The Practice of Radiology Education (eBook)

The Practice of Radiology Education 1
Title Page 2
Copyright Page 3
Foreword 4
Acknowledgements 6
Contents 8
Contributors 16
Abbreviations 20
Introduction 23
Chapter 1 26
Transcending the Barriers of Interprofessional Collaboration: Our Continuing Journey as Educators in Medical Imaging 26
1.1 Introduction 26
1.2 A View of the Teaching Profession 26
1.3 Establishing a Partnership 27
1.4 Crossing Borders 28
1.4.1 The First Step 28
1.4 What Are Some of the Barriers? 29
1.4.1 Diff erent Cognitive Values 29
1.4.1.1 What Role Does Culture Play? 29
1.4.1.2 Institutional Support 30
1.5 Recognizing the Limitations 31
1.6 Final Thoughts 32
References 32
Chapter 2 34
Curriculum Matters! Designing Curriculum for Radiology Resident Rotations 34
2.1 The Evolution 34
2.2 Components of Radiology Teaching 35
2.2.1 Rotations 35
2.2.1.1 Rotation Objectives 36
2.2.1.2 Learning 36
2.2.1.3 Reporting 36
2.2.2 Rounds or Small Group Case Based Learning 37
2.2.2.1 Rounds by Radiologists 37
2.2.2.2 Rounds by Residents 38
2.2.3 Academic Afternoons 39
2.3 Components of Radiology Assessment and Evaluation 39
2.3.1 Resident Assessment and Evaluation 39
2.3.2 Radiologist and Rotation Assessment and Evaluation by Residents 41
2.3.3 Reflection, Last But Not Least 41
2.4 Summary 42
References 42
Suggested Reading 43
Journals 43
Associations 43
Appendix Abdominal/Body Imaging Rotations 44
Rotation Objectives by Resident Year 44
By the end of the PGY2 Rotation the resident will: 44
Assessment 44
By the end of the PGY3/4 Rotation the resident will: 44
Assessment 44
CanMEDS Rotation Objectives Pgy2–5 45
Medical Expert 45
Technology 45
Anatomy 45
Skills 45
Interpretation 46
Communicator 46
Collaborator 46
Manager 47
Health Advocate 47
Scholar 47
Learning 47
Teaching 48
Professional 48
Rotation Evauluation 48
Chapter 3 49
Applying CanMEDS to Academic Afternoons 49
3.1 Theory and Principle 49
3.2 Challenge 1: What Are the CanMEDS Roles and What Do They Mean for Radiology? 50
3.2.1 Medical Expert 50
3.2.2 Communicator 51
3.2.3 Collaborator 52
3.2.4 Manager 52
3.2.5 Health Advocate 53
3.2.6 Scholar 53
3.2.7 Professional 54
3.3 Challenge 2: How Do I Implement the CanMEDS Framework into Formal Radiology Curriculum? 54
3.4 Practical Implementation 54
3.4.1 CanMEDS Academic Half-Day Presentations 55
3.4.2 Idea 1: Small-Group Presentation of CanMEDS Topics: Format and Description 56
3.4.3 Examples: Sample Small-Group Sessions 57
3.4.3.1 Example 1 57
Background 58
Learning objectives 58
Group 1: What makes a good report? 58
Group 3: Horizons in reporting 58
3.4.3.2 Example 2 59
Background 59
Learning objectives 59
Group 1: Conflict definition and sources 59
Group 2: Conflict resolution – styles and suggested strategies 59
Group 3: Team building and strategies for dealing with team challenges 60
3.4.3.3 Example 3 60
Background 60
Learning Objectives 60
Group 1: Identifying stresses 61
Group 2: Physician stress and basic self-care 61
Group 3: Advanced strategies for coping 61
3.4.3.4 Example 4 61
Background 61
Learning Objectives 62
Group 1: The Basics – Important principles in screening 62
Group 2: Harm vs. Good 62
Group 3: Beyond screening – controversies in self-referral and whole-body CT 62
3.4.3.5 Example 5 63
Background 63
Learning Objectives 63
Group 1: Practical aspects 63
Group 2: Images and animation 64
Group 3: The Anatomy of a good talk 64
3.4.3.6 Example 6 64
Background 65
Learning Objectives 65
Group 1: The resident as a professional 65
Group 2: The resident as a role model 65
Group 3: The resident as an effective communicator 66
3.4.4 Idea 2: CanMEDS Retreat Day: Format and Description 66
3.4.5 Sample Retreats 67
3.4.5.1 Example 1 67
Learning Objectives 67
Workshop Outline 67
Workshop Content 67
Welcome and Introduction 67
