Virtual Read-Out: Radiology Education for the 21st Century During the COVID-19 Pandemic

Streaming Success: Harnessing Social Media for Dynamic Radiology Education

Social media are increasingly used as tools in radiologists education. This article describes features that aid with the selection of SM platforms, and how to emulate educator roles in the digital world. In addition, we summarize best practices regarding curating and delivering stellar content, building a SM brand, and rules of professionalism when using SM in radiology education.

The importance of educational tools and a new software solution for visualizing and quantifying report correction in radiology training

A novel software, DiffTool, was developed in-house to keep track of changes made by board-certified radiologists to preliminary reports created by residents and evaluate its impact on radiological hands-on training. Before (t0) and after (t2-4) the deployment of the software, 18 residents (median age: 29 years; 33% female) completed a standardized questionnaire on professional training. At t2-4 the participants were also requested to respond to three additional questions to evaluate the software. Responses were recorded via a six-point Likert scale ranging from 1 ("strongly agree") to 6 ("strongly disagree"). Prior to the release of the software, 39% (7/18) of the residents strongly agreed with the statement that they manually tracked changes made by board-certified radiologists to each of their radiological reports while 61% were less inclined to agree with that statement. At t2-4, 61% (11/18) stated that they used DiffTool to track differences. Furthermore, we observed an increase from 33% (6/18) to 44% (8/18) of residents who agreed to the statement "I profit from every corrected report". The DiffTool was well accepted among residents with a regular user base of 72% (13/18), while 78% (14/18) considered it a relevant improvement to their training. The results of this study demonstrate the importance of providing a time-efficient way to analyze changes made to preliminary reports as an additive for professional training.

Embracing Remote Academic Radiologists

Over the past two years at our large academic center, we successfully developed a formal remote academic radiologist division - composed of permanent fully remote radiologists across multiple subspecialties, living geographically distant from our institution. In this article, we share our experience implementing a remote radiologist division, review the benefits and challenges of this approach, discuss expectations of academic remote radiologists as clinicians, educators, and scholars, and provide tips for success.

Introducing virtual classrooms for undergraduate physiology teaching during the COVID-19 pandemic: acceptance by students and subjective impact on learning

The COVID-19 pandemic and worldwide lockdowns brought major changes in education systems. There was a sudden obligatory shift toward utilization of digital resources for teaching and learning purposes. Medical education, specifically physiology teaching, comprises hands-on training in the laboratory. It is challenging to offer a course like physiology in a virtual format. The objective of this study was to assess the effectiveness and influence of virtual classroom technology on online physiology education in a sample size of 83 first-year MBBS undergraduates. A questionnaire comprising questions related to technology accessibility and utilization, comprehensibility and effectiveness of instructions, faculty proficiency, and learning outcomes was administered to the group. The responses were collected and analyzed. Validation through principal components and factor analysis showed that online teaching is not very effective and has a limited application in the physiology education of undergraduate MBBS students. Our study also revealed that virtual physiology teaching of undergraduate medical students during the COVID-19 pandemic had a moderate level of effectiveness.NEW & NOTEWORTHY In the present qualitative study, we have conducted and validated an online physiology teaching platform at a medical college to continue medical education during the peak times of the COVID-19 pandemic and prolonged lockdowns. Furthermore, we have evaluated the effectiveness of online physiology teaching through multidimensional feedback from undergraduate MBBS students. It is experimental evidence of inadequate sustainability, moderate efficacy, limited application, and poor first-hand experience gained by the students in virtual physiology teaching in a preclinical and clinical setting.

Evidence for an adverse impact of remote readouts on radiology resident productivity: Implications for training and clinical practice

After their rapid adoption at the onset of the coronavirus pandemic, remote case reviews (remote readouts) between diagnostic radiology residents and their attendings have persisted in an increasingly remote workforce, despite relaxing social distancing guidelines. Our objective was to evaluate the impact of the transition to remote readouts on resident case volumes after the recovery of institutional volumes. We tabulated radiology reports co-authored by first-to-third-year radiology residents (R1-R3) between July 1 and December 31 of the first pandemic year, 2020, and compared to the prior two pre-pandemic years. Half-years were analyzed because institutional volumes recovered by July 2020. Resident volumes were normalized to rotations, which were in divisions categorized by the location of the supervising faculty during the pandemic period; in 'remote' divisions, all faculty worked off-site, whereas 'hybrid' divisions had a mix of attendings working on-site and remotely. All residents worked on-site. Data analysis was performed with Student's t test and multivariate linear regression. The largest drops in total case volume occurred in the two remote divisions (38% [6,086 to 3,788], and 26% [11,046 to 8,149]). None of the hybrid divisions with both in-person and remote supervision decreased by more than 5%. With multivariate regression, a resident assigned to a standardized remote rotation in 2020 would complete 32% (253 to 172) fewer studies than in identical pre-pandemic rotations (coefficent of -81.6, p = .005) but would be similar for hybrid rotations. R1 residents would be expected to interpret 40% fewer (180 to 108) cases on remote rotations during the pandemic (coefficient of -72.3, p = .007). No significant effect was seen for R2 or R3 residents (p = .099 and p = .29, respectively). Radiology residents interpreted fewer studies during remote rotations than on hybrid rotations that included in-person readouts. As resident case volume is correlated with clinical performance and board pass rate, monitoring the readout model for downstream educational effects is essential. Until evidence shows that educational outcomes remain unchanged, radiology residencies may wish to preserve in-person resident readouts, particularly for junior residents.

Improving Oral Presentation Skills for Radiology Residents through Clinical Session Meetings in the Virtual World Second Life

BACKGROUND

The objective of this study was to conduct a clinical session meeting in the virtual world of Second Life to improve the oral presentation skills of radiology residents and to assess the perception of the attendees.

METHODS

A clinical session meeting (10 two-hour sessions over four weeks), where participants presented their own clinical sessions, followed by a turn of interventions by the attendees, was designed and carried out. Attendees were asked to complete an evaluation questionnaire. Descriptive statistics were performed.

RESULTS

Twenty-eight radiology residents attended the meeting, and 23 (81.2%) completed the evaluation questionnaire; 95.7-100% of them agreed that the virtual environment was attractive and suitable for holding the meeting and that the content was appropriate for their training as residents. They rated with ≥8.9 points (from 1 to 10) different aspects of the experience, highlighting the role of teachers (9.7 ± 0.6) and the usefulness of their training (9.4 ± 0.9).

CONCLUSIONS

Second Life can be used effectively to train oral communication skills in public, in an environment perceived as attractive and suitable for learning, through an experience described by the attendees as interesting and useful, highlighting the advantages of social contact with their peers.

