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

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

Background

During the COVID-19 lockdown, it was difficult for residency training programs to conduct on-site, hands-on training. Distance learning, as an alternative to in-person training, could serve as a viable option during this challenging period, but few studies have assessed its role.

Objective

This study aims to investigate the impact of distance learning during the lockdown on residents' self-assessed competency development and to explore the moderating effect of poor mental health on the associations. It is hypothesized that radiology residents who were trained through distance learning during the lockdown were more likely to report higher self-assessed competency compared to those who did not receive organized, formal training.

Methods

A cross-sectional survey was conducted in 2021 among all of the radiology residents in 407 radiology residency programs across 31 provinces of China. To estimate the long-term outcomes of radiology residents' training after the initial COVID-19 outbreak, this study measured 6 core competencies developed by the US Accreditation Council for Graduate Medical Education reported by radiology residents. Multiple linear regression and moderating effect analysis were conducted to examine the associations between distance learning, mental health status, and self-assessed competencies. Mental health status moderated the association between distance learning and self-assessed competency of radiology residents.

Results

A total of 2381 radiology residents (29.7% of the 8,008 nationwide) met the inclusion criteria and were included in the analysis. Among them, 71.4% (n=1699) received distance learning during the COVID-19 lockdown, and 73.2% (n=1742) reported mental health struggles ranging in severity from slight to extremely severe. Radiology residents who were trained through distance learning (β=0.35, 90% CI 0.24-0.45) were more likely to report higher self-assessed competencies. This was particularly true for the competency of "interpersonal and communication skills" (β=0.55, 90% CI 0.39-0.70). Whereas, the competency of "patient care and technical skills" (β=0.14, 90% CI 0.01-0.26) benefited the least from distance learning. Poor mental health significantly moderated the relationship between distance learning and competency (β=-0.15, 90% CI -0.27 to -0.02).

Conclusions

Distance learning, a means of promoting enabling environments during the COVID-19 lockdown, serves its purpose and helps generally improve residents' self-assessed competencies, though different competency domains benefit unequally. The impact of mental health status calls for special attention so that distance learning can fulfill its potential.

Enhancing medical imaging education: integrating computing technologies, digital image processing and artificial intelligence

The rapid advancement of technology has brought significant changes to various fields, including medical imaging (MI). This discussion paper explores the integration of computing technologies (e.g. Python and MATLAB), digital image processing (e.g. image enhancement, segmentation and three-dimensional reconstruction) and artificial intelligence (AI) into the undergraduate MI curriculum. By examining current educational practices, gaps and limitations that hinder the development of future-ready MI professionals are identified. A comprehensive curriculum framework is proposed, incorporating essential computational skills, advanced image processing techniques and state-of-the-art AI tools, such as large language models like ChatGPT. The proposed curriculum framework aims to improve the quality of MI education significantly and better equip students for future professional practice and challenges while enhancing diagnostic accuracy, improving workflow efficiency and preparing students for the evolving demands of the MI field.

The effect of mobile health application training based on micro-learning method on the level of resilience and happiness among intensive care nurses: a randomized controlled trial

BACKGROUND

Increasing the level of resilience and happiness of intensive care nurses can lead to an improvement in their psychological health. This study aimed to extract the possible effectiveness of mHealth application utilizing the micro-learning method on a mobile phone platform on the intensive care nurses' resilience and happiness.

MATERIALS AND METHODS

This single-blind randomized controlled trial was conducted in 2022-24. Sixty nurses working in intensive care units at two hospitals in Tehran, Iran were recruited using purposive sampling and randomly assigned to either the intervention or control group. Techniques of resilience and increasing happiness were taught to the intervention group using the mHealth application based on the micro-learning method. No training was provided to the control group. For data collection, questionnaires of individual characteristics, Connor-Davidson Resilience, and Oxford Happiness were used.

RESULTS

Before the intervention, there was no significant difference between the mean of the subscales and the total score of resilience and happiness of the intervention and control groups (P < 0.05). However, after the intervention, there was a significant difference (P < 0.05). After using the mHealth application, the total resilience score of the intervention group increased from 67.30 ± 10.12 to 79.27 ± 5.87 (P < 0.0001), while the resilience of the control group changed from 68.80 ± 9.09 to 65.93 ± 8.44 (P = 0.548). Similarly, using the mHealth educational application based on micro-learning led to an increase in the happiness score of the intervention group from 38.50 ± 11.10 to 67.83 ± 8.84 (P < 0.0001), whereas the happiness score of the control group nurses after the intervention (38.93 ± 14.33) compared to the baseline (41.40 ± 14.51) did not change significantly (P = 0.388).

