Radiology Residency Training Research Articles

Prospective Randomized Comparison of Standard Didactic Lecture Versus High-Fidelity Simulation for Radiology Resident Contrast Reaction Management Training

The objective of our study was to assess whether high-fidelity simulation-based training is more effective than traditional didactic lecture to train radiology residents in the management of contrast reactions. This was a prospective study of 44 radiology residents randomized into a simulation group versus a lecture group. All residents attended a contrast reaction didactic lecture. Four months later, baseline knowledge was assessed with a written test, which we refer to as the "pretest." After the pretest, the 21 residents in the lecture group attended a repeat didactic lecture and the 23 residents in the simulation group underwent high-fidelity simulation-based training with five contrast reaction scenarios. Next, all residents took a second written test, which we refer to as the "posttest." Two months after the posttest, both groups took a third written test, which we refer to as the "delayed posttest," and underwent performance testing with a high-fidelity severe contrast reaction scenario graded on predefined critical actions. There was no statistically significant difference between the simulation and lecture group pretest, immediate posttest, or delayed posttest scores. The simulation group performed better than the lecture group on the severe contrast reaction simulation scenario (p = 0.001). The simulation group reported improved comfort in identifying and managing contrast reactions and administering medications after the simulation training (p ≤ 0.04) and was more comfortable than the control group (p = 0.03), which reported no change in comfort level after the repeat didactic lecture. When compared with didactic lecture, high-fidelity simulation-based training of contrast reaction management shows equal results on written test scores but improved performance during a high-fidelity severe contrast reaction simulation scenario.

Radiology Education Needs an Urgent Overhaul

In 3 years, the ABR will be changing the oral board format to a computer-based examination. In anticipation of this, residency training programs must be proactive and optimize the learning environment to maximize residents’ preparation for this examination and their subsequent careers. Undoubtedly, it is vital that training programs provide education to residents to make good clinical judgments rather than using residents for their work product. The optimal residency program provides graduated levels of responsibility such that residents are engaged in active leaning. Unfortunately, radiology residency training programs fall short of providing the optimal “adult” learning as a result of Socratic and didactic lecture style constraints. The problem with the didactic lecture, in which slides are shown one after another with the presenter providing a narrative (typically read from the slide), is that listeners succumb to an insidious mental numbness. In the large lecture halls with the lights low, some residents have actually fallen asleep, as have some attending physicians. Who hasn’t let their mind wander in a long lecture? The attention span of an adult is limited to 20 minutes, and further accumulation of knowledge is not improved by more of the same. Lectures using the Socratic method are lauded for an interactive experience in which an expert guides an individual through a series of questions with the purpose of stimulating critical thinking and illuminating ideas. Here, the reasoning process is considered more important than preconceived facts or beliefs. Unfortunately, the Socratic lecture format is dependent on an expert with a high level of knowledge who corrects erroneous responses before they become “black pearls.” Another problem with the Socratic method is that it can easily degenerate into a pimping session whereby residents recite pertinent facts by rote memory without any thoughtful discourse. An additional issue is the variable application of questions that lead, divert, or even mislead residents. Using these techniques, an examiner can easily make a poor resident look good or a good resident look bad—so not everyone likes the spotlight. The current residency education system using the Socratic method and didactic lecture styles is limited by the inability to incorporate new technologies that maximize decision support. For example, a multiplanar

Orion: A Web-Based Application Designed to Monitor Resident and Fellow Performance On-Call

