partnered with the radiology residency program at the Aga Khan University Hospital in Nairobi (Kenya) to evaluate a novel cloud-based testing method that provides an authentic radiology viewing and interpretation environment. It is based on Lifetrack, a unique Google Chrome-based Picture Archiving and Communication System, that enables a complete viewing environment for any scan, and provides a novel report generation tool based on Active Templates which are a patented structured reporting method. We applied it to evaluate the skills of AKUHN trainees on entire CT scans representing the spectrum of acute non-trauma abdominal pathology encountered in a typical on-call setting. We aimed to demonstrate the feasibility of remotely testing the authentic practice of radiology and to show that important observations can be made from such a Lifetrack-based testing approach regarding the radiology skills of an individual practitioner or of a cohort of trainees. Methods A total of 13 anonymized trainees with experience from 12 months to over 4 years took part in the study. Individually accessing the Lifetrack tool they were tested on 37 abdominal CT scans (including one normal scan) over six 2-hour sessions on consecutive days. All cases carried the same clinical history of acute abdominal pain. During each session the trainees accessed the corresponding Lifetrack test set using clinical workstations, reviewed the CT scans, and formulated an opinion for the acute diagnosis, any secondary pathology, and incidental findings on the scan. Their scan interpretations were composed using the Lifetrack report generation system based on active templates in which segments of text can be selected to assemble a detailed report. All reports generated by the trainees were scored on four different interpretive components: (a) acute diagnosis, (b) unrelated secondary diagnosis, (c) number of missed incidental findings, and (d) number of overcalls. A 3-score aggregate was defined from the first three interpretive elements. A cumulative score modified the 3-score aggregate for the negative effect of interpretive overcalls. Results A total of 436 scan interpretations and scores were available from 13 trainees tested on 37 cases. The acute diagnosis score ranged from 0 to 1 with a mean of 0.68 ± 0.36 and median of 0.78 (IQR: 0.5-1), and there were 436 scores. An unrelated secondary diagnosis was present in 11 cases, resulting in 130 secondary diagnosis scores. The unrelated secondary diagnosis score ranged from 0 to 1, with mean score of 0.48 ± 0.46 and median of 0.5 (IQR: 0–1). There were 32 cases with incidental findings, yielding 390 scores for incidental findings. The number of missed incidental findings ranged from 0 to 5 with a median at 1 (IQR: 1–2). The incidental findings score ranged from 0 to 1 with a mean of 0.4 ± 0.38 and median of 0.33 (IQR: 0- 0.66). The number of overcalls ranged from 0 to 3 with a median at 0 (IQR: 0–1) and a mean of 0.36 ± 0.63. The 3-score aggregate ranged from 0 to 100 with a mean of 65.5 ± 32.5 and median of 77.3 (IQR: 45.0, 92.5). The cumulative score ranged from − 30 to 100 with a mean of 61.9 ± 35.5 and median of 71.4 (IQR: 37.4, 92.0). The mean acute diagnosis scores and SD by training period were 0.62 ± 0.03, 0.80 ± 0.05, 0.71 ± 0.05, 0.58 ± 0.07, and 0.66 ± 0.05 for trainees with ≤ 12 months, 12–24 months, 24–36 months, 36–48 months and &gt; 48 months respectively. The mean acute diagnosis score of 12–24 months training was the only statistically significant greater score when compared to ≤ 12 months by the ANOVA with Tukey testing (p = 0.0002). We found a similar trend with distribution of 3-score aggregates and cumulative scores. There were no significant associations when the training period was categorized as less than and more than 2 years. We looked at the distribution of the 3-score aggregate versus the number of overcalls by trainee, and we found that the 3-score aggregate was inversely related to the number of overcalls. Heatmaps and raincloud plots provided an illustrative means to visualize the relative performance of trainees across cases. Conclusion We demonstrated the feasibility of remotely testing the authentic practice of radiology and showed that important observations can be made from our Lifetrack-based testing approach regarding radiology skills of an individual or a cohort. From observed weaknesses areas for targeted teaching can be implemented, and retesting could reveal their impact. This methodology can be customized to different LMIC environments and expanded to board certification examinations.