CONCLUSIONS

The use of the mHealth application based on the micro-learning method played an effective role in training resilience and happiness skills in nurses. It is recommended to conduct more studies using this new educational approach.

TRIAL REGISTRATION

The study has been registered in the Iranian Registry of Clinical Trials (No. IRCT20221225056916N1, Date: 04/29/2023).

Evolving radiology continuing medical education: Tapping into the power of online learning

INTRODUCTION

Global education, particularly Continuing Medical Education (CME) for healthcare professionals, is quickly shifting online. This study assesses the opportunities and challenges of adopting online learning in radiology CME. It explores how radiologists and radiographers have adapted to this digital shift and the changing landscape of radiology education. The study also seeks to envision an innovative future for radiology education.

METHODS

A descriptive cross-sectional survey was conducted among radiologists and radiographers working in radiology departments in the United Arab Emirates (UAE). The survey collected data on participant demographics, experiences with CME, sources of CME, and perceptions of online learning. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software.

RESULTS

The survey involved 65 radiologists and 215 radiographers. Findings indicated a significant shift from face-to-face to online CME activities, with 76.9% of radiologists and 70.7% of radiographers utilizing online resources for CME. Concerns about time management, technical issues, and expenses have emerged as challenges for online CME. Participants also highlighted the importance of free-of-charge CME and the value of active participation and anonymity in online discussions.

CONCLUSION

Radiology professionals have rapidly adapted to the changing landscape of CME by embracing online learning. While this shift offers greater flexibility and accessibility, technology-related challenges and concerns over time management persist. The study suggests that the future of radiology CME may involve personalized, adaptive, and interactive learning experiences, emphasizing mental well-being and resilience.

IMPLICATIONS FOR PRACTICE

Radiology professionals must embrace online CME for continuous skill enhancement, addressing technical challenges, fostering interactive learning environments, and ensuring accessibility to maintain high standards in patient care and medical advancements.

The Role of Twitter in Radiology Medical Education and Research: A Review of Current Practices and Drawbacks

The trends in society have provided favourable conditions for the rapid growth of radiology on social media, specifically there has been an expanding presence on Twitter. Currently, simple searches on Twitter yield a plethora of radiology education resources, that may be suited for medical students, residents or practicing radiologists. Educators have many tools at their disposal to deliver effective teaching. Over time, strategies such as including images and scrollable stacks often are more successful at gaining popularity or clicks online. Journals and authors can use Twitter to promote their new scientific work and potentially reach audiences they couldn't have prior. Attendees at conferences can get involved in the conversation by tweeting about the meeting and engaging with other attendees with mutual interests. Interested medical students, residents and even practicing radiologists can use Twitter as a means of networking and connecting with other scholars all around the globe. Within its glory, Twitter does carry some drawbacks including privacy concerns, equality, and risk of misinformation. Above all, the future of Twitter is bright and promising for all who are currently on it and plan to use it for their education, research, or professional advancement.

Using Rubrics to Evaluate E-Learning Tools in Radiology Education

Recent trends in medical education with an emphasis on active learning strategies and blended learning techniques have resulted in a growing volume and utilization of online educational resources. Integration of online learning tools into medical curricula has been further necessitated during the COVID-19 pandemic. With access to abundant digital radiology education resources, it has become increasingly important for educators to be able to evaluate the efficacy of e-learning tools for use in radiology education. In this manuscript, the authors describe their successful search for a vetted method to evaluate e-learning tools in radiology education. The selected rubric was designed by educational developers supporting technology to be used as a formative tool in higher education. The rubric was applied in condensed and noncondensed formats to 2 existing popular highly subscribed radiology e-learning resources and results were displayed in narrative and visual formats. More widespread application of this rubric would be beneficial to the content creators and learners alike.