Radiology residency and fellowship training provides a unique opportunity to evaluate trainee performance and determine the impact of various educational interventions. We have developed a simple software application (Orion) using open-source tools to facilitate the identification and monitoring of resident and fellow discrepancies in on-call preliminary reports. Over a 6-month period, 19,200 on-call studies were interpreted by 20 radiology residents, and 13,953 on-call studies were interpreted by 25 board-certified radiology fellows representing eight subspecialties. Using standard review macros during faculty interpretation, each of these reports was classified as "agreement", "minor discrepancy", and "major discrepancy" based on the potential to impact patient management or outcome. Major discrepancy rates were used to establish benchmarks for resident and fellow performance by year of training, modality, and subspecialty, and to identify residents and fellows demonstrating a significantly higher major discrepancy rate compared with their classmates. Trends in discrepancies were used to identify subspecialty-specific areas of increased major discrepancy rates in an effort to tailor the didactic and case-based curriculum. A series of missed-case conferences were developed based on trends in discrepancies, and the impact of these conferences is currently being evaluated. Orion is a powerful information technology tool that can be used by residency program directors, fellowship programs directors, residents, and fellows to improve radiology education and training.

Clinical Training as an Essential Component of Radiology Residency Training

Clinical Training as an Essential Component of Radiology Residency Training

Comisión Nacional de la especialidad de Radiodiagnóstico. ¿Qué es y para qué sirve?

The National Commission for the Specialty of Diagnostic Imaging is an organ of the Ministry of Health and Consumer Affairs and of the Ministry of Education that is responsible for the evaluation of the training of specialists in diagnostic imaging. Within the chapter on the training of radiology residents, the jurisdiction and function of the Nation Commission for the Specialty of Diagnostic Imaging are described as including the elaboration of a training program, the elaboration of the resident's logbook, the establishment of criteria for evaluation, the proposal of areas of specific competence, the establishment of criteria for the evaluation of teaching and training units, and the participation in the design of integrated plans within the specialty. Other, merely administrative, functions that have repercussions in the radiological community are also detailed.

Views of Radiology Program Directors on the Role of Mentorship in the Training of Radiology Residents

The successful mentoring of resident physicians has been linked to several beneficial outcomes for trainees including increased research productivity, improved career satisfaction, and retention in academics. Female residents may have greater difficulty establishing mentoring relationships than male residents. The purpose of this study was to assess the attitudes of radiology residency program directors toward the subject of mentorship, to determine the prevalence of formal mentoring programs, and to evaluate several issues specifically pertaining to the mentoring of female residents. An anonymous, voluntary survey was sent to 156 members of the Association of Program Directors in Radiology. The survey assessed views on mentorship during residency training, the potential role of mentorship in resident career development, and the prevalence of mentorship programs in residency programs. Subanalyses evaluated survey responses according to program director sex. Seventy program directors (45%) responded to the survey. The majority of respondents (85%) agreed it is important for residents to have mentors, but only 52% thought that current residents had identified mentors. Compared with male program directors, female program directors differed in their views on the role of mentorship and of the importance of female resident access to female mentors. Program directors consider mentoring relationships to be an important resource for resident professional development and a potential resource to increase the proportion of residents pursuing academic careers and positions of leadership. Female residents may have specific mentoring needs that should be explored with further study.

Demographic Changes in Radiology Residency Positions 1980–2007: The Divergence Between California and the Rest of the United States

The objective of our study was to show the disparity in the expansion of radiology residency training slots over the past 27 years between California and the rest of the United States and to relate that divergent distribution to regional differences in medical school enrollment as a precursor and state-based per capita ratios of population to radiologist trainees as a consequence. Radiology positions were obtained from the annual editions of the American Medical Association's Graduate Medical Educational Directory. Population data were recorded from U.S. censuses for 1980, 1990, 2000, and 2007. Medical school matriculant data were provided by the American Association of Medical Colleges. The numbers of radiologists in practice were provided by the American College of Radiology. From 1980 to 2007, the U.S. population increased by 35%, predominantly in the South (52%) and West (65%). At the same time, the number of medical school matriculants remained relatively constant. Simultaneously diagnostic radiology positions increased by 55%, rising from 1980 to 1993, declining until 2001, and rising again since then. The greatest increases in radiology residency positions were observed in the Northeast and South, and the least increase was seen in the West. The greatest discrepancy between concomitant population growth and radiology resident positions occurred in California where training slots increased by 17% while population grew by 54%. Since 1980, a disparity between population growth and radiology residency position growth has been sustained between the West and the rest of the country. This disparity is a consequence of California's policy of restricting medical school enrollment and radiology residency positions despite continual population growth.