Virtual Practical Examination for Student Nurse Educators in Health Sciences Education during the COVID-19 Pandemic: A Narrative Review

(1) Background: There is a gap in the literature that explores challenges and opportunities relating to virtual or e-assessment health science education with particular relevance to the Health Sciences Education practical examination for student nurse educators. Therefore, this review aimed to address this gap and provide recommendations for enhancing identified opportunities and for overcoming identified challenges.; (2) Methods: The review was conducted across Google Scholar, PubMed/MEDLINE, Science Direct, Directory of Open Access Journals, Complementary Index, SCOPUS, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) with the intention of identifying opportunities and challenges presented by e-assessment in the HSE practical examination for student nurse educators during the COVID-19 pandemic.; (3) Results: The following aspects are discussed: (1) opportunities, including benefits, for both student nurse educators and facilitators and opportunities for Nursing Education; and (2) challenges, including issues with accessibility and connectivity as well as the attitudes of both students and facilitators.; (4) Conclusions: Despite challenges which included connectivity issues that led to frustration and stress, the unpreparedness and attitudes of students and facilitators, there are some opportunities that have emerged from e-assessment that can be beneficial to both the students and the facilitators, as well as the institutions. These include a reduced administrative burden, improved teaching and learning, and immediate feedback from facilitators to students and from students to facilitators.

Teaching with Technology-Matching Pedagogy with Purpose in Radiology Education

The response to pandemic-related teaching disruption has revealed dynamic levels of learning and teaching flexibility and rapid technology adoption of radiology educators and trainees. Shutdowns and distancing requirements accelerated the adoption of technology as an educational tool, in some instances supplanting in-person education entirely. Despite the limitations of remote interaction, many educational advantages were recognized that can be leveraged in developing distance learning paradigms. The specific strategies employed should match modern learning science, enabling both students and educators to mutually grow as lifelong learners. As panel members of the "COVID: Faculty perspective" Task Force of the Association of University Radiologists Radiology Research Alliance, we present a review of key learning principles which educators can use to identify techniques that enhance resident learning and present an organized framework for applying technology-aided techniques aligned with modern learning principles. Our aim is to facilitate the purposeful integration of learning tools into the training environment by matching these tools to established educational frameworks. With these frameworks in mind, radiology educators have the opportunity to re-think the balance between traditional curricular design and modern digital teaching tools and models.

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.

AUR Radiology Resident Core Curriculum Lecture Series - A Model for Multi-Society Collaborative Virtual Education

To fulfill ACGME requirements, radiology residency programs are required to provide an educational experience that includes a core didactic curriculum for each subspecialty. Although developing and delivering such a core curriculum may not present a problem for large academic programs, it can present a significant challenge for smaller programs with limited faculty in each subspecialty area. Success of the core curriculum lectures series developed for cardiothoracic radiology by the Society of Thoracic Radiology and for musculoskeletal radiology by the International Skeletal Society in collaboration with the Society for Skeletal Radiology prompted the idea of creating a comprehensive core curriculum lecture series encompassing all subspecialties. This paper aims to describe the multi-society collaborative effort entailed in building a curated, on line resident focused core curriculum lecture series detailing the barriers encountered, effects of the COVID-19 pandemic and impact of the finished project.

Knowing the ABCs: teaching the principles of radiology to medical students in Turkey

BACKGROUND

Radiology education in Turkey is mainly taught during clinical years of medical school and often lacks main principles. Exposure to the fundamentals of radiology at an early stage of medical education may drastically help students generate a better understanding of radiology and expand their interest in the specialty. With the Principles of Radiology Course that we provided, pre- and post-session tests, and assessment survey at the end of the course, we aimed to evaluate the effectiveness of such an online course among Turkish medical students.

METHODS

A total of nine online sessions on imaging modalities principles was developed by radiology professors. Each session was given through Zoom by radiologists from different U.S.-institutions to Turkish medical students from state (n = 33) and private (n = 8) universities. Pretests and post-tests were given to participants via Qualtrics before and after each session, respectively. Paired two-sample t-tests were conducted to detect the variance and p=-.05 was used as the significance level. An evaluation survey was distributed at the end of the course to collect their feedback through SurveyMonkey.

RESULTS

A total of 1,438 predominantly Turkish (99.32%) medical students engaged with this course. An average of 506 students completed both pre-test and post-test. There was a statistically significant (p < .001) increase in the scores in post-test (mean[range]:7.58[5.21-8.53]) relative to pre-test (mean[range]:5.10[3.52-8.53]). Four hundred and thirty-nine participants (F/M:63.33%/35.54%) completed the end-of-course survey. A total of 71% and 69.70% of the participants strongly agreed that the course would be useful in their clinical practice and had increased their understanding of radiology. They also reported that their level of confidence in the subjects had increased 68% and reached a weighted average of 3.09/4. The survey revealed that 396 (90.21%) of the participants strongly or somewhat agree that introductory principles and concepts should be presented in earlier years of medical education. Compared to in-person education, 358 (81.55%) found the course extremely or very convenient.

CONCLUSION

Online lecture series consisting of the principles of the radiological imaging modalities can be offered to Turkish medical students to enhance their grasp of the various imaging modalities and their correct clinical application.

Asynchronous online learning as a key tool to adapt to new educational needs in radiology during the COVID-19 pandemic

The risk of contagion and the lockdown caused by the COVID-19 pandemic forced a change in teaching methodologies in radiology. New knowledge about the disease that was being acquired on a daily basis needed to be rapidly spread worldwide, but the restrictions imposed made it difficult to share this information. This paper describes the methodology applied to design and launch a practice-based course on chest X-ray suggestive of COVID-19 right after the pandemic started, and aims to determine whether asynchronous online learning tools for radiology education are useful and acceptable to general practitioners and other medical personnel during a pandemic. The study was carried out from April to October 2020 and involved 2632 participants. Pre- and post-testing was used to assess the participants' gain of knowledge in the course content (paired t-tests and chi-squared tests of independence). A five-point Likert scale questionnaire inspired by the technological acceptance model (TAM) was provided to evaluate the e-learning methodology (ANOVA tests). The results from the pre- and post-tests showed that there were significant differences in the scores before and after completing the course (sample size = 2632, response rate = 56%, p<0.001). As for the questionnaire, all questions surpassed 4.5 out of 5, including those referring to perceived ease of use and perceived usefulness, and no significant differences were found between experienced and inexperienced participants (sample size = 2535, response rate = 53%, p=0.85). The analysis suggests that the applied methodology is flexible enough to adapt to complex situations, and is useful to improve knowledge on the subject of the course. Furthermore, a wide acceptance of the teaching methodology is confirmed for all technological profiles, pushing for and endorsing a more widespread use of online platforms in the domain of radiology continuing education.