Mobile applications in radiology: own study based on polish data

As the number of smartphones increases, so does the number of medical apps. Medical mobile applications are widely used in many medical fields by both patients and doctors. However, there are still few approved mobile applications that can be used in the diagnostic-therapeutic process and radiological apps are affected as well. We conducted our research by classifying radiological applications from the Google Play® store into appropriate categories, according to our own qualification system developed by researchers for the purposes of this study. In addition, we also evaluated apps from the App Store®. The radiology application rating system we created has not been previously used in other articles. Out of 228 applications from the Google Play store, only 6 of them were classified as "A" category with the highest standard. Apps from the App Store (157) were not categorized due to the lack of download counts, which was necessary in our app-rating system. The vast majority of applications are for educational purposes and are not used in clinical practice. This is due to the need of obtaining special permits and certificates from relevant institutions in order to use them in medical practice. We recommend applications from the Google Play store that have been classified in the "A" category, evaluating them as the most valuable. App Store apps data is described and presented in the form of diagrams and tables.

A Review of COVID-19's Impact on Radiology Residents' Academics and Wellness in North America

BACKGROUND

The COVID-19 pandemic caused major disruptions in radiology departments throughout North America. Radiology residency programs were forced to make dramatic changes to their training programs, which had major impacts on resident academics and wellness. The goal of this review is to evaluate the impact of COVID-19 on radiology residents' academics and wellness in North America, while also identifying effective measures taken by programs to mitigate the effects of the pandemic.

METHODS

The search strategy involved database search via PubMed, Embase, and Web of Science with specific key words related to COVID-19, radiology residents, education, wellness, and virtual learning. Studies discussing the education and wellness of radiology residents in North America published after 2020 were included. The data were analyzed using a narrative synthesis approach.

RESULTS

The three main domains affected by the pandemic include the residency curriculum, research, and resident wellness. The decline in case volume and diversity of cases had negative overall impact on education of radiology residents, but simulated cases and virtual learning proved its value during the pandemic and may have lasting implications for the postpandemic world. Research initiatives transitioned to a remote format with greater emphasis on quality improvement and COVID-19-related studies. Reduced face-to-face interaction opportunities made it difficult to establish strong and meaningful interpersonal connections and had a negative impact on resident wellness, mentorship, and professional development. Implementing mentorship programs and virtual "town hall meetings" were effective measures to maintain connections during times of social distancing. Finally, the COVID-19 pandemic introduced unprecedented stressors and challenges for radiology residents that negatively impacted their mental health and wellness. Incorporating wellness initiatives such as wellness hours and team-building activities and using social media were helpful in promoting wellness and mental health for radiology residents.

CONCLUSION

The COVID-19 pandemic has had a significant impact on the academics and wellness of radiology residents across North America but has taught us many lessons that can help us navigate the ongoing challenges of the pandemic, the postpandemic world, and future pandemics.

Results of the 2021-2022 Survey of the American Alliance of Academic Chief Residents in Radiology

RATIONALE AND OBJECTIVES

An annual survey of chief residents in accredited North American radiology programs is conducted by the American Alliance of Academic Chief Residents in Radiology (A3CR2). Special topics surveyed for the 2021-2022 academic year were procedural competency and virtual radiology education in the COVID-19 pandemic. The purpose of this study is to summarize the 2021-2022 A3CR2 chief resident survey.

MATERIALS AND METHODS

An online survey was distributed to chief residents from 197 Accreditation Council on Graduate Medical Education-accredited radiology residency programs. Chief residents responded to questions regarding their individual procedural readiness and attitudes on virtual radiology education. A single chief resident from each residency answered programmatic questions including the use of virtual education, faculty coverage, and fellowship choices among their graduating classes.

RESULTS

We received 110 individual responses from 61 programs, yielding a 31% program response rate. Although the majority (80%) of programs maintained purely in-person attending readout throughout the COVID 19 pandemic, only 13% of programs reported purely in-person didactics and 26% converted to all virtual didactics. The majority (53%-74%) of chief residents perceived virtual learning (in read-out, case conference, and didactic formats) to be less effective than in-person learning. One third of chief residents reported decreased procedural exposure during the pandemic, and 7%-9% of chief residents felt uncomfortable with basic procedures (basic fluoroscopy examinations, basic aspiration/drainage procedures, and superficial biopsy procedures). The number of programs with 24/7 attending coverage increased from 35% in 2019 to 49% in 2022. Body, neuroradiology, and interventional radiology were the most popular advanced training options among graduating radiology residents.

CONCLUSION

The COVID-19 pandemic had a profound impact on radiology training, particularly in terms of virtual learning. These survey results suggest that although digital learning offers increased flexibility, most residents still prefer in-person readout and didactics. Despite this, virtual learning will likely remain a viable option as programs continue to evolve following the pandemic.

