The State of Medical Student Teaching of Interventional Radiology: Implications for the Future

Level of Awareness Regarding Interventional Radiology Among Medical Students at Northern Border University in Arar, Saudi Arabia

Introduction Interventional radiology (IR) is a highly specialized field of radiology that employs advanced imaging techniques like MRIs, CT scans, X-rays, and ultrasounds to detect and treat a variety of medical disorders. By using minimally invasive procedures, interventional radiologists can access the body's internal organs and tissues with minimal discomfort and reduced risks compared to traditional surgical techniques. Some common IR procedures include angioplasty, embolization, biopsy, and stent placement, among others. Overall, IR is an innovative and effective approach to medical care that offers numerous benefits to patients. As this specialty expands, there is a huge demand for increasing staff. However, due to a lack of awareness, this increased demand could not be fulfilled. Objective The objective is to assess medical students' knowledge regarding IR and compare this knowledge between male and female students. Materials and methods This cross-sectional study was carried out at Northern Border University's College of Medicine in Arar, Saudi Arabia. The study aimed to assess the medical students' knowledge of IR. All students enrolled in the clinical years at Northern Border University were included in the study, and a self-administered online questionnaire was used to collect data. The minimum sample size required was 169. Appropriate statistical analysis was applied to the collected data, and a p-value of less than 0.05 was considered significant. Results One hundred and seventy-two participants in all who met the inclusion criteria answered the study's questionnaire. The fourth-year students represented the highest percentage of the sample, with 65 participants (37.8%), followed by 54 (31.4%) fifth-year students and 53 (30.8%) sixth-year students. The study found that 66 participants (38.4%) rated their knowledge of IR as adequate, while only 8 (4.7%) considered it excellent. The participants' self-rated knowledge of IR did not significantly differ across male and female groups. Conclusion The study's findings suggest that medical students have limited knowledge of IR and that there is no discernible difference in the knowledge and interest of males and females in this subject. Further research and targeted educational interventions may be necessary to improve the medical students' overall knowledge and interest in IR.

One-week radiology boot camp for pre-clerkship medical students: A novel format improving image interpretation and confidence

RATIONALE AND OBJECTIVES

To measure change in radiology knowledge, confidence in radiology skills, and perceptions pertaining to radiology following a one-week boot camp elective for undergraduate medical students.

MATERIALS AND METHODS

A five-day comprehensive radiology boot camp was developed including sessions on image interpretation, procedural skills, and appropriate image ordering. A multiple-choice quiz was administered before and after the elective, utilizing radiology questions from the validated AMSER STARS database. Additionally, a pre- and post-elective survey was administered assessing radiology career interest, confidence in radiology-based skills, and the potential ability of radiology-based skills to increase confidence in specialties other than radiology. Responses from the assessments were analysed using paired t-tests.

RESULTS

15 students enrolled in the course and 14 completed all assessments. The average score on the quiz increased from 50.1% to 66.0% (p<0.001). On the post-elective survey, the average student confidence score increased by more than one point on a six-point Likert scale in each of radiographic interpretation (p=0.004), ultrasound interpretation (p=0.0002), CT/MRI interpretation (p=0.02), general radiology knowledge including procedural skills (p=0.0001), and appropriate image ordering (p=0.004). Average student satisfaction with the elective was 8.1 out of 10.

CONCLUSION

A one-week radiology boot camp for pre-clerkship medical students improved radiology knowledge and confidence in radiology skills, showing potential for this format to meet the demand for increased radiology content in undergraduate training. Students indicated that confidence in radiology knowledge would increase confidence on non-radiology clerkship rotations, highlighting the importance of how a one-week radiology bootcamp can impact both future radiology and non-radiology clerkship experiences.

Radiology program director's perspective on a novel hands-on advanced elective

With the advent of the USMLE Step 1 exam moving to a pass/fail status, Radiology Program Directors (PDs) and Associate Program Directors (APDs) need alternative methods of identifying interested and engaged medical students who are applying to their program. Additionally, undergraduate radiology medical education in the United States varies widely from institution to institution with no universal mandatory radiology component. To address these problems, we implemented an advanced fourth year hands-on radiology elective where the students were treated as first year radiology residents (R1s), giving them resident-level access to the Picture Archive and Communication System (PACS) and dictation software, and allowing them to perform entry-level procedures with appropriate supervision. After implementation of the elective, a 5-question online survey was sent to two hundred and ninety-eight PDs and APDs via the Association of Program Directors in Radiology (APDR) listserv, of which seventy-two responses were compiled, yielding a response rate of 24%. The survey focused on how a hands-on medical student elective would help in assessing prospective candidates and predicting R1 performance. Most respondents felt interest in radiology, motivation, and interpersonal skills would be better assessed after such an elective and the vast majority felt hands-on Advanced Elective would be at least slightly predictive of first year resident performance. Based on this information, we believe implementing a hands-on advanced radiology elective would significantly help address the passive nature of traditional radiology electives, providing valuable information to PDs and APDs and giving the best possible radiology experience to our medical students.