Goals and Objectives for an Integrated, Graduated Curriculum in Abdominal Radiology

The Residency Review Committee of the American Council of Graduate Medical Education has designated abdominal radiology as one of the subspecialty areas required for radiology residency training. Because it spans both gastrointestinal and genitourinary organ systems and multiple modalities, a graduated, integrated abdominal radiology curriculum, which is based on the General Competencies, was developed.

Homage to Prof. Dr. Danielle Balériaux, elected as honorary member of ESNR 2009

Danielle Baleriaux was born in Ostend, Belgium. She studied medicine at the Universite Libre de Bruxelles (ULB, Free University of Brussels) and graduated in 1969 magna cum laude (avec grande distinction) as “Docteur en Medecine, Chirurgie et Obstetrique” (M.D.). Given her keen interest in neuroscience and imaging, she decided to apply for residency training in radiology with Prof. Dr. Louis Jeanmart at the famous Jules Bordet Institute in Brussels, where the neurosurgical department of the ULB was located. She rapidly sub-specialized in neuroradiology. Immediately after completing her training, she was appointed as staff radiologist in the same institute, where she was given the opportunity to develop “new” neuroradiological techniques such as pneumo(tomo)encephalography, cerebral angiography and computed tomography (CT). In the late 1970s, she was invited to move to the newly opened Hopital Erasme, the flagship academic teaching hospital of the ULB. She was successful in building a section of neuroradiology, which quickly earned a reputation for clinical and scientific excellence. In recognition of her academic and scientific achievements, she was appointed in 1981 as professor of neuroradiology at the ULB. Her hospital career flourished and the next year, in 1982, she became “chef de clinique” of neuroradiology; in 1992 she became “chef de service adjoint” in the department of radiology at Hopital Erasme. Throughout her distinguished career, Prof. Baleriaux has always been at the cutting-edge of new technological developments in neuroradiology. In the 1970s she became one of the first physicians in Belgium to work with computed tomography. In the early 1980s, when magnetic resonance imaging (MRI) was still unknown to most radiologists, she was one the very first European neuroradiologists to fully understand the awesome potential of this new technique. She did not hesitate to travel regularly from Brussels to the Philips Medical Systems factory in The Netherlands to perform MRI scans on selected patients. Her pioneering work, in close collaboration with Philips engineers and scientists, helped to expand neuroradiological applications of MRI and quickly bring them to a very high level. She worked with enthusiasm and dedication to improve the quality of MRI examinations, and was at the forefront of many new ideas to study diseases of the central nervous system. In 1984, the first MRI unit in an academic institution in Belgium was installed in her department. Prof. Baleriaux has accumulated an impressive scientific curriculum vitae. She has authored or co-authored more than 170 peer-reviewed scientific papers and wrote more than 40 book chapters. She successfully introduced several important innovations in the organization of clinically oriented scientific research and teaching. She was editor of a series of educational CD-ROM's on neuroradiology. P. M. Parizel (*) Department of Radiology, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium e-mail: paul.parizel@uza.be