Current Status of Radiology Education Online: a Comprehensive Update

The purpose of this study is to evaluate various online resources available for radiology education. An online search was conducted using PubMed (National Library of Medicine, Bethesda, MD) and Google Scholar for publications discussing the applications of online learning in radiology. The search strategy employed a combination of the following terms: radiology, web-based conferencing, radiology education seminars, radiology education online, radiology education programs, online lectures, radiology residency, radiology degree, Radiology-Integrated Training Initiative (R-ITI) e-learning platform, UTAUT, Moodle, active image-based learning, Video conference platforms (VCPs), education, undergraduate, medical students, teaching, virtual learning, blended learning, e-learning, COVID-19, pandemic, OER, open education resources, online learning, course assets, accessibility, 5G Internet, game-based learning, radiology competition, and virtual world. The literature published was reviewed and consolidated. Data from the literature shows that radiology education online and radiology education seminars are undergoing a revolution due to advancements in computers, online software, and 5G Internet speed. The pace of this development has accelerated even further due to the COVID-19 pandemic and thus forced distance online education. Various technologies are available and are being implemented by residency programs across the world to improve radiology education, making it more interactive and safer in this pandemic. Online learning has become an integral part of education in radiology, with new facets being added to it.

Radiology trainee and attending satisfaction with virtual readouts during the COVID-19 pandemic

RATIONALE AND OBJECTIVES

In response to COVID-19, our institution implemented three virtual readout systems: a commercial HIPAA compliant web-based video conferencing platform used for screen-sharing (Starleaf), an interactive control sharing system integrated into PACS allowing simultaneous multi-user mouse control over images (Collaborate), and the telephone. Our aim was to assess overall satisfaction with and perceived effectiveness of these virtual readout methods to optimize best practices for the future.

MATERIALS AND METHODS

An IRB-exempt survey was electronically distributed to 64 trainees and 76 attendings at one tertiary-care institution via Survey Monkey. Questions focused on overall satisfaction, perceived effectiveness, technical difficulties, and continued future use of the three virtual readout strategies. Answers were collected with Likert scales, tick boxes, and open-ended questions.

RESULTS

32/64 trainees (50%) and 32/76 attendings (42%) completed the survey. Trainees and attendings were more satisfied with screen sharing (Starleaf) and perceived it more effective than control sharing (Collaborate) or the telephone (p < 0.0001). Respondents experienced more technical difficulties with control sharing versus screen sharing (p = 0.0004) with a negative correlation between level of technical difficulties and satisfaction with screen sharing (r = -0.50, p < 0.0001) and control sharing (r = -0.38, p = 0.0006). Trainees and faculty supported a combination of in-person and virtual readouts in the future (p < 0.0001).

CONCLUSION

Platforms mirroring in-person readouts, such as Starleaf, are preferred by both trainees and attendings over non-screen sharing platforms such as the telephone. However, technical stability determines satisfaction between similar platforms. Both trainees and attendings support incorporation of virtual readout methods in combination with traditional in-person readouts in the post-COVID-19 era.

Immediate consequences and solutions used to maintain medical education during the COVID-19 pandemic for residents and medical students: a restricted review

BACKGROUND

The COVID-19 outbreak has dramatically impacted medical education, both bedside and academic teaching had to be adapted to comply with the reorganisation of care and social distancing measures.

OBJECTIVES

To overview the impact of the pandemic on medical education, including the pedagogical responses adopted and their assessment by medical students and residents.

MATERIAL AND METHODS

This restricted systematic review was performed using Rayyan QCRI, to select observational or interventional articles and field experience reports assessing the impact of the COVID-19 pandemic on medical education for medical students and residents. Study design, study population, geographical origin, use of an educational tools (including softwares and social media), their type and assessment, were recorded. For studies evaluating a specific tool the Medical Education Research Study Quality Instrument (MERSQI) was used to assess study quality.

RESULTS

The literature search identified 1480 references and 60 articles were selected. Most articles focused on residents (41/60; 69%), and half (30/60; 50%) involved surgical specialties. Online courses were the most frequently used pedagogical tool (52/60; 88%). Simulation tools were used more frequently in articles involving surgical specialties (15/29; 52%) compared with medical specialties (2/14; 12%) (p=0.01). Only four studies reported the assessment of pedagogical tools by medical students, their MERSQI scores ranged from 5.5/18 to 9.0/18.

CONCLUSION

Medical education was highly impacted by the COVID-19 pandemic particularly in surgical specialties. Online courses were the most frequently attempted solution to cope with social distancing constraints. Medical students' assessment of pedagogical tools was mostly positive, but the methodological quality of those studies was limited.

De-Identification Mechanism of User Data in Video Systems According to Risk Level for Preventing Leakage of Personal Healthcare Information

A problem with biometric information is that it is more sensitive to external leakage, because it is information that cannot be changed immediately compared to general authentication methods. Regarding facial information, a case in which authentication was permitted by facial information output by a 3D printer was found. Therefore, a method for minimizing the leakage of biometric information to the outside is required. In this paper, different levels of identification information according to the authority of the user are provided by the de-identification of metadata and face information in stages. For face information and metadata, the level of de-identification is determined and achieved according to the risk level of the de-identified subject. Then, we propose a mechanism to minimize the leakage path by preventing reckless data access by classifying access rights to unidentified data according to four roles. The proposed mechanism provides only differentially de-identified data according to the authority of the accessor, and the required time to perform the de-identification of one image was, on average, 3.6 ms for 300 datapoints, 3.5 ms for 500 datapoints, and 3.47 ms for 1000 datapoints. This confirmed that the required execution time was shortened in proportion to the increase in the size of the dataset. The results for the metadata were similar, and it was confirmed that it took 4.3 ms for 300 cases, 3.78 ms for 500 cases, and 3.5 ms for 1000 cases.

Educational adaptation to clinical training during the COVID-19 pandemic: a process analysis

BACKGROUND

The COVID-19 pandemic is unprecedented in terms of the extent and rapidity of the disruption forced upon formal clinical education, most notably the extensive transition of clinical skills learning to interactive video-based clinical education.

METHODS

In a phenomenologic study, we used thematic analysis to explore the COVID-19 disruption to clinical training and understand processes relating to adaptation in a large academic medical center. We conducted semi-structured interviews with 14 clinical teachers and 16 trainees representing all levels of clinical learning. Interviews occurred within the initial three months of the crisis, and data were analyzed following a thematic analysis coding process.