A 5-Year Update on the IR Residency Match: 2022 National Survey Results of Program Directors and Matched Applicants Compared with 2017

PURPOSE

To characterize the experiences of matched applicants (MAs) and program directors (PDs) in the 2022 interventional radiology (IR) residency Match and compare with 2017 data.

METHODS

Surveys were distributed to IR PDs and MAs from the 2022 Match. Findings were compared with those of 2017 using the 2-sample t test and Fisher exact test.

RESULTS

In total, 68 MAs (40%) and 47 PDs (52%) responded. Collected demographic traits were similar, including ongoing male predominance (77% of MAs, 83% of PDs). Moreover, 86% of MAs and 87% of PDs were "satisfied" with Match outcomes. Compared with those in 2017, MAs applied to more IR programs (P < .001). MAs reported more research (P = .003) and abstracts/publications (P < .001) and ranked these as more important than PDs did (P < .001 for both). Approximately 82% of PDs gave special attention to candidates who completed a visiting rotation at their institution; 60% of MAs and 95% of PDs believed virtual interviews resulted in overinterviewing (P < .001); both agreed they provided convenience and accessibility. Furthermore, 63% of MAs believed a Step 1 pass/fail system will be less equitable for applicants. Additional data on demographics, medical school experiences, applications, interviews, intern year, and rank process were reported.

CONCLUSIONS

Satisfaction with Match results remained high from 2017 to 2022, although efforts are needed to improve applicants' ability to navigate the application process, address overapplying, and evaluate concerns regarding the Step 1 pass/fail system. These survey findings will help inform applicants and PDs for future match cycles.

Leveraging the virtual learning environment to enhance medical student engagement with interventional radiology

PURPOSE

To evaluate medical student engagement with Interventional Radiology (IR) before and after a virtual elective course.

METHODS

The elective was nine, one-hour lectures over ten weeks. An anonymous pre and post-course survey was administered to students. The hypothesis was that this course would increase student engagement with IR. Respondents answered nine questions to score their interest in, exposure to, familiarity with, and understanding of IR using a five-point Likert scale. Demographics were reported for the pre-course group only. A Wilcoxon signed-ranked test was performed to assess for significant mean change in pre and post-course responses. Among the 276 registered students, there were 144 individual, complete responses for the pre-course survey, and 60 paired responses for both surveys.

RESULTS

Thirty-seven percent of respondents were first or second year medical students. Thirty percent of participants were enrolled at an institution outside of the United States, 26% are the first in their family to attend college, and 41% identified as female. Thirty-six percent reported this virtual course was one of their earliest experiences with IR. There was a significant increase in student exposure to IR generally, familiarity with IR compared to other specialties, familiarity with the IR training pathway(s), understanding of what an Interventional Radiologist does, understanding of the difference between IR and Diagnostic Radiology, and understanding of when to consult IR for patient care after completion of the course.

CONCLUSION

A virtual IR elective is an effective means to increase exposure to, familiarity with, and understanding of IR.

Subinternship in Diagnostic Radiology: Bringing the Shadowers Out of the Shadows

RATIONALE AND OBJECTIVES

Diagnostic radiology subinternships are uncommon. We started a diagnostic radiology subinternship at our institution in 2020 and present 3 years of data assessing the impact of the course on students' perceptions of and interest in diagnostic radiology.

MATERIALS AND METHODS

The initial course design consisted of daily shadowing shifts, small group lectures with attending radiologists, asynchronous self-paced learning assignments, an ultrasound skills session, multidisciplinary tumor board attendance, and completion of 2 formal case presentations. "Junior resident" shifts, where students dictated studies under attending supervision, an emergency radiology call shift, and an ultrasound procedures shift were subsequently added in response to student feedback. Students were asked to complete surveys before and after completing the course.