2008 RSNA Outstanding Researcher

HomeRadiologyVol. 250, No. 2 PreviousNext CommunicationsSpecial Communications2008 RSNA Outstanding ResearcherTheresa C. McLoud, Anne G. OsbornTheresa C. McLoud, Anne G. OsbornTheresa C. McLoudAnne G. OsbornPublished Online:Feb 1 2009https://doi.org/10.1148/radiol.2502082555MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryPublished in print: 2009 FiguresReferencesRelatedDetailsRecommended Articles Alexander R. Margulis, MDRadiology2018Volume: 289Issue: 3pp. 884Diagnosis Please Certificates of Recognition Awarded to Five Individuals and to International and North American Radiology Resident GroupsRadiology2020Volume: 297Issue: 2pp. 247-250Microwave Ablation versus Surgery for Papillary Thyroid Carcinoma: More Therapeutic Options, More ControversiesRadiology2022Volume: 304Issue: 3pp. 714-715David C. Levin, MDRadiology2020Volume: 295Issue: 1pp. 251-252Herbert Leroy Abrams, MDRadiology2016Volume: 279Issue: 3pp. 985See More RSNA Education Exhibits Five Stages of Artifacts: Denial, Anger, Bargaining, Depression, and AcceptanceDigital Posters2019Engaging Medical Students in Interventional Radiology: In the Era of the New Integrated IR ResidencyDigital Posters2018Novel Image-Guided Micro-Invasive Percutaneous Treatments of Breast Lesions: Where Do We Stand?Digital Posters2019 RSNA Case Collection Dedifferentiated Thyroid CancerRSNA Case Collection2020Male Breast CancerRSNA Case Collection2021Supracondylar Avian SpurRSNA Case Collection2021 Vol. 250, No. 2 Metrics Altmetric Score PDF download

Radiology in Taiwan

11 (RSROC) in Taiwan [6]. With the assistance of Paul C. Hodges of the University of Chicago and the many radiologists who returned to Taiwan from the United States in the aftermath of World War II, radiology as a specialty gradually matured in the country [7]. In 1987, the Society of Nuclear Medicine in Taiwan was established, followed in 1993 by the formation of the Taiwan Society for Therapeutic Radiology and Oncology. Since its inception, the RSROC has evolved into a society focusing on diagnostic and interventional radiology. To avoid confusion with the existing Chinese Society of Radiology [8] in the People’s Republic of China (PROC), the council of the RSROC is considering renaming the society the Taiwan Society of Radiology. The official journal of the RSROC is the Chinese Journal of Radiology, which commenced publication in March 1976 as a quarterly journal. The English-language journal’s mandate is the publication of original research, workshop proceedings, technical notes, and case reports of the society’s members. The Chinese Journal of Radiology is currently cited by EMBASE/Excerpta Medica. The current Taiwan medical education system is a modification of the American system [9]. After senior high school, students undertake a 7-year medical university training period that includes a 1-year rotating internship. Students who choose radiology as their career then undertake a 4-year radiology resident training program that includes a 6-month period of general medicine training. After passing the radiology board examination administered by the Department of Health, they are qualified as radiologists. Currently, most subspecialties work as subcommittees under the RSROC umbrella. Every year in March, the 733 radiologists (as of December 31, 2007), more than 130 trainees, and about 200 technical exhibitors attend the society’s annual meeting, which Radiology in Taiwan

System-Based Practice: Proposal for a Comprehensive Curriculum

Systems-based practice (SBP) is the sixth competency of the required ACGME core competencies in US-based residency programs. SBP aims to ensure that residents ( 1 Accreditation Council for Graduate Medical Education. The ACGME Outcome Project: An introduction. Available from www.acgme.org. Accessed January 2007. Google Scholar ) are aware of a larger context and system of health care and ( 2 Association of Directors of Anatomic and Surgical PathologyCurriculum content and evaluation of resident competency in anatomic pathology: A proposal. Hum Pathol. 2003; 34: 1083-1090 Abstract Full Text Full Text PDF PubMed Scopus (29) Google Scholar ) have the ability to effectively call upon system resources to provide care of optimal value ( 1 Accreditation Council for Graduate Medical Education. The ACGME Outcome Project: An introduction. Available from www.acgme.org. Accessed January 2007. Google Scholar ). Therefore diagnostic radiology residency training programs must provide SBP education.

