Instructional technology and radiologic education

MRI physics and technical issues: Where do Italian radiographers search for information?

INTRODUCTION

Our aim was to investigate the means radiographers and radiographers in training (RTrs) use to seek information on magnetic resonance imaging (MRI) physics and technical issues.

METHODS

An estimated 3000 radiographers and RTrs were reached by e-mail. We proposed an online survey with eight English-language multiple choice questions investigating how often radiographers have doubts about MRI physics or technical issues, where and what kind of information they search for, and on which websites. The statistical χ² test was used.

RESULTS

We obtained 300 answers from European professionals (228 radiographers, 72 RTrs) from 9 European countries, with 288 of 300 (96%) responses coming from Italy. Within the Italian respondents, 41% of RTrs have doubts about MRI physics versus 56% of radiographers (p = 0.028). Basic MRI sequences details are more searched by RTrs (36%) than radiographers (22%) (p = 0.088), as well as clinical protocols (64% versus 44%, p = 0.054). Radiographers and RTrs mostly search on the Internet (74% versus 81%, p = 0.404); "older colleagues" are more frequently asked for information by RTrs (27% versus 61%, p = 0.001), they consult the "MRI manufacturer" less frequently (11% versus 34%, p = 0.001); and 66% of radiographers and 72% of RTrs search "in mother-language and English" (p = 0.590). For clinical protocols RTrs prefer the website mriquestions.com (17% versus 44%, p = 0.001). Websites most used were: mriquestions.com (41%), radiopaedia.org (31%), and mrimaster.com (13%). In addition, 30 respondents mentioned using the Italian site fermononrespiri.com.

CONCLUSION

Italian radiographers and RTrs frequently search for information about MRI physics and technical issues, with slight differences between groups regarding sources and clinical protocols. Protocol setting, and MRI physics and sequences seem to be the main limitations of RTr knowledge. To remedy this gap, more time on training/university lectures and a rethinking of the practical training activities is required.

Harnessing Technology: Using an iPad to Enhance Radiology Medical Student Education

RATIONALE AND OBJECTIVES

Our goal was to determine whether use of the iPad would increase the students' radiologic knowledge, aid in their interpretation of imaging exams, and increase learner satisfaction.

MATERIAL AND METHODS

iPads were pre-populated with ten image data sets, which included plain film, ultrasound, and CT of the head, chest, abdomen, and pelvis. The students, working in small groups, were charged with identifying the salient imaging findings, formulating a differential diagnosis, and choosing the most appropriate imaging modality, if further work-up was necessary. After the student group problem-solved for an hour, a faculty facilitator joined the group and reviewed the cases with them in an interactive fashion. Pre- and post- intervention tests were administered, and statistical analysis was performed.

RESULTS

Student satisfaction surveys were administered to 125 students in the first 2 years of the study. These scores rated their assessment of the iPad exercise and ranged from 4.6 to 4.9 out of 5. The knowledge evaluation group included 219 students, 110 in the study group and 109 in the control group, in the latter 3 years of the study. The average improvement from the initial to the second test was 1.04 points among the control group and 2.32 among the study group, which was statistically significant (p = 0.0001).

CONCLUSION

We demonstrate increased learner satisfaction, as well as improved knowledge acquisition and interpretive skills of third year medical students engaged in hands-on learning using iPads.

Pedagogical Approaches to Diagnostic Imaging Education: A Narrative Review of the Literature

OBJECTIVE

The purpose of this study was to examine literature on how radiology is taught and learned by both radiology residents and undergraduates in the health professions.

METHODS

A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references.

RESULTS

Of the 4716 unique abstracts reviewed by the author, 91 were found to be relevant to the purpose of this study. The literature retrieved reported pedagogical approaches to teaching radiology including the following: problem solving, technology as teacher, independent learning tools, visiting lectureships, case based teaching, and conferences. There was some exploration of the relative effectiveness of educational formats. Suggestions for future research identify 7 areas of relative consistency.

CONCLUSION

Radiology is a clinical skill that requires integration science, clinical information, clinical experiences, and information recorded on diagnostic imaging studies. The research in this area focuses on problem solving, the use of algorithm/scripts, introducing uncertainty in clinical scenarios, incorporating technology in learning environments, active learning techniques, and methods of independent learning. Although the literature in this area is still in its infancy, the research examining the relative effectiveness of these various educational formats is often contradictory, suggesting that this is a complex area of study with numerous factors influencing student learning.