RESULTS

We constructed eight themes synthesizing our participants' perceptions of the immediate unanticipated disruption, noting in the process their alignment with a change management framework. These included: urgency in adapting, with an obvious imperative for change; overcoming inconsistent involvement and support through the formation of self-organized frontline coalitions; attempts to develop strategy and vision via initially reactive but eventually consistent communication; empowering a volunteer army through co-creation and a flattened hierarchy; and efforts to sustain improvement and positive momentum with celebration of trial, error, and growth. The majority of participants found positive outcomes resulting from the tumultuous change process. Moreover, they were now more readily accepting of change, and tolerant of the ambiguous and iterative nature inherent in the education change process. Many anticipated that some innovation would, or would at least deserve to, continue post- crisis.

CONCLUSIONS

The COVID-19 pandemic afforded an opportunity to study the content and process of change during an active crisis. In this case of clinical education, our findings provide insight into the ways an academic medical system adapts to unanticipated circumstances. We found alignment with broader organizational change management models and that, compared with crisis management models (and their shorter term focus on resolving such crises), stakeholders self-organized in a reliable manner that carries the potential advantage of preserving such beneficial change.

Promoting Lactation Support: Challenges and Solutions to Supporting Breastfeeding Radiologists

RATIONALE AND OBJECTIVES

Although the evidence for the benefits of breastfeeding is strong, parents are often unable to continue breastfeeding upon returning from maternity leave for a variety of reasons. Breastfeeding parents in medicine face unique challenges upon returning to the workforce after maternity leave. Current research on breastfeeding radiologists is limited. The objective of this research is to evaluate breastfeeding barriers and identify potential solutions to help radiologists reach their breastfeeding goals.

MATERIALS AND METHODS

A 17-question survey was developed from validated surveys and pilot tested using focus groups. The survey was emailed to members of the American Association for Women in Radiology and promoted through social media. Bivariate analyses were performed using chi-square tests. p values <0.05 were considered statistically significant. Institutional review board deemed that this anonymous voluntary survey met criteria for exemption.

RESULTS

50 respondents met criteria for study inclusion (estimated response rate 42%). Of the respondents, 60% were trainees, 80% practiced in academic institutions and 92% were full-time. 100% intended to breastfeed, of whom 56% met personal breastfeeding goals (12-month median duration). Available lactation facilities included: Dedicated lactation room (38%), private space (58%), hospital grade pump (30%), refrigerator (46%), dedicated PACS (8%). Cited workplace challenges included lack of time (82%), lack of space (34%), and unsupportive work culture (42%). Having adequate time was associated with meeting breastfeeding goals (p = 0.028). No other factors were statistically significant (p > 0.05).

CONCLUSION

Almost half of breastfeeding radiologists (44%) did not meet breastfeeding goals, citing a variety of facility-based and institutional barriers. Among these, having sufficient time to pump/breastfeed was associated with achieving breastfeeding goals. Given the barriers faced by breastfeeding radiologists, there is an opportunity to make structural and cultural changes to provide lactation support at work.

Review of Learning Tools for Effective Radiology Education During the COVID-19 Era

Coronavirus disease 2019 (COVID-19) has significantly disrupted medical education around the world and created the risk of students missing vital education and experience previously held within actively engaging in-person activities by switching to online leaning and teaching activities. To retain educational yield, active learning strategies, such as microlearning and visual learning tools are increasingly utilized in the new digital format. This article will introduce the challenges of a digital learning environment, review the efficacy of applying microlearning and visual learning strategies, and demonstrate tools that can reinforce radiology education in this constantly evolving digital era such as innovative tablet apps and tools. This will be key in preserving and augmenting essential medical teaching in the currently trying socially and physically distant times of COVID-19 as well as in similar future scenarios.

Remote Reading and Teaching of Nuclear Medicine in the Era of COVID-19

Community SARS-CoV-2 has profoundly affected traditional elements of learning and teaching in nuclear medicine and diagnostic radiology departments. The response of the nuclear medicine community to the challenges imposed by the COVID-19 pandemic can be described in 3 phases: accommodation, consolidation and optimization, and a return towards normalcy. Adoption of virtual communication platforms has emerged as the crucial interim tool for preservation of trainee supervision and diagnostic imaging education. Development of supplemental teaching materials, refocusing research interests, and relaxation of requirements have all contributed toward stabilization of the residency programs. As we embark on a gradual return to normalcy, many of the virtual solutions that were employed have gained a degree of enduring popularity and may find a place in the postpandemic period.

A Comparison of WebRTC and Conventional Videoconferencing for Synchronized Remote Medical Image Presentation

DICOM viewers must fulfill roles beyond primary diagnostic interpretation, including serving as presentation tools in teaching and multidisciplinary conferences, thereby enabling multiple individuals to review images collaboratively in real time. When in-person gathering is not possible, a variety of solutions have been deployed to maintain the ability for spatially separated users to view medical images simultaneously. These approaches differ in their backend architectures, utilization of application-specific optimizations, and ultimately in their end user satisfaction. In this work, we systematically compare the performance of conventional screensharing using a videoconferencing application with that of a custom, synchronized DICOM viewer linked using Web Real Time Communications (WebRTC) technology. We find superior performance for the WebRTC method with regard to image quality and latency across a range of simulated adverse network conditions, and we show how increasing the number of conference participants differentially affects the bandwidth requirements of the two viewing solutions. In addition, we compare these two approaches in a real-world teaching scenario and gather the feedback of trainee and faculty radiologists, who we found to favor the WebRTC method for its decreased latency, improved image quality, ease of setup, and overall experience. Ultimately, our results demonstrate the value of application-specific solutions for the remote synchronized viewing of medical imaging, which, given the recent increase in reliance on remote collaboration, may constitute a significant consideration for future enterprise viewer procurement decisions.

Chemical Engineering Teaching in COVID-19 Times: Successfully Adapting a Capstone Design Course to a Remote Format

The coronavirus COVID-19 pandemic required educational institutions to adapt face-to-face to remote teaching. This study reports the experience in the first semester of 2020 for a Chemical Engineering Capstone Design Course at the University of Campinas in Brazil. In this course, senior year students develop a group project, in which they simulate a chemical plant and evaluate its technoeconomic feasibility. In 2020, the groups were proposed to design a process to replace diesel fuel from the bus fleet in Campinas city with renewable fuel DME. Because of the pandemic, several adaptations were needed: the theoretical classes became asynchronous, group meetings were online, a commercial simulator was replaced by an open access one, and the schedule was extended by 2 weeks. Despite that, the students had a great performance, comparable to face-to-face. To assess student satisfaction, a questionnaire was used. The course met the expectations of most of the students who also recommended keeping it in the remote format or merging it with face-to-face teaching. Therefore, these changes made it possible to apply new teaching dynamics and tools that could be used in the future to improve the course quality.

Multidisciplinary approach of teaching radiology to medical students in Egypt: Is this an effective method?