Introduction to Radiology Practice 68
Business Practices 68
“Other things to consider” 68
“If I only knew then what I know today” 68
“Where to I go from here?” 68
Wrap up 68
3.4.5.2 Example 2 69
Learning Objectives 69
Workshop Outline 69
Workshop Content 69
Welcome and Introduction 69
Communication – “It’s all about the patient” 69
Communication and Delegation Issues from the Medico-legal Perspective 70
Strategies for Conflict Resolution 70
3.5 Wrap Up: Where Do I Go from Here? Implications for Mobilizing Confl ict Resolution Strategies During Residency Training 70
3.6 Summary 70
3.7 Taking CanMEDS Beyond the Academic Half-Day 71
3.8 Take Home Message 72
3.9 Final Tips 72
References 72
Suggested Reading CanMEDS 73
Communicator The Radiology Report 73
The Missed Diagnosis 73
Communication 74
Informed Consent 74
Collaborator Conflict Resolution 74
Manager Physician Well-Being: Stress in the Workplace 74
Career Planning and Job Searching 75
Health Advocate 75
Screening for Disease 75
Self-Referral and Whole-Body CT Screening 76
Unnecessary Testing and Radiation Safety 76
Scholar Resident Teaching and Effective Presentations 76
Professional Professionalism and Role Models 77
Patient Confidentiality 77
Chapter 4 78
Building a Teaching Module in Clinical Inquiry for Radiology Residents1 78
4.1 Overview 78
4.1.1 Evaluating a Diagnostic Test 79
4.1.2 Radiology-Specific Questions 80
4.1.3 Hierarchy of Research 80
4.2 Barriers to Evidence-Based Radiology and Critical Inquiry 81
4.3 Defining the Critical Inquiry Agenda and Resources 81
4.3.1 Teaching ROC: An Example of a Critical Inquiry Module 84
4.3.2 ROC Didactic Component 85
4.3.3 Analysis of a Paper Which Uses ROC Methodology 85
4.3.4 Performing an ROC Study: Diet from Regular Soda? 86
4.4 Conclusion 88
References 89
Chapter 5 91
The Medical Radiation Technologist: A Valuable Resource 91
5.1 Why this Topic? 91
5.2 Who Are the People Behind the Aprons, “Shooting the Pictures”?(And What Do All of Those Letters Mean?) 92
5.2.1 Radiological (X-Ray) Technologists 92
5.2.2 Nuclear Medicine Technologists 92
5.2.3 Radiation Therapist 93
5.2.4 Magnetic Resonance Technologists 93
5.3 What Education Is Required to Become a Medical Radiation Technologist? 93
5.3.1 Radiological Technologists 94
5.4 How Does a Person Become Credentialed as a Medical Radiation Technologist? 94
5.5 Are Medical Radiation Technologists Regulated? 94
5.6 Are MRTs Required to Demonstrate Ongoing Competency? 95
5.7 Do MRTs Have Expanded Practice Roles? 96
5.8 In What Ways Can a Medical Radiation Technologist Be Utilized as Resource? 96
5.9 MRTs and Radiologists Have Been Working Together for Years, What Has Changed? 97
5.10 A Case to Illustrate the Role of the MRT 98
5.11 Some Concluding Thoughts 98
References 99
Chapter 6 100
Scholarship as a Foundation for Health 100
6.1 Introduction 100
6.2 Methods and Materials 102
6.3 Results 103
6.4 Discussion 110
6.5 Diff erential Diagnosis 110
6.5.1 Recognition 111
6.5.2 Curriculum 111
6.5.3 Faculty Development 111
6.5.4 Role-Modeling and Mentorship 112
6.6 Recommendation for Rx 112
6.6.1 Increasing Recognition and Rewards for Scholarship 112
6.6.2 Implementing Well-developed Curriculum 113
6.6.3 Embracing Interdisciplinary Collaborations 113
6.6.4 Improving Communication 114
6.6.5 Generating a Culture of Role-Modelling and Mentorship 114
6.7 Prognosis 114
References 116
Chapter 7 117
An Integrated Curriculum in Medical Imaging 117
7.1 Theory and Principle: Why an Integrated Curriculum in Medical Imaging 117
7.1.1 Defi nitions 117
7.1.2 Knowledge in Professional and Academic Contexts 118
7.2 Practical Issues 119
7.2.1 Planning an Integrated Curriculum 120
7.2.2 Implementing an Integrated Curriculum 120
7.3 Take Home Message 123
References 124
Chapter 8 127
Resident Case Review: Working Smarter to Optimize the Learning Experience 127
