Radiology Training Programs Research Articles

The Art of Medicine: Applying the Visual Thinking Strategy to Radiology.

The purpose of this project was to develop a formal visual arts training curriculum and evaluate if there was improvement in the observational and descriptive skills of first- and second-year medical students for radiologic images. Materials and methods: A demographic survey and an initial pre-test of 12 radiologic images were administered asking an open-ended question to describe the image and to identify the abnormality in their own words.Three virtual one-hour sessions of visual thinking strategy (VTS) training occurred, and an immediate post-test and a six-month post-test were administered, each with images different from the pre-test, as well as a final questionnaire. All tests were independently graded by two graders with a previously established grading rubric.Differences in scores were analyzed using paired T-tests. Thirty-nine medical students participated.The mean pre-test score was 62.2 +/- 18.6, and the mean post-test score improved by 41.7 +/- 17.9 points (p<0.01) to an average score of 103.9 +/- 20.4.Nine participants were lost to follow-up at six months, and the average six-month post-test score was 110.2 +/- 29.1 for a mean improvement of 9.3 +/- 13.1 points (p=0.320) from the initial post-test. Conclusion: There was a significant improvement in observational and descriptive skills in first- and second-year medical students when describing radiologic images, which was retained after six months.A formal VTS curriculum could play a beneficial role in medical student and radiology training programs not only to improve observational skills but also to address perceptual errors in diagnostic imaging.

Designing a Collaborative Breast Radiology Training Program to Tackle Tanzania’s Breast Cancer Crisis

Breast cancer incidence and mortality continue to increase in Africa. In Tanzania, breast cancer is the second leading cause of cancer death for women, and breast cancer incidence and mortality are projected to increase by 80% by 2030. Education gaps among health care workers, delayed presentation, limited screening, and low health literacy all pose significant challenges to providing optimal breast cancer care. Considering these factors, it is imperative to train expert breast radiologists. We present a collaborative breast radiology training program in Tanzania aimed at building local capacity to address national breast cancer challenges. Although cancer control in Africa faces many challenges, developing customized training programs for breast radiology, in conjunction with national cancer programs, may represent a key strategy for addressing breast cancer.

Supporting endovascular practice in 2023 and beyond: the BSET Fellowship Programme

British Society of Endovascular Therapy (BSET) Fellowships were introduced to provide an opportunity for vascular or interventional radiology trainees to acquire new or more complex endovascular skills during a 6-month period in a UK-based endovascular unit of their choice. They were established in 2008 in response to the rapidly expanding field of endovascular practice, with the aim to support high quality endovascular training as well as a new hybrid skillset for those from a vascular surgical background. Since vascular surgery gained independence as a specialty in 2012, evolutions in both vascular surgery and interventional radiology training programmes have facilitated increased exposure to complex endovascular interventions. However, these Fellowships continue to offer a unique opportunity, where trainees benefit from a period of concentrated exposure, working to develop a specific subspecialty interest and ‘fine tune’ their skills in preparation for consultant practice. Further, these Fellowships also offer interventional radiology trainees to be exposed to a larger volume and variety of endovascular procedures, benefiting their future independent practice.

Psychological Safety as a New ACGME Requirement: A Comprehensive All-in-One Guide to Radiology Residency Programs

With the Accreditation Council for Graduate Medical Education recently updating their common program requirements to include components of psychological safety as a core principle, radiology training programs and academic radiology institutions will need to evaluate psychological safety within their residency programs and implement practices to sustain a safety culture. This article reviews current literature to present a concise guide for radiology programs on best practices for implementing psychological safety, considering the plethora of literature that is available. We searched PubMed for published studies evaluating safety culture in medical education and residency. The key words used were Psychological Safety, Education, Radiology, Workplace Culture, and Leadership. Ninety two studies were reviewed that contributed to the topics examined throughout this manuscript, including a brief history of psychological safety, evolving challenges, and a summation of best practices at the institutional, interpersonal, and individual levels that can result in a sustainable psychologically safe culture for radiology residents. This article will highlight unique considerations pertinent to a radiology residency program, including suggestions for creating a less stressful environment during case conferences, fostering and supporting residents who are struggling, and inclusive psychological safety practices that also consider non-resident contributors to a residency program, such as attending physician faculty and non-physician radiology technicians.