RESULTS

Forty-seven fourth-year medical students completed the course over 3 years. The first 2 groups were predominantly male, whereas the third group showed near even gender representation (54% male). 21 (45%) chose to apply to diagnostic radiology for residency. Student reported interest in diagnostic radiology as a career, valuation of diagnostic radiology as a specialty, comfort with imaging interpretation, and perceptions of the availability of patient interaction and procedures in diagnostic radiology all significantly increased after participation in the course. Students ranked the junior resident shifts and small group attending lectures as the most valuable course components.

CONCLUSION

Implementation of a diagnostic radiology subinternship significantly improved students' interest in and perceptions of the field. We encourage the creation of similar courses in other radiology departments and stress the importance of active learning experiences.

Evolution of the Interventional Radiology (IR) Pathway-Various Changes and Interrelation to Diagnostic Radiology (DR)

Interventional radiology continues to evolve into a more robust and clinically dynamic specialty underpinned by significant advancements in training, education, and practice. This article, prepared by members of the 2020-2021 Association of University Radiologists' task force of the Radiology Research Alliance, will review these developments, highlighting the evolution of interventional radiology pathways with attention to growing educational differences, interrelation to diagnostic radiology training, post-training practice patterns, distribution of procedures and future trends, amongst other key features important to those pursuing a career in interventional radiology as well as those in practice.

Perception of Interventional Radiology among Jazan Medical Students: Assessment of Knowledge and Career Intentions

Context Lack of awareness among the students in the medical field is the greatest challenge to overcome in the emergence of contemporary interventional radiology (IR).

Objectives We aimed to conduct a survey among medical students of Jazan University to explore their knowledge about IR, interest in IR as a future career, and preferred methods of training in IR.

Materials and Methods This was a cross-sectional, self-directed questionnaire study. The target population was all medical students at Jazan University. Surveys were sent to 600 students. The questionnaire consisted of 11 closed and open-ended questions.

Statistical Analysis We calculated the size of the sample using the Raosoft Sample Size Calculator Web site. Data analysis was performed using SPSS statistics.

Results A total of 270 students responded (45%); more than half of the respondents (58.5%) were in the preclinical stage, while the rest were in the clinical stage. About 62.5% of clinical students and 66.4% preclinical students reported that their perception regarding the terminology of IR was good or excellent. Regarding the identification of interventional radiologists, 50.9% from the clinical students thought them to be radiologists and 50% from preclinical students also identified them as such.

About 29.5% from the clinical students and 27.8% from the preclinical students thought them special surgeons, and 31.3% clinical students compared with 30.4% preclinical students believed they are vascular surgeons working with X-rays. About 19.6% clinical students compared with 17.7% preclinical students said they are general surgeons working with X-rays, and 48.2% clinical students compared with 45.6% preclinical students said they are special radiologists who work with percutaneous techniques. There was a significant difference (p = 0.041) in the responses between preclinical and clinical students regarding knowledge about what this medical specialty does. About 60.8% of clinical students reported that their knowledge and information regarding IR are efficient in comparison to 39.2% of preclinical students.

Conclusion This study demonstrated that the basic knowledge among Jazan medical students is poor. About half of the respondents were clinical students who understood the radiology specialty, compared with one-third of preclinical students. This could impact the student’s decision toward IR as a future career.

Medical Student Education During the COVID-19 Pandemic: Initial Experiences Implementing a Virtual Interventional Radiology Elective Course

Rationale and objectives

In response to the COVID-19 pandemic reducing medical student presence on clinical services and in classrooms, academic institutions are utilizing a virtual format to continue medical student education. We describe a successful initial experience implementing a virtual elective in interventional radiology (IR) and provide the course framework, student feedback, and potential improvements.

Materials and methods

A 2-week virtual IR elective curriculum was created utilizing a combination of synchronous and asynchronous learning and the “flipped” classroom educational model. Students virtually participated in daily IR resident education conferences, resident-led case review sessions, and dedicated lectures. Asynchronous prelearning material consisted of text and video correlating to lecture topics. Anonymous precourse and postcourse surveys were sent to all participating students (n = 10).

Results

Ten students (100%) completed precourse and seven (70%) completed postcourse surveys. Enrolled students were considering residencies in surgery (50%), internal medicine (40%), interventional radiology (30%), and/or diagnostic radiology (30%). Students’ understanding of what IRs do and the procedures they perform (p < 0.001), when to consult IR for assistance in patient management (p = 0.005), and the number of IR procedures students could recall (p = 0.015) improved after the course. Case-review sessions and virtual lectures ranked as having the highest education value. Students recommended additional small-group case workshops.