8.1 Introduction 127
8.2 Case Review: Current Problems 128
8.3 Volume of Cases 129
8.4 Variety of Pathologies 132
8.5 Quality of Teaching 133
8.6 Summary 134
References 134
Chapter 9 138
Redesigning A National Training Program in Radiology: The Australian–New Zealand Experience 138
9.1 Theory and Principles 138
9.1.1 Old Faithful 138
9.1.2 A Great Leap Forward 139
9.1.3 If It Isn’t Broken… 139
9.1.4 Change We Had to Have 140
9.1.5 Starting with the End in Mind 141
9.2 Practical Implementation 141
9.2.1 Curriculum Development 141
9.2.2 Who Are We? 142
9.2.3 What Should We Do? 142
9.2.3.1 Medical Expert Role 143
9.2.3.2 Nonmedical-Expert Roles 144
Team Work 144
Communication Skills 144
Patient Support and Advocacy 144
Professionalism 145
Management and Administrative Skills 145
Research and Education 145
9.2.4 How Should We Do It? 145
9.2.4.1 Development of Syllabi and Learning Objectives 145
9.2.4.2 Equity of Learning Materials 146
9.2.4.3 General vs. Systems-Based Training 147
New Training Modules 149
9.2.4.4 How and What Should We Measure? 149
Training Progress and Practical Competencies 149
From Seamless to Stepwise 151
Examination Evolution 151
9.2.4.5 A Training Blueprint 152
9.2.5 Planning the Delivery 152
9.2.6 Stakeholder Engagement 153
9.2.6.1 Director of Training Meetings 153
9.2.6.2 Examiner Briefi ngs and Meetings 153
9.2.6.3 Radiology Curriculum Roadshows 153
9.2.6.4 Engagement with Health Jurisdictions 154
9.3 Take Home Messages 155
9.3.1 Change Is the Only Constant 155
9.3.2 A Single Step 155
References 156
Chapter 10 157
Training Musculoskeletal Ultrasound Specialists: European Education and Clinical Guidelines: Work in Progress 157
10.1 Introduction 157
10.2 ESSR (European Society of Musculoskeletal Radiology) 157
10.3 Work in Progress 158
10.3.1 Technical Guidelines 158
10.3.2 Clinical Indications 158
10.3.3 Annual ESSR Meeting: US Course 159
10.3.4 Module Systems 160
10.4 ESR (European Society of Radiology): Annual Meeting US Course 162
10.5 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) 162
10.6 EULAR (European League Against Rheumatism) 169
10.7 Challenges in MSK US 169
10.8 US-Guided Interventions 170
10.9 Summary 171
References 171
Chapter 11 174
Radiology Training in Thailand: Challenges and Innovations 174
11.1 Introduction 174
11.2 Radiology Residency Training Programs: General Radiology 174
11.3 Lack of Radiologists 175
11.4 Applications for Residency: Language Challenges 175
11.5 Length of Residency Training 176
11.6 Training Schemes 177
11.7 Additional Curriculum 178
11.8 E-Learning for Postgraduate Education 178
11.8.1 Self-Assessment Test 179
11.8.2 Self-Learning Materials 179
11.9 Research 179
11.10 Final Examination 179
11.11 Subspecialties in Radiology 180
11.12 Closing Thoughts 180
References 181
Chapter 12 182
Building Scientifi c Capacity in PET/CT for Global Health 182
12.1 Introduction 182
12.2 The Challenge 182
12.3 The Educational Framework 184
12.4 Coordinated Research Projects (CRPs) 184
12.4.1 An Example of a Doctoral CRP 185
12.5 Curriculum Design and Teaching Materials 185
12.6 Examples of Publications 186
12.6.1 Appropriate Use of FDG-PET for the Management of Cancer Patients in the Asia-Pacifi c Region. IAEA Recommendations 186
12.6.2 Quality Assurance for PET and PET/CT Systems 186
12.7 Educational and Training Activities Through the Technical Cooperation Programme (TCP) 186
12.7.1 Example of TC National Project 187
12.7.1.1 The Impact 187
12.7.2 Examples of TC Regional Projects 188
12.7.2.1 Strengthening Clinical Applications of PET in ‘Regional Cooperative Agreement for Asia’ States 188
12.7.2.2 Distance-Assisted Training (DAT) for Nuclear Medicine Technologists 188
12.8 Conclusion 188
References 189
Chapter 13 190
Building Capacity in Medical Physics for Radiological Imaging: Role of the International Atomic Energy Agency (IAEA) 190