Core and Advanced Thoracic Imaging Curricula to Guide Residency and Fellowship Training: A Framework From the Canadian Society of Thoracic Radiology

A well-defined curriculum with goals and objectives is an inherent part of every radiology training program. Following a needs assessment, the Canadian Society of Thoracic Radiology Education Committee developed a thoracic imaging curriculum using a mixed- method approach, complimentary to the cardiac curriculum published as a separate document. The Thoracic Imaging Curriculum consists of two separate yet complimentary parts: a Core Curriculum, aimed at residents in-training, with the main goal of building a strong foundational knowledge, and an Advanced Curriculum, designed to build upon the core knowledge and guide a more in-depth subspecialty training. The curricular frameworks aim to enhance the educational experience of residents and fellows and provide an educational framework for clinical supervisors and residency and fellowship program directors. The Canadian Society of Thoracic Radiology championed the creation of Cardiovascular and Thoracic Imaging curricula encompassing clinical knowledge and technical, communication, and decision-making skills with the goal of providing direction to a strong foundational knowledge for residents and to guide specialty training for fellowship programs.

Radiology Resident Diagnostic In-Training Exam Scores: Impact of Subspecialty Imaging Volume and Rotation Scheduling

PurposeTo determine the relationship between resident imaging volumes and number of subspecialty rotations with Diagnostic Radiology In-Training (DXIT) subspecialty scores. MethodsDXIT-scaled subspecialty scores from a single large diagnostic radiology training program from 2014 to 2020 were obtained. The cumulative number of imaging studies dictated by each resident and specific rotations were mapped to each subspecialty for each year of training. DXIT subspecialty scores were compared against the total subspecialty imaging volume and the total number of rotations in a subspecialty for each resident year. A total of 52 radiology residents were trained during the study period and included in the dataset. ResultsThere was a positive linear relationship between the number of neuro studies and scaled neuro DXIT scores for R1s (Pearson coefficient: 0.29; p-value: 0.034) and between the number of breast studies and the number of neuro studies with DXIT scores for R2s (Pearson coefficients: 0.50 and 0.45, respectively; p-values: 0.001 and 0.003, respectively). Furthermore, a positive significant linear relationship between the total number of rotations in cardiac, breast, neuro, and thoracic subspecialties and their scaled DXIT scores for R2 residents (Pearson coefficients: 0.34, 0.49, 0.33, and 0.32, respectively; p-value: 0.025, 0.001, 0.03, and 0.036, respectively) and between the total number of nuclear medicine rotations with DXIT scores for R3s (Pearson coefficient: 0.41; p-value: 0.016). ConclusionResident subspecialty imaging volumes and rotations have a variable impact on DXIT scores. Understanding the impact of study volume and the number of subspecialty rotations on resident medical knowledge will help residents and program directors determine how much emphasis to place on these factors during residency.

Survey of factors affecting satisfaction and success of residents enrolled in European College of Veterinary Diagnostic Imaging (ECVDI) residency programs.

Several published studies have described the success and satisfaction of residents enrolled in human radiology training programs, however comparable studies for veterinary radiology residents are currently lacking. The purpose of this descriptive, survey study was to evaluate resident perceptions of the European College of Veterinary Diagnostic Imaging (ECVDI) residency training programs. A web-based survey was sent to all listed 114 ECVDI residents and received a 57.0% response (65/114). Of these, 88% of respondents enjoyed their training and 73.5% of finishing respondents agreed they felt ready to work as a veterinary radiologist. First-time pass rates for the theoretical and practical components of the board certifying examinations were >80%. Regarding research and exam preparation, 41.5% and 49.2% of respondents, respectively, did not feel they received appropriate guidance. Eleven percent of respondents felt a lack of mentoring and 7.7% reported not receiving annual appraisals. Findings from this study can be used as background for future studies on perceptions of ECVDI residents and ECVDI residency program directors and for future policy decisions regarding ECVDI residency training programs.