Educational technology in medical education

This article aims to review the past practices of educational technology and envision future directions for medical education. The discussion starts with a historical review of definitions and perspectives of educational technology, in which the authors propose that educators adopt a broader process-oriented understanding of educational technology. Future directions of e-learning, simulation, and health information technology are discussed based on a systems view of the technological process. As new technologies continue to arise, this process-oriented understanding and outcome-based expectations of educational technology should be embraced. With this view, educational technology should be valued in terms of how well the technological process informs and facilitates learning, and the acquisition and maintenance of clinical expertise.

Radiology education in 2005: world wide web practice patterns, perceptions, and preferences of radiologists

Internet use has increased greatly in the past decade across all demographic sectors in the United States, and the World Wide Web currently serves as a valuable informational resource for physicians. A study was conducted in 2005 to evaluate the role of the Web in radiology education. A 28-question multiple-choice survey was administered during two institutionally run continuing medical education (CME) conferences. Questions addressed perceptions and use of the Web, as well as preferred resources for radiologic information and radiology education. Surveys were submitted by 92 radiologists, 97% of whom use the Web for radiology education. The reliability of information on the Web was deemed equal to that of information from traditional sources by 69% of respondents. Forty-five percent use the Web for CME; however, an institutionally run course was selected most frequently as the preferred method of CME, as well as the most effective and efficient. The search engine used by the largest number of participants to identify radiologic information is Google. For reading journal articles, 67% of respondents prefer hard copy. Monthly review of publications made available online before the print version is performed by only 26%. The results of the survey indicate that, despite an increase in Internet use and the perception that Web-based information is reliable, most practicing radiologists still prefer traditional educational resources for radiologic information and radiology education.

Radiology teaching: essentials of a quality teaching programme

Medical student teaching is an important component of radiology education. Despite the practice of radiology undergoing significant changes during the last two or three decades, the importance of radiology has not translated fully into medical school curricula in Australia and New Zealand. This article reviews the essential components of a quality medical student teaching programme.

Singapore National Medical Image Resource Centre (SN.MIRC): A World Wide Web Resource for Radiology Education

Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education. Key words: CME, Image repository, MIRC, PACS, Radiological teaching file

www.tnt-radiology.de: Teach and be taught radiology: implementation of a web-based training program based on user preferences as determined by survery

RATIONALE AND OBJECTIVES

To create a Web-based training program addressing the needs of a large, heterogeneous audience of users.

MATERIALS AND METHODS

We defined our target group as consisting of medical professionals who teach radiology, or who, by their own perception, would benefit from improving their radiologic image interpretation skills. We interviewed 483 members of this group, eliciting their preferences with regard to layout, interactivity, contents, and other categories (11 in total). Considering majority preferences as recommendations and using the help of a special interest group of medical students, we assembled 500 teaching cases over a 1-year period into an interactive training program and made it available on the World Wide Web.

RESULTS

Important preferences expressed by majorities of interviewees were: high levels of interactivity, clear layout, intuitive usability, short page load times, permissibility of saving content locally, cost-free access, consideration of user input in the site development. To our knowledge, our web program TNT-Radiology, accessible at , is the first to implement all of these recommendations simultaneously.

CONCLUSIONS

We have created a Web-based program usable for teaching and learning radiologic image interpretation that meets the needs of a heterogeneous target audience to an unprecedented extent.

Financing Radiology Graduate Medical Education: Today’s Challenges

Radiology graduate medical education (GME) is exposed to huge financial challenges. First, there is a continuous increase in demand for imaging services by referring doctors and the general population, aggravating the staff shortage. Second, there has been an important decline in reimbursements. Third and probably most important is the progressive reduction of federal funds subsidizing GME. Medicare is the largest single contributor to GME. The Balanced Budget Act (BBA) of 1997 introduced reductions in Medicare payments to the major teaching hospitals calculated at $5.6 billion over the first 5 years after implementation. The BBA also brought other changes directly affecting GME. Financial changes in health care over the past decade have increased the pressure on academic institutions, which must preserve or improve the quality of training and the quality of care and manage an increased workload with fewer funds available and a narrow margin for errors. Yet the use of new technology promises to help simplify processes, decreasing workloads for residents and faculty members and increasing overall productivity, and new sources of funding have been suggested. By reviewing the financial challenges of radiologic training in today's academic centers, the authors reach the conclusion that there is still space for improving academic quality and the quality of care within current financial boundaries. But more reliable data about the specific benefits and drawbacks of having a residency program in a clinical radiology department are required.

[HNORAD]

BACKGROUND

New media are gaining importance in undergraduate as well as postgraduate and continued medical education. We aimed to create an interactive educational program for imaging diseases of the ear, nose and throat (ENT).