Radiology for anatomy educators: Success of an online, 2-day course for radiology training

Incorporation of radiology training into anatomy education from community college to health professional schools is becoming increasingly popular. However, anatomy educators generally lack training in common radiology modalities, including X-ray, CT, MRI, and ultrasound. Professional development or continuing education courses provide current and new educators the chance to gain new skills within a short timeframe. Here, a 2-day, online course for anatomy educators was created. The goals of which were for the participants: to gain basic knowledge of different radiology modalities, recognize normal radiographic images, and apply that information to common diseases or injuries in interactive case studies. Each day focused on different modalities, where Day 1 studied X-ray, CT, and MRI; and Day 2 studied Ultrasound. A 10-question pre- and post-test was taken by attendees for each day of instruction on a voluntary basis. Following the completion of the course, attendees were provided a survey to determine their perceptions on course content and knowledge acquired. Most attendees instructed undergraduates at 4-year universities, though several attendees came from community colleges and high schools. All attendees showed a significant improvement in knowledge from their pre- to post-test scores in X-ray, CT, MRI, and ultrasound following training. This was also reflected in their survey responses, where attendees felt the course was effective in increasing their knowledge and confidence in radiology. Overall, this study demonstrates the effectiveness of online continuing education courses and the need for more introductory radiology courses for anatomy educators.

Perceived Usefulness of Smartphone Medical Apps As Theoretical and Clinical Learning Aids Among Medical Students in Pakistan: A Cross-Sectional Study

Background Smartphone applications have become popular tools in clinical educational environments, particularly because they enhance learning in any setting through their accessibility. Despite students utilizing these apps in their daily learning, Pakistan's medical education system has yet to strongly endorse them. Given the rising usage of medical applications among clinical year medical students and the wide range of apps accessible on contemporary devices aimed specifically at the student population, there is a lack of literature addressing the use of these apps on clinical learning in low- and middle-income countries (LMIC) such as Pakistan. Objectives Our study aims to (1) assess the level of awareness among clinical-year medical students in Pakistan, of smartphone applications for academic purposes, (2) determine the usefulness of medical apps as educational tools for clinical-year medical students, in terms of enhancing overall patient-care skills and (3) identify barriers to the usage of apps among students who do not have them installed. Methods This online questionnaire-based study includes clinical year medical students across four medical colleges (two private and two public sectors) in Pakistan. Participant identity was kept anonymous and informed consent was required to participate. A sample size of 360 was used based on previous studies in the UK and student estimates from chosen medical colleges. The questionnaire tool used consists of three sections; demographics and medical school information, perceived usefulness of medical smartphone apps on a Likert Scale and barriers to usage among students who do not have them installed. Results 97.9% of the total study population chose to participate in the study. There was roughly an equal percentage of responses from each clinical year and 72% of students reported active use of medical apps of which the vast majority (48%) have one to two apps on their phones. Only 39% of students felt that their medical colleges encourage the use of smartphone apps for academic purposes. 54% of students use apps to look up medical criteria for disease processes and almost 42% use them to search medications. On a Likert scale of 1-5, improvement of clinical performance received highest average score among users (3.92, SD 1.1), followed by quick access to medical guidelines (3.83, SD 1.0). The most common reasons for nonuse of medical apps were medical colleges not offering subscriptions and not knowing how to utilize apps. Conclusion Smartphone apps are widely used by clinical year medical students for academic purposes in our study. Despite lack of endorsement from their respective medical colleges, these apps are still popularly utilized for revision and research on disease criteria during clinics and rounds. Encouragement from the university has been identified as a significant barrier, however. Students who use smartphone apps reported an improvement in clinical performance overall; they were able to retrieve information quicker during rounds and noticed enhancements in formulating diagnoses and reading radiological images. In contrast, those not using these apps faced challenges with interpreting imaging results, recalling pharmacological properties of medications and developing differential diagnoses. Through these findings, we highlight the benefits of incorporating technological media into the undergraduate curriculum and hope medical universities from Pakistan can take inspiration.

Electronic platform-based education for radiology residents: results of a two-year survey

BACKGROUND

Electronic platform based-learning for residents is increasing. The aim of this study was to identify the most reliable predictor variables related to the usage of electronic platform-based educational material for radiology residents which can predict a successful multiple-choice test during the academic year.