13.1 What Is the Role of the Medical Physicist in Imaging? 190
13.2 What are the Educational Tools at the Disposal of the IAEA? 191
13.3 Strategies for Building Medical Physicist Capacity in Imaging 192
13.3.1 Advocacy for Professional Recognition 192
13.3.2 Strengthening the Standard of Academic Education 193
13.3.3 Clinical Curriculum Design and Implementation 194
13.3.4 Development of Standards of Practice 194
13.3.5Continuing Professional Development 196
13.4 Conclusion 196
References 197
Chapter 14 198
Challenges and Professional Developments for a New Chair/Chief 198
14.1 Introduction 198
14.2 Problem-Based Learning (PBL) 199
14.3 Back to the Interview…. 201
14.4 Undergraduate Program 201
14.5 Postgraduate Program 203
14.6 Fellowship Program 204
14.7 Continuing Education 205
14.8 Research 206
14.8.1 MIIRCAM 207
14.9 Evaluation 208
14.9.1 Annual Review and Monitoring Tools 208
14.10 Conclusion 208
References 209
Chapter 15 210
Fostering a Translational Research Attitude Among Residents in Radiology/Nuclear Medicine 210
15.1 Introduction 210
15.2 Transdisciplinarity and Professional skills 211
15.2.1 From Trainee to Team Leader 211
15.3 Innovation and Flexibility 211
15.4 Platform 1: Integrated Research Projects 212
15.5 Platform 2: Transdisciplinary Learning 213
15.5.1 On-Line Foundation Courses 213
15.5.2 Research Seminars 214
15.5.3 Scientifi c Communications 214
15.6 Platform 3: Professional Skills 215
15.6.1 Bi-Weekly Professional Skills Seminar Series 215
15.7 Platform 4: Translation of Knowledge 215
15.8 Conclusion 216
Chapter 16 217
Fostering Research in a Canadian Radiology Training Program: A Residency Research Director’s Perspective 217
16.1 Introduction 217
16.2 A Profi cient Resident Research Project 218
16.3 Ensuring the Success of Resident Research 219
16.3.1 Responsibilities of the Program 219
16.3.2 Responsibilities of the Resident 221
16.4 Conclusion 222
References 222
Chapter 17 223
Resident Recruitment and Selection 223
17.1 Introduction 223
17.2 Role of Residents in the Radiology Department 223
17.3 Issues Surrounding Resident Recruitment and Selection 224
17.4 The Phases of Resident Recruitment and Selection 224
17.5 Conclusion 227
References 227
Chapter 18 228
Building Capacity Within a Residency Program 228
18.1 The Chief Resident Role 228
18.2 Radiology Call Preparation 231
18.2.1 Introduction 231
18.2.2 Formal Didactic Lecture Series 231
18.2.3 Early PGY2 Rotations 232
18.2.4 Formal Buddy Call 232
18.2.5 Core Knowledge 232
18.2.5.1 Neuroradiology: Brain 233
18.2.5.2 Neuroradiology: Spine 234
18.2.5.3 Neuroradiology: Head and Neck 234
18.2.5.4 Chest 234
18.2.5.5 Vascular 235
18.2.5.6 Abdomen 235
18.2.5.7 Pediatric 236
18.2.5.8 MSK 236
18.2.6 Rookie Call Practice Sessions 236
18.2.7 Precall Exam 236
18.2.8 Summary 237
18.3 Resident Selection Strategies 237
18.4 Diff erentiated Instruction 239
18.4.1 Let Us Consider this Within the Context of the Residency Training Program 242
18.4.2 Planning for Diff erentiated Instruction 242
18.5 Conclusion 245
References 246
Chapter 19 247
Philosophy in Radiology: The Ontological Challenge 247
19.1 Introduction 247
19.2 Universal Language 248
19.2.1 Failures of Language 248
19.2.2 Biomedical Ontologies 249
19.3 The Structure of the Report 251
19.4 Applications to Education 253
19.5 Conclusion 255
References 256
Chapter 20 257
Practical Rules of Engagement: Responding to Learners Experiencing Diffi culty 257
20.1 In-Training Evaluation Guidelines 257
20.2 Appeal of a “Failure” of a Rotation 258
20.3 No Appeal of Failure: The Way Forward 259
20.4 Writing Remediation Plans 260
20.5 Probation 261
20.6 Dismissal 264
20.7 Emergency Situations, Special Circumstances of Learners in Diffi culty 265
20.8 Summary 265
References 266
Index 269