MATERIALS AND METHODS

Cases and images representing clinical routine were collected, arranged by content and graphically presented according to instructional criteria. Undergraduate students participating in the project used an authoring system to generate case studies, which were then published at http://www.HNORAD.de.

RESULTS

HNORAD is an interdisciplinary teaching program offering more than 100 classical disease presentations. Three systematic indices offer a choice of instructional approach. Apart from typical images, the information presented includes patient history, clinical findings, imaging findings as described by a board-qualified radiologist, diagnosis, differential diagnosis and internet links. Elements of the radiologist's report are linked with the images in such a way that the structure or finding described can be interactively highlighted. An evaluation index allows proficiency testing in self study and as a part of taught courses.

CONCLUSION

HNORAD is a valuable resource for students, ENT surgeons and radiologists at the undergraduate, postgraduate and CME level for self study as well as for course work.

[How to cope with the demands of the new "Approbation Regulation" (AR) by radiology-related interdisciplinary courses. The Erlangen model]

BACKGROUND

To create radiology-related interdisciplinary programs for the undergraduate education in terms of the new "Approbation Regulation".

MATERIAL AND METHODS

Medical students developed in collaboration with radiologists and clinical partners virtual, radiology-related interdisciplinary training courses for different fields. Students and teachers evaluated the acceptance of the programs' structure and content as well as the possibility to replace the radiologist partly during interdisciplinary lessons.

RESULTS

Six target group oriented virtual, radiology-related interdisciplinary training courses were developed which will relieve the implementation of the new AR's demands for more interdisciplinary education in small groups and the dreaded shortage of personnel.

CONCLUSION

By the use of web- and CDRom-based interdisciplinary course models different fields of medicine and diagnostic radiology can be bridged in the sense of the new AR's demands as well as manpower in radiology can be saved.

Emerging strategic themes for guiding change in academic radiology departments

Academic radiologists are faced with increasing demands on their time and energy, particularly in the clinical arena, where larger examination volumes and higher service expectations are the norm for most medical centers. These demands are intensified by the continuing shortage of academic radiologists. If academic radiology departments continue to devote most of their resources to the clinical mission at the expense of research and educational missions, then there are potentially serious adverse consequences for long-term viability of the profession of radiology. This dilemma represents a critical strategic problem, not just for academic radiology but also for the entire profession of radiology. In this article, the success and growth of academic radiology during the 20th century are framed as the result of the dogged pursuit of certain key strategic themes. With the concept of paradigm shift, introduced by Kuhn, several new strategic themes are identified that are just emerging from changes in work practices, organizational structure, and mind-sets in radiology departments at academic medical centers. One benefit of this approach is that it facilitates the ability of radiologists to articulate and focus on those strategic themes that will help academic radiology departments to adapt more rapidly and successfully to environmental changes during the 21st century.

The scope of educational resources for radiologists on the internet

The quantity of radiological educational resources available via the internet is enormous and is constantly increasing. The quality is variable, and much time can be wasted trying to find what is required. Web-based learning is highly attractive as it is widely available, cheap, accessible at any time and frequently updated (in contrast to conventional study materials). We present an introduction to the scope and diversity of educational websites in radiology. Effective evaluation of web-based material is essential to maximize the benefit to the user: a suitable method of evaluating radiological educational websites is described.

ELERA: a WWW application for evaluating and developing radiologic skills and knowledge

RATIONALE AND OBJECTIVES

To provide an online facility for evaluating, comparing, and building expertise in radiologic anatomy and clinical radiology.

MATERIALS AND METHODS

Project participants were recruited from an experienced special interest group of students at the local medical school. A rigid protocol was agreed upon, defining and assigning the tasks of case selection, data entry, test task creation, and peer review. The presentation of test tasks and evaluation of user input was implemented as a custom web application.

RESULTS

ELERA, an online assessment and learning resource based on 1,650 pathologic cases and 550 anatomy cases, was created and made publicly accessible as a world wide web application.

CONCLUSION

The project design facilitated the creation of a free, highly accessible and user-friendly resource that offers capabilities for individual longitudinal and intersubject comparative assessment.

Patient-specific region-of-interest fluoroscopy device for X-ray dose reduction

A region-of-interest (ROI) fluoroscopy device that provides an automatically generated ROI filter with an arbitrary shape, as well as digitally compensated images, was built and evaluated. ROI filters were generated by using a deformable attenuation material. Images were compensated by using a compensation ratio and a running average interpolation method. Image compensation parameters were predicted on the basis of the x-ray tube potential used. The image quality with and without an ROI filter was evaluated. This ROI fluoroscopic technique was shown to substantially reduce patient and operator radiation exposure without degrading image quality within the ROI.