METHODS

A two year survey was conducted based on the records of electronic platform-based educational material for radiology residents. Radiology resident education was based on the educational content of two educational electronic platform databases named RADPrimer and STATdx (Elsevier, Amsterdam) consisting in evidence-based and expert-vetted summary information to support learning and diagnosing in radiology. A pool of multiple-choice questions was addressed in RADPrimer by each resident after 6 months from the beginning of each academic year, and at the end of the respective residency year as part of end of the year assessment. A per-resident analysis was performed to analyze the correlation between the amount of electronic platform content accessed by residents (measured by total login times, login frequency per month, and the number of per-topic addressed questions) in preparation for the electronic test during the academic year (predictor variables) and per-resident average percentage of correct answers on electronic test (outcome variable). Statistical significance (p < 0.05) was determined using logistic regression and correlation analysis.

RESULTS

Total login times (OR, 3; 95% CI, 2.2 -4), login frequency per month (OR, 4; 95% CI, 3.1-5.3), the number of per-topic addressed questions (OR, 3; 95% CI, 2.2 -4), and the number of topic-verified correct answers to multiple choice test (OR, 30.5; 95% CI, 12.8-80.9) all showed a statistically significant correlation with final percentage of correct answers on final year electronic test.

CONCLUSION

The number of correct answers to multiple choice test was related to the number and frequency of login access, the number of per-topic addressed questions and the number of topic-verified correct answers to multiple choice test. The electronic-based educational material contributes significantly to a successful radiology residency program.

Developing a Comprehensive Resident-driven Research Training Pathway: A Chief Resident's Perspective

Wide variation exists in research training, experience, opportunities, and exposure across various radiology residency training programs, ranging from having a dedicated research track to no exposure to hypothesis driven projects. Studies conducted at different residency training programs with varied resources and National Institutes of Health funding have shown that resident-driven research initiatives and mentorship programs have the potential to improve research experience during residency training, engage more medical students in research, increase departmental peer-reviewed publications and increase peer-reviewed publications of early-career faculty physicians. In an attempt to standardize the research training during radiology residency, we propose a standardized resident-led program which institutions may adapt, as well as resources that the American Alliance of Academic Chief Residents in Radiology (A³CR²) might compile in collaboration with other national organizations to improve trainee's research experience during their radiology residency training.

The experience of using Online education in a radiological academic department during the pandemic of Corona Virus COVID-19

Purpose

In response to the coronavirus (COVID-19) pandemic, most educational institutions transitioned to online delivery because the of the urgent need to avoid spreading the virus. For this study, the emergency transformation to 100% online education in a diagnostic radiology department was evaluated based on student experience and performance.

Methods

134 radiology students participated in this study. Reflecting on the department's shift to online education, students rated their experience: their general opinions about courses, preferences for online education, their evaluation of the procedures of the implemented plans, and their evaluation of academic components such as exams, lectures, assignments, teamwork, interaction, and compensating for the loss of practical learning.

Findings

The results indicate that the students appreciated the online emergency plan. Overall, they preferred online education compared to traditional classes, especially with regard to lectures, exams, teamwork, and interaction. Students agreed that some courses can be delivered online effectively, such as physics and research courses, while others should not. In general, this study demonstrates that radiology courses can be effectively delivered using online distance methods, and this should be a compulsory part of instruction in the future.

Contribution of the study

This study describes the effects of moving to online education in the field of radiology on both practical and theoretical learning outcomes.

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.

Institutional Strategies to Maintain and Grow Imaging Research During the COVID-19 Pandemic

Understanding imaging research experiences, challenges, and strategies for academic radiology departments during and after COVID-19 is critical to prepare for future disruptive events. We summarize key insights and programmatic initiatives at major academic hospitals across the world, based on literature review and meetings of the Radiological Society of North America Vice Chairs of Research (RSNA VCR) group. Through expert discussion and case studies, we provide suggested guidelines to maintain and grow radiology research in the postpandemic era.

Formación online en Radiología en tiempos de COVID

La pandemia por COVID-19 ha alterado de forma significativa la metodología que tradicionalmente se ha empleado para la enseñanza de la Radiología en pregrado, posgrado y formación continuada. La necesidad de continuar con la formación en Radiología bajo una situación de distanciamiento físico ha provocado el uso masivo de metodología online y aquí es donde Internet se ha constituido en una solución para mitigar el problema. El objetivo de este trabajo es presentar una serie de recursos útiles de acceso gratuito que comparten la filosofía #FOAMRad para la formación online en Radiología en estos tiempos de COVID.