Conclusion

This successful virtual IR elective provides a framework for others to continue IR medical student education during the pandemic and grow the specialty's presence within an increasingly virtual medical school curriculum. The described model may be modified to improve IR education beyond the COVID-19 era.

Implementation of a Novel Hands-on Advanced Radiology Elective

Despite the use of imaging in many medical and surgical practices, no universal mandatory radiology component is required by the Liaison Committee on Medical Education. In contrast, United States medical students are required to complete at least one core subinternship during their final year of medical school in medicine, surgery, pediatrics, or family medicine, regardless of their chosen field of interest. Students are expected to perform just below the level of an intern, performing functions such as assisting in writing notes, placing orders, and arranging for appropriate follow-up. To our knowledge, there are few institutions that offer a comparable clinical experience in radiology. In order to address this, we successfully designed and implemented a hands-on medical student advanced radiology elective, which allowed for experiential learning through independent dictation of radiographic examinations and procedure-based practice. Here, we describe the process of developing such an elective, how to implement it at other institutions, and some insight into troubleshooting any potential pitfalls should they arise. Overall, our novel hands-on elective enables a more student-centered, active learning approach, allowing for more in-depth, accurate evaluation of specialty choice while also equipping faculty and residency programs with the skills to best assess student interest, motivation, knowledge, and communication skills.

Trends in interventional radiology: Survey of medical students at an educational symposium

Objective:

Symposiums are great avenues to expose students to interventional radiology (IR) and gauge their interest in the field. This study compares student interest and knowledge of the specialty before and after a state- wide IR symposium.

Materials and Methods:

A state-wide IR symposium consisted of lecture didactics and interactive hands-on IR simulations. Pre-symposium and post-symposium survey assessments were provided to each attendee to complete. The surveys remained anonymous and were performed for quality assurance purposes. The survey included questions on knowledge of IR, interest in IR, application strategies for the IR match, and career options in IR.

Results:

A total of 101 medical students registered for the symposium. Thirty-nine completed the pre-symposium survey and 40 completed the post-symposium survey. About 71.1% of the respondents reported “Little Knowledge” of IR before the symposium, which decreased to 40.5% after the symposium. Furthermore, 21% of the respondents believed that they had a “Good Foundation” in IR before the symposium and 59.5% after the symposium (P < 0.0001). The percentage of students planning to pursue IR increased from 35.9% to 45.9% (P = 0.160) after the symposium. About 77.8% reported that having an IR clinic is important in their career in the post-symposium survey compared to 64.1% in the pre-symposium survey (P = 0.077).

Conclusions:

Symposiums are an effective method in exposing medical students to IR. Students have expressed both strong interest in the field and increased knowledge post-symposium. Prospective applicants have reported dual applying to the integrated IR and diagnostic radiology (DR) residencies due to their concern about the competitive nature of integrated IR due to small number of positions available.

Awareness and knowledge of interventional radiology among medical students at an Indian institution

Purpose

Interventional radiology (IR) is a novel and evolving sub-specialty that encompasses image guided diagnostic and therapeutic procedures. With the advent of new imaging techniques and an increasing demand of minimally invasive procedures, IR continues to grow as a core component in medical and surgical therapeutics. Radiology teaching is a part of medical undergraduate curriculum; however, the medical undergraduate cohort lacks exposure to IR principles, methods and techniques. The purpose of this study is to determine the knowledge and awareness of IR among medical students in a single university in India.

Materials and methods

Electronic anonymous surveys were sent to 350 medical students of Pt. JNM Medical College, Raipur, India. Each survey comprised of questions assessing knowledge and exposure to IR. A total of 70 students (20%) responded.

Results

85.7% of respondents positively reported that radiologists have a role in diagnostic as well as therapeutic interventions, however, 60% of students cited a very poor/poor knowledge of IR. A larger part, 91.5%, stated that they would be interested in IR based teaching delivered as a part of their undergraduate teaching program. Those who knew at least one interventional radiology technique were 1.51 (95% CI: 1.02–2.22; p < 0.05) times more likely to be considering it as a career.

Conclusion

Medical Students demonstrate a poor knowledge of IR. This corresponds to a limited and inconsistent exposure to IR in medical schools. The study suggests that there is a need to deliver an IR based curriculum in medical undergraduate teaching in India. Our proposition includes introducing a regulated IR teaching in undergraduate medical education using new module designs and presenting medical students an opportunity to attend IR education days, symposiums and conferences to incite early participation.