2007 ASNR Cornelius G. Dyke Memorial Award

Dr. Yulin Ge is assistant professor in the Department of Radiology at New York University School of Medicine. He received his medical degree at Shandong Medical University in 1989 and completed his diagnostic radiology residency training in 1995 in Beijing Titan Hospital. Selected by the Chinese

Proposed ACGME Change in Length of Radiology Residency Training Before Independent Call

To assess radiology residency program directors' and chief residents' views regarding the Radiology Residency Review Committee's proposed revision of program requirements which would delay independent call until a resident has had 12 months of radiology training. A Web-based survey was distributed electronically to the program directors and chief residents of 188 radiology residency programs. Survey responses were collected for two weeks in November-December 2006. The survey was completed by 91 Program Directors and 165 Chief Residents. There were no statistically significant differences between the two groups of respondents on any of the 9 questions pertaining to the proposed call requirement change. Approximately 70% of the program directors and 80% of the chief residents disagreed or disagreed strongly that they were in favor of the proposed ACGME change. Strong opposition to the change was independent of both program size and current compliance with the proposed change. Over 70% in both groups disagree or strongly disagree that the proposed change would positively affect residency training. The majority of survey respondents oppose changing the minimum required length of radiology residency training prior to residents' providing independent on-call radiology interpretations from 6 months to 12 months.

Teaching Radiology Resident Didactics Using Videoconferencing: Development of a Videoconferencing Network to Increase the Efficiency of Radiology Resident Training

Teaching Radiology Resident Didactics Using Videoconferencing: Development of a Videoconferencing Network to Increase the Efficiency of Radiology Resident Training

Residency Training as Technology Matures: A Survey of Radiology Residents’ Training Experiences

The aim of the study is to assess radiology resident training experience in cardiac magnetic resonance imaging (MRI), positron emission tomography (PET), obstetrical (OB) ultrasound (US), carotid US, and barium esophagram. One hundred eighteen radiology residents completed surveys. Surveys assessed resident year of residency training, hospital size, program affiliation with an academic institution, state, performance of the examinations listed, number of examinations performed per week, and number of weeks spent on rotations for each modality. The study was approved by the institutional review board and was Health Insurance Portability and Accountability Act (HIPAA) compliant. t-Test and chi-square test were performed, and results were analyzed for statistical significance. Most (94 respondents; 80%) respondents were third-year residents, 101 residents (86%) stated their program was affiliated with an academic institution, 92 residents (78%) performed cardiac MRI, 104 (88%) performed PET, 84 (71%) performed OB US, 71 (60%) performed carotid US (one did not respond), and all performed esophagrams (although one did not respond). Only performance of cardiac MRI and PET correlated positively with a larger average hospital size (P < .01). Residents at an academically affiliated program were significantly more likely to perform cardiac MRI (P < .05). Geographic region significantly affected likelihood of performance of cardiac MRI only. Such factors as hospital size, academic institution affiliation, and geography affect radiology resident training, particularly for such maturing applications as cardiac MRI and PET. This information may be useful in attempts to standardize radiology residency training.

Integrating Imaging Informatics Into the Radiology Residency Curriculum: Rationale and Example Curriculum

Imaging informatics, as part of the wider emerging discipline of medical informatics, remains poorly defined. However, many educators agree that formalized and flexible training in the collection, display, manipulation, storage, retrieval, and communication of imaging data, as well as the integration of these data into larger databases, should be introduced into the period of radiology residency training. The authors review the importance of such training to those individuals now preparing for clinical practice and research. They describe a sample imaging informatics curriculum that can be incorporated into a 4-year radiology residency program and the significance of such training in establishing a new subdiscipline focusing on imaging information technologies.