Status of LGBTQ+ Inclusion: Multi-Institution Assessment of US Radiology Residencies

Status of LGBTQ+ Inclusion: Multi-Institution Assessment of US Radiology Residencies

Perceptions of Canadian radiology residents regarding competence by design

Purpose: This study sought to evaluate the perceptions of Canadian Radiology residents on Competence by Design (CBD) and to identify areas in which further information and guidance is required.Methods: Radiology residents at five Western Canadian Radiology programs were eligible to participate in this online survey. The survey contained an assortment of question formats, including 5-point Likert-scale responses, multiple-choice questions, and free-text response. The questions assessed understanding of resident perspectives on feedback and coaching, learning and gaps in knowledge, and quality of training and preparedness within the CBD model.Results: Twenty-one residents from each of the five radiology residency programs and across each year of training participated in the survey. The majority of residents reported they disagreed (43%) or strongly disagreed (19%) that the CBD model will be more beneficial compared to the traditional training model. 90% reported their overall perspective of CBD as indifferent or negative. Entrustable professional activities (EPAs), milestones and promotions decisions and committee review were the top 3 areas residents required further information on. Residents identified timely and direct feedback as a positive aspect of CBD but expressed concern over time management within the new curriculum.Conclusion: This study identified specific areas of concern that may contribute to the overall negative or indifferent perception towards CBD by residents. Addressing resident concerns and gaps in knowledge during the early stages of CBD implementation may encourage long-term engagement and provide an opportunity to address the overall negative or indifferent perception of CBD.

A roadmap to success: Securing a radiology residency through a research fellowship – Insights from a former international fellow

A roadmap to success: Securing a radiology residency through a research fellowship – Insights from a former international fellow

Utility of instant messaging application, WhatsApp, as a tool to augment post-graduate radiology education

BackgroundSmart phone technology including different instant messaging applications like, WhatsApp, can be used for the development of radiological skills, reporting, and performance. To determine the utility, attitude, and outcome of WhatsApp for augmenting education in FCPS radiology residency program. To assess the opinion of radiology residents regarding WhatsApp as a tool to enhance postgraduate training.MethodologyA mixed method (qualitative and quantitative) was conducted at Dow Institute of Radiology, Karachi, Pakistan. All FCPS Radiology residents were given a radiological case by principal investigator followed by residents’ response in 24 h. Key findings were shared by the mentor. Before and after the intervention of WhatsApp, all residents were evaluated with written and radiological imaging reporting exam. For quantitative analysis, a closed ended questionnaire was used containing information about total number of messages, images, webpage links shared, level of contribution (active/non-active), and utility (contribution in education related topic only). A feedback form with Likert scale was also got filled by all residents. For qualitative research, semi structured interviews (SSIs) were conducted.ResultsMedian number of total images shared were 293 (IQR 1002 images), messages shared 110 (IQR), webpages shared were 54 webpages (61 webpages) and total contents shared by participants was 243 (544 contents). Active contributors showed better performance in utility, competency of contents and attitude towards using social media as a medium for learning. Comparison of written and OSCE results showed better performance after the intervention. Feedback form with Likert scale revealed that students responded positively regarding the shared learning content. Thematic analysis showed 52 codes and 16 themes.ConclusionIn this research we have observed that WhatsApp is highly efficient and productive academic tool which can amplify postgraduate radiology education. Student’s narrative reflects that residents have found the missing link which can take them to radiological professional excellence through targeted high-profile learning outside lecture hall in time and place convenient motivational environment. Once it will be blended with existing teaching strategy, it can prove to be a game changer.

Insights Into Radiology Residency Education and Recruitment: AJR Podcast Series on Training and Education, Episode 2.

In this episode of the AJR Podcast Series on Training and Education, Shaunagh McDermott, MBBCH, BAO, a radiology residency program director, joins host Monica Cheng, MD, to share insights into radiology residency education, recruitment, and ways to cultivate a culture of learning and growth.