Background

In multidisciplinary education, different perspectives from more than one discipline are used to illustrate a certain topic. The aim of this study was to evaluate the effectiveness of an online, multidisciplinary radiology curriculum to teach radiology to medical students in Egypt. A multidisciplinary team of radiologists, surgeons, and internists taught a series of 5 case-based radiology sessions on a web conference platform. Topics included common clinical case scenarios for various body systems. Undergraduate medical students across Egypt were enrolled in the course. A pre-test–post-test design was used to evaluate the efficacy of each session. Upon course completion, students filled out a subjective survey to assess the radiology education series.

Results

On average, 1000 students attended each session. For each session, an average of 734 students completed both the pre-test and post-test. There was a statistically significant increase in post-test scores compared to pre-test scores across all 5 sessions (p < 0.001) with an overall average score improvement of 63%. A subjective survey at the end of the course was completed by 1027 students. Over 96% of students found the lecture series to be a worthwhile experience that increased their imaging knowledge and interest in radiology, and that the use of a multidisciplinary approach added educational value. About 66% of students also reported that the session topics were “excellent and clinically important.” There was a marked increase in reported confidence levels in radiology competencies before and after attendance of the sessions.

Conclusions

An online radiology curriculum with a multidisciplinary approach can be implemented successfully to reach a large group of medical students and meet their educational objectives.

Nursing Faculty Experience With Online Distance Education During COVID-19 Crisis: A Qualitative Study

BACKGROUND

COVID-19 pandemic influenced education and forced universities to shift from face-to-face teaching to remote online teaching. This sudden shift in educational pedagogy provoked several challenges to educators.

PURPOSE

The purpose of this study is to explore the first experience of nursing faculty members with online distant education (ODE) within the context of COVID-19 national curfew.

METHODS

A qualitative descriptive design guided by a phenomenological approach was used utilizing purposive sampling for exploring the experiences of fifteen nursing faculty members by two focus group discussions through Zoom.

RESULTS

Qualitative analysis, using Colaizzi's method revealed four major themes including: (1) resolving immediate reaction toward abrupt compulsory online teaching; fulfilling teaching responsibilities; managing the challenges of ODE, (2) struggling with available resources and capabilities; (3) ODE defeated geographic and time boundaries, and interrupted personal time management: yet a new learning experience; insufficiency of ODE; and (4) achieving clinical competencies and learning outcomes.

CONCLUSIONS

This study provides evidence on the importance of preparing and training faculty to embrace and sustain the mastery of ODE to ensure the success of ODE. It also emphasizes the institutional and infrastructure readiness to enhance the transition from traditional teaching and learning to ODE.

Trainee and Faculty Perceptions of Remote PACS Workstations and Next Steps in a Large US Academic Medical Institution

Objective

Remote workstations were rapidly deployed in our academic radiology practice in late March 2020 in response to the COVID-19 pandemic. Although well-received by faculty, there were concerns for the impact on resident education.

Materials and Methods

Surveys of the radiology trainees and faculty were conducted online seven- and thirteen-months following workstation deployment as a part of a quality improvement project to assess the impact on radiology education and faculty wellness, as well as assess the desired trajectory of remote work in an academic setting.

Results

The majority of trainees (52%) reported the implementation had negatively impacted resident education, greatest among lower level residents (p < .001). This perception did not change despite interventions and perceived improvement in teleconferencing.

Greater than 75% of radiologists with remote workstations reported improved wellness and lower stress levels compared to the onsite radiologists. The majority of all respondents voted to continue or expand remote work following the COVID-19 pandemic in both surveys.

Conclusions

Onsite teaching is important for the education of residents, particularly for lower-level residents. However, the adoption of a hybrid model in an academic setting may prove beneficial for faculty wellness and recruitment of the next generation.

Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review

BACKGROUND

Technologies have been extensively implemented to provide health care services for all types of clinical conditions during the COVID-19 pandemic. While several reviews have been conducted regarding technologies used during the COVID-19 pandemic, they were limited by focusing either on a specific technology (or features) or proposed rather than implemented technologies.

OBJECTIVE

This review aims to provide an overview of technologies, as reported in the literature, implemented during the first wave of the COVID-19 pandemic.

METHODS

We conducted a scoping review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. Studies were retrieved by searching 8 electronic databases, checking the reference lists of included studies and relevant reviews (backward reference list checking), and checking studies that cited included studies (forward reference list checking). The search terms were chosen based on the target intervention (ie, technologies) and the target disease (ie, COVID-19). We included English publications that focused on technologies or digital tools implemented during the COVID-19 pandemic to provide health-related services regardless of target health condition, user, or setting. Two reviewers independently assessed the eligibility of studies and extracted data from eligible papers. We used a narrative approach to synthesize extracted data.

RESULTS

Of 7374 retrieved papers, 126 were deemed eligible. Telemedicine was the most common type of technology (107/126, 84.9%) implemented in the first wave of the COVID-19 pandemic, and the most common mode of telemedicine was synchronous (100/108, 92.6%). The most common purpose of the technologies was providing consultation (75/126, 59.5%), followed by following up with patients (45/126, 35.7%), and monitoring their health status (22/126, 17.4%). Zoom (22/126, 17.5%) and WhatsApp (12/126, 9.5%) were the most commonly used videoconferencing and social media platforms, respectively. Both health care professionals and health consumers were the most common target users (103/126, 81.7%). The health condition most frequently targeted was COVID-19 (38/126, 30.2%), followed by any physical health conditions (21/126, 16.7%), and mental health conditions (13/126, 10.3%). Technologies were web-based in 84.1% of the studies (106/126). Technologies could be used through 11 modes, and the most common were mobile apps (86/126, 68.3%), desktop apps (73/126, 57.9%), telephone calls (49/126, 38.9%), and websites (45/126, 35.7%).

CONCLUSIONS

Technologies played a crucial role in mitigating the challenges faced during the COVID-19 pandemic. We did not find papers describing the implementation of other technologies (eg, contact-tracing apps, drones, blockchain) during the first wave. Furthermore, technologies in this review were used for other purposes (eg, drugs and vaccines discovery, social distancing, and immunity passport). Future research on studies on these technologies and purposes is recommended, and further reviews are required to investigate technologies implemented in subsequent waves of the pandemic.

Prospective Analysis of Radiology Resource Utilization and Outcomes for Participation in Oncology Multidisciplinary Conferences

RATIONALE AND OBJECTIVES

Radiology participation is necessary in oncology multidisciplinary conferences (MDCs), but the resources required to do so are often unaccounted for. In this prospective study we provide an analysis of resource utilization as a function of outcomes for all MDCs covered by an entire radiology section and provide a time-based cost estimate.