CAD-Aided Mammogram Training 1

Although computer-aided detection (CAD) improves the diagnosis rate of early breast cancer, it has not been well integrated into radiology residency and technician training program. Moreover, CAD performance studies ignore the reader's training and experience with CAD. The purpose of this study was to investigate whether CAD training via a cognitive-perceptual based hypermedia program has effects on the performance studies of mammogram reading. Three observers read a pretest set of 80 breast cancer cases (43 negative, 23 benign, and 14 malignant cancer cases). During 4 weeks' training, the observers used a hypermedia instructional program in CAD-aided mammography interpretation. The program includes modules of CAD attention-focusing schemes, CAD procedural knowledge, and case-based simulations in mammography interpretation in consensus with CAD. By the end of the fourth week of the training, they reviewed a posttest set of cases. Data were analyzed with multireader, multicase receiver operating characteristic methods. Three readers performed better in mammogram reading after training in CAD knowledge than they did before CAD training. CAD training and experience improved the performance of CAD-aided mammography interpretation. A statistically significant difference was found in each observer's performance in CAD-aided mammogram reading before and after the training. CAD training will influence the perception, recognition, and interpretation of early breast cancer and CAD performance studies. Furthermore, the young generation of radiologic professionals can have more training in various attention-focusing features, declarative knowledge, procedural knowledge, and conditional knowledge of CAD and incorporate them into their knowledge base and strategic processing for the purpose of improving the accuracy of mammography interpretation performance.

The Impact of Self-Referral on Radiology Residency Training Programs

The self-referral by nonradiologist physicians of diagnostic imaging and interventional procedures has affected radiology residency training programs. The Association of Program Directors in Radiology surveyed its members to assess the impact on specific areas of training. The authors surveyed 186 residency program directors. Forty-three percent of those contacted responded. Fifty-two of 80 respondents (65%) said that in their opinion, self-referral had had an impact on residency training. Of the 52 program directors who said that their programs had been affected, 47 (90%) reported that in their opinion, self-referral had a negative impact on their training programs. The areas most affected were vascular interventional radiology, obstetric ultrasound, and nuclear cardiology. Self-referral endangers the quality of radiology residencies. The authors discuss strategies to protect radiology residency programs.

General Competencies in Radiology Residency Training: Definitions, Skills, Education and Assessment

The Accreditation Council for Graduate Medical Education (ACGME) Outcome Project is a long-term initiative by which the ACGME is increasing emphasis on educational outcomes in the accreditation of residency education programs (http://www.acgme.org). The impetus for this project is a system of medical education that relies heavily on public funding and is therefore accountable to the public to meet public needs and prepare well-qualified new physicians as cost effectively as possible. The current model of accreditation focuses on the potential of a residency program to educate residents (ie, whether the program complies with the requirements, has established objectives and an organized curriculum, and evaluates the residents and itself). Examining structure and process, however, is not a direct way to measure the quality of a program’s educational outcomes. In future, accreditation will focus on a program’s actual accomplishments, through assessment of program outcomes (ie, whether residents achieve the stated learning objectives, whether the program provides evidence of this achievement, and whether it demonstrates continuous improvement in its educational process). The ACGME Outcome Project Advisory Committee identified six general competencies that were subsequently endorsed by the ACGME in February 1999: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. By July 2002 all Residency Review Committees (RRCs) must include minimum language regarding the general competencies and evaluation processes in their respective program requirements. A major activity of the Outcome Project was the identification and development of measurement tools for programs to use as part of an overall evaluation system. The ACGME and the American Board of Medical Specialties (ABMS) collaborated on developing a “Toolbox of Assessment Methods” (version 1.1, September 2000; ACGME/ABMS; http://www.acgme.org/outcome/assess /toolbox.asp). The Toolbox includes descriptions of instruments recommended for use by programs assessing the outcomes of their educational efforts, as well as information pertaining to the use, the psychometric qualities, and the feasibility and practicality of different assessment methods. A radiology “quadrad,” made up of representatives from the radiology RRC (including a resident member of the RRC), the American Board of Radiology (ABR), and the Association of Program Directors in Radiology (APDR), was formed in the spring of 2000 to interpret the six competencies as they relate to radiology. The Acad Radiol 2002; 9:721–726