The Impact of the Dobbs Decision on Diagnostic Radiology Applicants, Residents, and Program Directors

In the Dobbs decision the United States Supreme Court overturned Roe v. Wade, returning the issue of abortion to the states. To date, there is little published data on the impact this might have on where future residents choose to pursue graduate medical education. We investigated the potential effects of the resultant varied political landscape of abortion care access laws with respect to influence on the selection of prospective diagnostic radiology training programs by medical students, comparing application rates for the 2022 recruitment cycle to the prior 4 years across a geographically diverse group of 22 academic and community sites across the United States. We provide strategies for program directors to consider in dealing with topics related to this continually evolving issue as it pertains to resident recruitment and retention.

Radiology Training Program Lessons Learned During the COVID-19 Pandemic.

The COVID-19 pandemic had major effects on radiology training programs throughout the country. Many of the challenges were shared, with some variation depending on the size and geographic location of each program. While some initial modifications, such as platoon-type scheduling and redeployment, have been abandoned, other changes such as home workstations and the option of remote conferences have become more permanently incorporated. Remote learning tools and virtual teaching are much more frequently used, although there is emphasis by many programs on preserving in-person training. Programs stressed the importance of communication and adaptability, and getting resident and faculty input is key in optimizing the educational experience.

An Artificial Intelligence Training Workshop for Diagnostic Radiology Residents.

To develop, implement, and evaluate feedback for an artificial intelligence (AI) workshop for radiology residents that has been designed as a condensed introduction of AI fundamentals suitable for integration into an existing residency curriculum. A 3-week AI workshop was designed by radiology faculty, residents, and AI engineers. The workshop was integrated into curricular academic half-days of a competency-based medical education radiology training program. The workshop consisted of live didactic lectures, literature case studies, and programming examples for consolidation. Learning objectives and content were developed for foundational literacy rather than technical proficiency. Identical prospective surveys were conducted before and after the workshop to gauge the participants' confidence in understanding AI concepts on a five-point Likert scale. Results were analyzed with descriptive statistics and Wilcoxon rank sum tests to evaluate differences. Twelve residents participated in the workshop, with 11 completing the survey. An average score of 4.0 ± 0.7 (SD), indicating agreement, was observed when asking residents if the workshop improved AI knowledge. Confidence in understanding AI concepts increased following the workshop for 16 of 18 (89%) comprehension questions (P value range: .001 to .04 for questions with increased confidence). An introductory AI workshop was developed and delivered to radiology residents. The workshop provided a condensed introduction to foundational AI concepts, developed positive perception, and improved confidence in AI topics.Keywords: Medical Education, Machine Learning, Postgraduate Training, Competency-based Medical Education, Medical Informatics Supplemental material is available for this article. © RSNA, 2023.

Creating New Opportunities for Interventional Radiology Nurses: Tanzania Interventional Radiology Initiative

The Road2IR consortium, an interventional radiology (IR) training program at a public hospital in Dar es Salaam, Tanzania, has produced Tanzania's first IR nurses. Nurses are vital IR team members and play a key role in caring for patients. Since 2018, Road2IR fostered a sustainable program via sending international IR teams of volunteer physicians, nurses, and technologists to train the Tanzanian IR team. Lead author and IR nurse, Rose Umbe, BSN, RN, shares her experience as a Tanzanian nurse trainee in the Road2IR program, while shedding light on some of the challenges the nursing profession in her country still face.

The Emerging Diverse Radiology Workplace: Case Studies on the Importance of Inclusion in Radiology Training Programs

Radiology remains one of the least diverse fields in medicine. With increasing understanding of the benefits of workforce diversity on health care outcomes, radiology society leadership and radiologists are engaging in necessary efforts to improve diversity, equity, and inclusion. To date, much of the initiatives have focused on pipeline development and recruitment strategies. Literature from organizational psychologists, human resources and business strategists suggest that incorporation of inclusion could overcome some of the persistent barriers to workforce diversity. Using case studies from real-life residency programs, we describe challenges associated with being a member of an underrepresented minority group in radiology. We illustrate concepts in inclusion, proposing concrete ideas for personal and institutional growth in this area, as a strategy for improving workforce diversity and team effectiveness.

Recommendations for Improving Canadian Radiology Equity, Diversity and Inclusion.

Improving equity, diversity, and inclusion (EDI) within Canadian radiology is critical for optimal patient care and to reduce health disparities. Although there are increasing national EDI initiatives, there is a paucity of resources available to assist radiology departments as the culture of EDI evolves and faculty and institutions are expected to incorporate EDI in their practice. We present practical recommendations for radiology departments, radiology training programs, and individual radiologists wishing or mandated to improve EDI in the workplace. Actionable strategies for creating an environment that promotes EDI, attracting and supporting diverse trainees, and for how individual radiologists can be allies are presented. These EDI strategies are imperative to provide the best patient care and to strengthen the future of Canadian radiology.