MATERIALS AND METHODS

Following institutional review board approval, prospective data on all MDCs covered by abdominal radiologists at a single tertiary care academic center were obtained over nine weeks. A predefined questionnaire was used by a single observer who attended every imaging review and recorded the total time spent by the radiologists and several outcome measures. The total time recorded was used to provide a time-based cost estimate using a national salary survey.

RESULTS

Six radiologists participated in a total of 57 MDCs, with 577 cases reviewed and discussed. 181 (31%) cases were performed at outside facilities requiring full reinterpretation. Clinically significant revisions to original reports were recorded in 107 (18.5%) cases. Radiologist input directly resulted in alteration of cancer staging in 65 (11%) patients and specific recommendations for follow-up diagnostic workup in 280 (48%) of cases. The mean total time devoted by the staff radiologist per week to MDCs was 18.7 hours/week, nearly a half of full-time effort, or 8% of total effort per radiologist. The total annual projected cost of radiology coverage for each weekly MDC was $26,920.

CONCLUSION

Section-wide radiologist participation in MDCs directly resulted in change in clinical management in nearly half of reviewed cases. This was achieved at a notable time cost, highlighting the need for efficient integration of radiology MDC participation into radiologist workflow and compensation models.

Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study

Objectives: With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted the integration of Zoom meetings into clinical rounds. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients. Design: Mixed quantitative and qualitative deductive thematic content analysis of narrative responses. Setting: PICU, single tertiary-care academic center. Participants: Multidisciplinary PICU HCWs. Interventions: Integration of Zoom meeting into clinical daily PICU rounds. Measurements: For the quantitative part, we gathered the details of daily PICU hybrid rounds in terms of times, number of HCWs, and type of files shared through Zoom. For the qualitative part, open-ended questions were used. Main Results: The physical round took statistically significantly less time (34.68 ± 14.842 min) as compared with the Zoom round (72.45 ± 22.59 min), p < 0.001. The most shared component in the virtual round was chest X-rays (93.5%). Thirty-one HCWs participated in focus group discussions and were included in the analysis. Some of the HCWs' perceived advantages of the hybrid rounds were enabling multidisciplinary discussions, fewer round interruptions, and practicality of virtual discussions. The perceived challenges were the difficulty of the bedside nurse attending the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if video streaming was not utilized. Conclusions: Multidisciplinary hybrid virtual and physical clinical rounds in the PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round should be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.

Online conferencing software in radiology: Recent trends and utility

Videoconferencing platforms have recently gained wide attention due to the COVID-19 pandemic, both within and outside of the medical community. This article reviews various applications of online meeting technology to the radiologic community, not only in response to the recent pandemic but also thereafter. Various platform features are outlined and discussed, specifically with respect to collaboration, training, and patient care. Platforms reviewed are GoToMeeting, Microsoft Teams, Skype, WebEx, and Zoom.

Postgraduate radiology education: what has Covid-19 changed?

Radiology training in the UK follows a standardised pathway with formative and summative assessments throughout. The Covid-19 pandemic has affected multiple existing educational methods commonly used during radiology training including small group teaching, multidisciplinary team meetings, online e-learning modules, radiology courses, exam provision and more. As such, significant adaptations have been implemented in order to maintain the standard of radiology training which come with their respective advantages and disadvantages. However, the question still remains as to the effectiveness of these methods, their acceptability and longevity. In this review, we discuss these educational adaptations and future directions for training in the ongoing pandemic.

Purposeful Remote Radiology Education: Strategies and Recommendations

The COVID-19 global pandemic has presented new challenges to radiology educators and their learners. As a specialty that is accustomed to adapting to continual technologic innovation, as well as one with the capacity for remote work, radiology is uniquely positioned to meet these challenges by taking advantage of online remote educational strategies. This represents an opportunity to not only leverage new methods and technologies but also reexamine the most effective way to implement established ones. The authors review the benefits of taking a purposeful goal-oriented approach to these challenges, provide a corresponding qreview of the general categories of resources that are currently available, and explore educational strategies by using broad categories of software solutions. An invited commentary by Awan is available online. Online supplemental material is available for this article. ^©RSNA, 2021.

The Virtual Homeroom: Utility and Benefits of Small Group Online Learning in the COVID-19 Era

Objective

During COVID-19, Harvard Medical School pivoted to online learning. A large student cohort took a completely virtual Radiology clerkship with daily programming including virtual small group teaching sessions or “homerooms.”

Materials and methods

One hundred and eleven medical students were divided into 12 virtual small group sessions which emphasized foundational concepts. Uniform teaching materials were used across all homerooms in order to deepen understanding and allow insight into the working methods of radiologists. Students evaluated the homeroom learning and teachers for utility and benefit to their educational experience.

Results

Most students (93%) felt the homerooms provided an educational benefit and reinforced topics studied (77%). Most students (84%) felt the leaders created an environment conducive to learning. Despite being virtual, students were able to form interpersonal connections with the homeroom leaders.

Conclusions

Incorporating virtual small group learning can be a valuable component of a virtual or hybrid Radiology clerkship, solidifying foundational concepts with the homeroom leaders playing a major role. While developed by necessity due to COVID-19, virtual small group learning with engaged leaders is an educational strategy whose benefit can continue even as there is return to in-person learning.

Technologic optimization of a virtual disease focused panel during the COVID pandemic and beyond

Since the beginning of the COVID-19 pandemic, several service fields have opted for virtual work as much as possible, in order to decrease the spread of the virus. Although several articles have now addressed the key issues in telecommunications and medical education, none have described the digital or virtual functionality of a professional society disease focused panel (DFP) or inter-institutional collaborations. This is extremely important as we believe that the virtual functioning of the DFP will be the new norm for years to come. In this article, we highlight the limitations in the functioning of DFP brought forth due to the ongoing pandemic, while also providing the digital technologic solutions to adapt and also maintain or increase its productivity.

Social Media for Knowledge Acquisition and Dissemination: The Impact of the COVID-19 Pandemic on Collaborative Learning Driven Social Media Adoption

During the COVID-19 outbreak, educational institutions were closed, and students worldwide were confined to their homes. In an educational environment, students depend on collaborative learning (CL) to improve their learning performance. This study aimed to increase the understanding of social media adoption among students during the COVID-19 pandemic for the purpose of CL. Social media provides a learning platform that enables students to easily communicate with their peers and subject specialists, and is conducive to students' CL. This study addresses the key concept of CL during the COVID-19 pandemic by assessing social media use among students in higher education. The relationship between social media use and students' performance is crucial to understanding the role of social media during a pandemic. This study is based on constructivism theory and the technology acceptance model. Structural equation modeling was used to analyze the conceptual model using SmartPLS. The research findings indicate that social media plays an important role during the pandemic because it provides opportunities for students to enhance CL under the aforementioned situations. This study makes noteworthy theoretical and practical contributions.