Impact of COVID-19 on Radiology Trainee Safety, Education, and Wellness: Challenges Experienced and Proposed Solutions for the Future.

Impact of COVID-19 on Radiology Trainee Safety, Education, and Wellness: Challenges Experienced and Proposed Solutions for the Future.

An adaptation-focused evaluation of Canada’s first competency-based medical education implementation in radiology

ObjectivesSystematic program evaluation of the Queen's University diagnostic radiology residency program following transition to a competency-based medical education (CBME) curriculum. MethodsRapid Evaluation methodology and the Core Components Framework were utilized to measure CBME implementation. A combination of interviews and focus groups were held with program leaders (n = 6), faculty (n = 10), both CBME stream and traditional stream residents (n = 6), and program staff (n = 2). Interviews and focus groups were transcribed and analyzed abductively. Study team met with program leaders to review common themes and plan potential adaptations. ResultsStrengths of CBME implementation included more frequent and timely feedback as well as the role of the Academic Advisor. However, frontline faculty felt insufficiently supported with regards to the theory and practical implementation of the new curriculum and found assessment tools unintuitive. The circumstances surrounding the curricular implementation also resulted in some negative sentiment. Additional faculty and resident education workshops were identified as areas for improvement as well as changes to assessment tools for increased clarity. Residents overall viewed the changes favorably, with traditional stream residents indicating that they also had a desire for increased feedback. ConclusionsRapid Evaluation is an effective method for program assessment following curricular change in diagnostic radiology. A departmental champion driving enthusiasm for change from within may be valuable. Adequate resident and faculty education is key to maximize change and smooth the transition. Advances in knowledge: This study provides insights for other radiology training programs transitioning to a CBME framework and provides a structure for programmatic assessment.

Comparison of Social Media Utilization Among Vascular Surgeons, Interventional Cardiologists, and Interventional Radiologists at Academic Training Institutions

Social media platforms, especially Twitter, are increasingly utilized across medical practice, education, and research. However, little is known about differences in social media use among physicians of varying specialties and its impact on recruitment of trainees. Our objective was to describe differences in social media use among vascular interventional proceduralists at academic training institutions. We identified institutions with training programs in vascular surgery (VS), interventional radiology (IR), and interventional cardiology (IC). Faculty providers were identified in each specialty at these institutions. A standardized search was used to identify non-anonymous social media profiles on Facebook, Instagram, and Twitter in September 2019. Influencers were defined as physicians with more than 1,000 Twitter followers. Follow ratio was defined as the number of followers divided by the number of accounts followed. Between-specialty differences were analyzed. A total of 1,330 providers (n=454 VS, n=451 IR, n=425 IC) were identified across 47 institutions in 27 states. Across all physicians, a minority of providers utilize social media (Facebook: 24.9%, n=331; Instagram: 10.8%, n=143; Twitter: 18.0%, n=240). VS were significantly more likely to use Instagram (P=0.001) but there was not a significant difference in utilization of Facebook and Twitter. Among Twitter users, VS had fewer followers on average (median 178, inter-quartile range [IQR] 39-555) than IR (median 272, IQR 50-793, P=0.26) and IC (median 286, IQR 71-1257, P=0.052). IC were most likely to be influencers (30.9%, n=25) followed by IR (17.9%, n=15) and VS (10.7%, n=8, P=0.006). On average, interventional cardiologists had the highest follow ratio (mean 4.9 ± 7.1) compared to interventional radiologists (mean 3.2 ± 5.5) and vascular surgeons (mean 2.5 ± 3.3, P < 0.001). A minority of academic vascular interventional proceduralists utilize social media in a non-anonymous manner. On Twitter, interventional cardiologists are most likely to be influencers based on number of followers and, on average, have the highest follow ratio. Vascular surgeons could potentially benefit from pursuing greater influence and visibility on social media as a means to recruit trainees.

The American Board of Radiology's Alternate Pathway for Diagnostic Radiology: What the Programs and the Applicants Need to Know

The American Board of Radiology (ABR) developed the international medical graduate alternate pathway to give foreign trained radiologists an alternate route to independent radiology practice without having to undergo radiology residency in the United States. After 4 years of fellowship/faculty experience in the same training institution, the foreign trained radiologist becomes eligible to sit for the radiology board examinations conducted by the ABR. As this pathway is not offered at every radiology training program, many training institutions are unfamiliar with the fundamentals of this pathway. At the same time, both the training institutions and the applying foreign-trained physicians face a plethora of confusing choices on the state and federal level. In this paper, we review the main factors which both the international medical graduate radiologists and training programs must consider before embarking on the diagnostic radiology ABR Alternate Pathway, namely, eligibility, visa options, state medical licensure requirements, their costs and implications for future employment opportunities.

Radiology subspecialisation in Africa: A review of the current status.

BackgroundRadiology subspecialisation is well-established in much of Europe, North America, and Australasia. It is a natural evolution of the radiology speciality catalysed by multiple factors.ObjectivesThe aim of this article is to analyse and provide an overview of the current status of radiology subspecialisation in African countries.MethodsWe reviewed English-language articles, reports, and other documents on radiology specialisation and subspecialisation in Africa.ResultsThere are 54 sovereign countries in Africa (discounting disputed territories). Eighteen African countries with well-established radiology residency training were assessed for the availability of formal subspecialisation training locally. Eight (Egypt, Ethiopia, Kenya, Morocco, Nigeria, South Africa, Tanzania, and Tunisia) out of the 18 countries have local subspecialist training programmes. Data and/or information on subspecialisation were unavailable for three (Algeria, Libya, and Senegal) of the 18 countries. Paediatric Radiology (Ethiopia, Nigeria, South Africa, Tunisia) and Interventional Radiology (Egypt, Kenya, South Africa, Tanzania) were the most frequently available subspecialist training programmes. Except Tanzania, all the countries with subspecialisation training programmes have ≥ 100 radiologists in their workforce.ConclusionThere is limited availability of subspecialist radiology training programmes in African countries. Alternative models of subspecialist radiology training are suggested to address this deficit.

Evolving Radiology Trainee Neuroimaging Workloads: A National Medicare Claims-based Analysis

While radiology training programs aim to prepare trainees for clinical practice, the relationship between trainee, and national radiology workforce demands is unclear. This study assesses changing radiology trainee neuroimaging workloads nationwide for neuroimaging studies. Using aggregate Medicare claims files from 2002 to 2018, we identified all computed tomography (CT) and magnetic resonance (MR) examinations of the brain, head and neck, and spine (hereafter "neuroimaging") in Medicare fee-for-service beneficiaries nationwide. Using separate Medicare files, we calculated population utilization rates, and work relative value unit (wRVU) weights of all diagnostic neuroradiology services. Using claims modifiers, we identified services rendered by radiology trainees. Using separate national trainee enrollment files, we calculated mean annual per trainee wRVUs. Between 2002 and 2018, total Medicare neuroimaging claims increased for both radiologists overall (86.1%) and trainees (162.5%), including increases in both CT (102.9% vs 196.8%), and MR (59.9% vs 106.6%). The national percentage of all radiologist neuroimaging wRVUs rendered by trainees increased 46.1% (3.8% of all wRVUs nationally in 2002 to 5.6% in 2018). National trainee increases were present across all neuroimaging services but greatest for head and neck CT (+86.5%). Mean annual per radiology trainee neuroimaging Medicare wRVUs increased +174.9% (42.1 per trainee in 2002 to 115.70 in 2018). Mean per trainee wRVU increases were greatest for spine CT (+394.2%) but present across all neuroimaging services. As neuroimaging utilization in Medicare beneficiaries has grown, radiology trainee neuroimaging workloads have increased disproportionately.

Virtual Radiology Readouts After the Coronavirus Disease (COVID-19) Pandemic

Social distancing concerns from the coronavirus disease (COVID-19) pandemic have led to the emergence of virtual readouts in radiology training programs. Given the myriad benefits of virtual readouts, radiology departments should continue virtual readouts in at least a hybrid format, even after social distancing restrictions become relaxed. This article highlights challenges and opportunities of the virtual readout and provides guidance and strategies for their long-term implementation by training programs.