Overview of Technologies Implemented During the First Wave of the COVID-19 Pandemic: Scoping Review (Preprint).. [DOI: 10.2196/preprints.29136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

Technologies have been extensively implemented to provide health care services for all types of clinical conditions during the COVID-19 pandemic. While several reviews have been conducted regarding technologies used during the COVID-19 pandemic, they were limited by focusing either on a specific technology (or features) or proposed rather than implemented technologies.

OBJECTIVE

This review aims to provide an overview of technologies, as reported in the literature, implemented during the first wave of the COVID-19 pandemic.

METHODS

We conducted a scoping review using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. Studies were retrieved by searching 8 electronic databases, checking the reference lists of included studies and relevant reviews (backward reference list checking), and checking studies that cited included studies (forward reference list checking). The search terms were chosen based on the target intervention (ie, technologies) and the target disease (ie, COVID-19). We included English publications that focused on technologies or digital tools implemented during the COVID-19 pandemic to provide health-related services regardless of target health condition, user, or setting. Two reviewers independently assessed the eligibility of studies and extracted data from eligible papers. We used a narrative approach to synthesize extracted data.

RESULTS

Of 7374 retrieved papers, 126 were deemed eligible. Telemedicine was the most common type of technology (107/126, 84.9%) implemented in the first wave of the COVID-19 pandemic, and the most common mode of telemedicine was synchronous (100/108, 92.6%). The most common purpose of the technologies was providing consultation (75/126, 59.5%), followed by following up with patients (45/126, 35.7%), and monitoring their health status (22/126, 17.4%). Zoom (22/126, 17.5%) and WhatsApp (12/126, 9.5%) were the most commonly used videoconferencing and social media platforms, respectively. Both health care professionals and health consumers were the most common target users (103/126, 81.7%). The health condition most frequently targeted was COVID-19 (38/126, 30.2%), followed by any physical health conditions (21/126, 16.7%), and mental health conditions (13/126, 10.3%). Technologies were web-based in 84.1% of the studies (106/126). Technologies could be used through 11 modes, and the most common were mobile apps (86/126, 68.3%), desktop apps (73/126, 57.9%), telephone calls (49/126, 38.9%), and websites (45/126, 35.7%).

CONCLUSIONS

Technologies played a crucial role in mitigating the challenges faced during the COVID-19 pandemic. We did not find papers describing the implementation of other technologies (eg, contact-tracing apps, drones, blockchain) during the first wave. Furthermore, technologies in this review were used for other purposes (eg, drugs and vaccines discovery, social distancing, and immunity passport). Future research on studies on these technologies and purposes is recommended, and further reviews are required to investigate technologies implemented in subsequent waves of the pandemic.

Impact of the COVID-19 Pandemic on Breast Imaging Education

Objective

To determine the impact of the COVID-19 pandemic on breast imaging education.

Methods

A 22-item survey addressing four themes during the early pandemic (time on service, structured education, clinical training, future plans) was emailed to Society of Breast Imaging members and members-in-training in July 2020. Responses were compared using McNemar's and Mann-Whitney U tests; a general linear model was used for multivariate analysis.

Results

Of 136 responses (136/2824, 4.8%), 96 U.S. responses from radiologists with trainees, residents, and fellows were included. Clinical exposure declined during the early pandemic, with almost no medical students on service (66/67, 99%) and fewer clinical days for residents (78/89, 88%) and fellows (48/68, 71%). Conferences shifted to remote live format (57/78, 73%), with some canceled (15/78, 19%). Compared to pre-pandemic, resident diagnostic (75/78, 96% vs 26/78, 33%) (P < 0.001) and procedural (73/78, 94% vs 21/78, 27%) (P < 0.001) participation fell, as did fellow diagnostic (60/61, 98% vs 47/61, 77%) (P = 0.001) and procedural (60/61, 98% vs 43/61, 70%) (P < 0.001) participation. Most thought that the pandemic negatively influenced resident and fellow screening (64/77, 83% and 43/60, 72%, respectively), diagnostic (66/77, 86% and 37/60, 62%), and procedural (71/77, 92% and 37/61, 61%) education. However, a majority thought that decreased time on service (36/67, 54%) and patient contact (46/79, 58%) would not change residents' pursuit of a breast imaging fellowship.

Conclusion

The pandemic has had a largely negative impact on breast imaging education, with reduction in exposure to all aspects of breast imaging. However, this may not affect career decisions.

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

Social distancing concerns arising 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 using virtual readouts in at least a hybrid format, even after social distancing restrictions become relaxed. This article highlights the challenges and opportunities associated with virtual readouts and provides guidance and strategies for their long-term implementation by training programs.

Medical student education in the time of COVID-19: A virtual solution to the introductory radiology elective

Rationale and objectives

During the COVID-19 pandemic, medical educators and students are facing unprecedented challenges while navigating the new virtual landscape that social-distancing policies mandate. In response to these challenges, a new virtual introduction to radiology elective was established with unique online resources and curriculum.

Materials and methods

A previously in-person 2-week introductory radiology elective was converted into a completely virtual experience using an internally developed, open-source, peer-reviewed, web-based teaching modules combined with virtual lectures, interdisciplinary conferences, and readout sessions of de-identified cases loaded to a DICOM viewer. Students from the first four months of course enrollment completed a multiple choice pre- and post-course knowledge assessments and a 5-point Likert Scale survey as part of their educational experience.

Results

In total, 26 4th-year medical students participated over 4 separate 2-week sessions from July to October of 2020. This included 12 students from the home intuition and 14 visiting students. On average, students scored 62.2% on the 55-question pre-test and 89.0% on the same test upon completion of the course, a statistically significant increase (p < 0.001). All 26 students felt engaged throughout the course. All 26 agreed (23 “strongly agreed”) that they were more comfortable looking at imaging studies following the course. All 26 also agreed (21 “strongly agreed”) that the course helped them prepare for their future clinical rotations and careers.

Conclusion

Initial pilot program using unique web-based resources and student encounters during a two-week virtual introductory radiology elective proved to be a positive educational experience for the first 26 students enrolled.

A virtual emergency: learning lessons from remote medical student education during the COVID-19 pandemic

Purpose

The COVID-19 pandemic resulted in the cancelation of traditional on-site clinical rotations for medical students across the country. Radiology educators have had to rapidly adapt to a new, virtual educational landscape. We describe our experience restructuring a Trauma and Emergency Radiology Elective to an online format and present survey data obtained from students who completed the course.

Methods

This elective is a 4-week course offered to third and fourth year medical students at a large Level 1 Trauma Center. Changes to the traditional rotation included assigning an increased number of self-study educational resources, independent review of unknown cases using a virtual workstation, and online interactive conferences. At the conclusion of each block, students were asked to complete post-course feedback surveys.

Results

Thirteen students enrolled in this online course; 92% submitted post-course surveys. Students strongly agreed that the course was clinically relevant, with accessible, engaging material (average score, 4.92/5), and 91.7% of students were very likely to recommend this rotation to others. Students reported improved post-course confidence in ordering and interpreting imaging studies. A majority (60%) of students who had previously taken an on-site course would have preferred a course that combined traditional and online learning elements.

Conclusions

The success of our online rotation highlights the merits of self-directed learning and flipped-classroom techniques. Many of the principles incorporated into this course could be applied and/or modified to increase medical student engagement when students return to the hospital.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10140-020-01874-2.

Impact of COVID-19 on Canadian Radiology Residency Training Programs

PURPOSE

The novel coronavirus disease (COVID-19) pandemic has swept the globe, with a domino effect on medical education and training. In this study, we surveyed Canadian radiology residents to understand the impact of the pandemic on their residency training, strategies utilized by the residency programs in mitigating those impacts, and factors important to residents in the selection of educational resources on COVID-19.

METHODS

A 10-item questionnaire was distributed to 460 resident members of the Canadian Association of Radiologists. The survey was open for 2 weeks, with a reminder sent at half-way mark.

RESULTS

We received 96 responses (response rate: 20.9%). The 4 highest affected domains of training were daytime case volumes (92.4%), daytime schedules (87.4%), internal and external assessments (86.5%), and vacation/travel (83.3%). Virtual teaching rounds (91.7%), change in schedules to allow staying home (78.1%), and virtual/phone readouts (72.9%) were the most utilized strategies by the Canadian radiology residency programs. Overall stress of exposure to the disease was moderate to low (86.5%). A minority of the residents were redeployed (6.2%), although most (68.8%) were on standby for redeployment. Residents preferred published society guidelines (92.3%), review papers (79.3%), video lectures (79.3%), and web tools (76.9%) for learning about COVID-19 imaging manifestations.

CONCLUSION

The COVID-19 pandemic has had a significant impact on various domains of the Canadian radiology residency programs, which has been mitigated by several strategies employed by the training programs.

Lessons Learned From the Effects of COVID-19 on the Training and Education Workflow of Radiology Residents-A Time for Reflection: Perspectives of Residency Program Directors and Residents in Canada

PURPOSE

The coronavirus disease 2019 (COVID-19) pandemic has led to widespread changes in all health care settings including academic radiology departments. The purpose of this survey-based study was to investigate the impact of COVID-19 on radiology resident training and education workflow in Canada in terms of the nature, scale, and heterogeneity of the changes, preparedness and adaptation, and perceptions of the present and future of radiology training.

METHODS

A 30-question web-based survey was sent to 17 radiology residency program directors across Canada. A separate 32-question survey was sent to 460 residents currently enrolled in a radiology residency in Canada. These surveys were open for 3 weeks.

RESULTS

We received responses from 16 program directors and 80 residents (response rates 94.1% and 17.4%, respectively). Most respondents agreed that objectives were being met for knowledge and interpretation but less so for case volumes and technical skills. Less time was allotted for on-site activities (eg, readouts) with more time for off-site activities (eg, videoconferencing). Daytime rotations were at least partly cancelled. Most respondents felt these changes were met with enthusiasm by both faculty and residents. However, there were perceived challenges including lack of training on virtual platforms for delivery of teaching and decreased staff-resident interaction, with short- and long-term anxiety reported.

CONCLUSIONS

The coronavirus disease 2019 has dramatically changed radiology resident training in Canada, with increased virtual learning at the expense of cancelled rotations and the resultant reduction in case volumes and staff-resident interaction. Although adopted with enthusiasm, these changes present substantial challenges and anxiety regarding the future of radiology resident education.

Understanding Education Difficulty During COVID-19 Lockdown: Reports on Malaysian University Students' Experience

The COVID-19 pandemic has struck the world and forced countries to go into lockdown including education sector. Students have been staying in hostels or houses, unable to go to university campuses. This situation has left university administrators no choice, but to have an online learning channel. Malaysian universities in particular have gone through many challenges to bring their online learning system up and ready to resume education process. However, students have found themselves caught in this situation (pure online learning) with no plan or readiness. Literature reviews showed that students encountered some challenges that could not be easily resolved. This study explored the challenges encountered by students of a government-linked university. This university is one of the largest in Malaysia with over 10 campuses across the country. This study collected 284 valid answers. The findings show that respondents lacked full readiness in this situation physically, environmentally, and psychologically with some differences in perspectives according to their gender, age, and residing state. Respondents were concerned about the implications of lockdown on their performance. The findings of this study indicate that a sudden switch to a pure online alternative creates considerable challenges to students who have no plans to be physically apart from classes. The findings also indicate that the current blended learning process which uses online learning as a support mechanism for face-to-face learning has faced a considerable challenge to replace it, particularly with unprepared students.

The Impact of a Virtual Radiology Medical Student Rotation: Maintaining Engagement During COVID-19 Mitigation

Introduction

The purpose of this study is to introduce a virtual radiology rotation curriculum that is being used to safely maintain medical student and intern education and engagement with the Department of Radiology at Walter Reed National Military Medical Center during coronavirus disease 2019 (COVID-19) mitigation.

Materials and Methods

The curriculum is designed as a 4-week block with each week representing one of the four highest yield radiology subspecialties for medical students; neuroradiology, thoracic radiology, body radiology, and musculoskeletal radiology. A subspecialist radiologist from each section was identified as a primary mentor and tasked with designing a daily schedule for medical students and interns. The first 2 months of virtual rotators were surveyed to assess the effectiveness of the course.

Results

Thirty-five of 41 rotators responded to the survey, a response rate of 85%. Thirty-one of 35 (89%) of the rotators gave this virtual elective rotation a positive rating, with 16 trainees scoring the course as 4 out of 5 and 15 trainees selecting 5 out of 5. Four respondents selected 3 out of 5. Five out of 5 respondents who had experienced an in-person radiology elective rotation before this virtual rotation rated the virtual elective as more educational than the in-person rotation. We found the 4-week subspecialist mentor-based structure to be highly versatile, allowing us to simultaneously accommodate multiple groups of full or partial block rotators throughout COVID-19 mitigation.

Conclusion

A virtual rotation curriculum is a viable method of maintaining medical student and intern education and engagement with the department of radiology during COVID-19 mitigation.