Impact of COVID-19 pandemic on radiology education, training, and practice: A narrative review

Comparative analysis of traditional and integrated approaches to radiology training for residents

BACKGROUND

The study aims to conduct a comparative analysis of traditional and integrated approaches to radiology teaching in order to evaluate the effectiveness of novel educational methods.

METHODS

The study was conducted in Shenzhen, China, between January and December 2023. It involved 100 radiology residents who were randomly assigned to either a traditional training (TT) group or an integrated training (IT) group. The average age of participants was 28 years.

RESULTS

The TT group received conventional lectures and practical training, while the IT group used simulation software, interactive platforms, and artificial intelligence (AI) tools. The analysis revealed that the mean score of the IT group in the theoretical knowledge test was 170.3 ± 15.1, which is significantly higher than that of the TT group (155.7 ± 20.4; t = 4.21, p < 0.001). In the practical skills test, the IT group scored 160.7 ± 22.4, while the TT group scored 135.8 ± 25.6 (t = 5.13, p < 0.001).

CONCLUSIONS

The findings of the study indicate a significant advantage of an integrated approach to radiology teaching over conventional methods. The integration of modern technologies into the learning process has been shown to enhance both short- and long-term educational outcomes in medical education. This finding is of practical significance for educational institutions in this field. It is recommended that integrated teaching methods be introduced in order to improve the quality of specialist training.

CLINICAL TRIAL NUMBER

Not applicable.

The extended impact of the COVID-19 pandemic on medical imaging case volumes: a retrospective study

OBJECTIVE

This study aims to investigate the long-term effects of the COVID-19 pandemic on medical imaging case volumes.

METHODS

This retrospective study analyzed data from the Integrated Radiology Information System-Picture Archive and Communication System (RIS-PACS), including monthly medical imaging case volumes at a public hospital, spanning from January 2019 to December 2022. The study collected data on medical imaging examinations, comparing the pre COVID-19 period, which acted as a control group, with the periods following COVID-19, which were designated as cohort groups.

RESULTS

The total number of medical imaging procedures performed (n = 597,645) was found significantly different (F = 6.69, P < 0.001) between 2019 and 2022. Specifically, the bone mineral density/computed radiography (BMD/CR) modality experienced a significant decrease (P = 0.01) of the procedures performed in 2020 and 2021 compared to 2019. Conversely, the nuclear medicine/computed tomography (NM/CT) and computed tomography (CT) modalities demonstrated a significant increase of the procedures performed in 2021 (P = 0.04) and (P < 0.0001), respectively, and in 2022 (P = 0.0095) and (P < 0.0001), respectively, compared to the pre-pandemic year. The digital X-ray modality (DX) showed the highest volume (67.63%) of the performed procedures overall between 2019 and 2022. Meanwhile, magnetic resonance imaging (MR) and ultrasound (US) modalities experienced a slight drop in the number of procedures in 2020-4.47% for MR and 1.00% for US, which subsequently recovered by 22.15% and 19.74% in 2021, and 24.36% and 17.40% in 2022, respectively, compared to 2019.

CONCLUSION

The COVID-19 pandemic initially led to a drop in the number of medical imaging procedures performed in 2020, with the most noticeable drop occurring during the early waves of the pandemic. However, this trend revealed a gradual recovery in the subsequent years, 2021 and 2022, as healthcare systems adapted, and pandemic-related restrictions were modified.

Barriers affecting the quality and consistency of barium studies in radiologists and registrars

The barium swallow study is a fluoroscopic study which provides valuable insights into the motility, function and morphology of the pharynx, oesophagus, gastroesophageal junction, proximal stomach and duodenum. It has been observed that the skill of radiology doctors with barium swallow studies in adults has diminished. This reduced proficiency with barium swallow study is closely linked to and perpetuated by the heterogeneity of technique amongst radiologists. Factors pertaining to the individual radiologist, patient factors, healthcare factors, and the widespread use of alternative investigations have led to this increased variance in performing the barium swallow study. Despite this reduction in its usage, the study remains a valuable tool in the care of patients. We advocate for standardised guidelines to increase consistency and improve radiologist familiarity with this procedure.

Impact of an automated report comparison tool on trainee report modification rate at a tertiary hospital

AIM

This study aims to compare trainee-modified report percentage rate and trainee/consultant satisfaction regarding the feedback process before and after implementation of an automated report comparison tool.

MATERIALS AND METHODS

An automated report comparison tool utilising natural language processing, presenting the trainee's preliminary report beside the final consultant report with changes highlighted, was used in a prospective interventional study. Modification rates, including character counts, of co-authored computed tomography (CT) studies were recorded before and after tool implementation over two 6-month periods and compared with Student's t-test. Trainees and consultants were surveyed before and after the interventional period for time spent and feedback satisfaction.

RESULTS

In total, 3851 (81.7%) of 4175 reports were modified in the baseline preimplementation phase, and 5215 (69.6%) of 7489 reports were modified during the postimplementation phase (p < .001). The average character count change preimplementation was 132, corresponding to 9.0% of the original preliminary report, compared with 91 characters and 7.1% postimplementation, respectively (p < .001). This statistically significant difference generally applied regardless of the level of trainee experience. Prospective data collected in the preimplementation period revealed that for more than two-thirds of after-hours shifts, trainees spent fewer than 5 minutes receiving feedback on their after-hours work. At the conclusion of the implementation phase, 92.3% of trainees and 70% of consultants agreed that the report comparison tool improved feedback.

CONCLUSION

Following the implementation of an automated report comparison tool, there was a reduction in trainee report modification rates and subjectively improved trainee feedback. This adjunct to existing feedback mechanisms presents a relatively simple intervention to facilitate efficient case review and feedback.

Transformations in postgraduate medical education following the COVID-19 pandemic: lessons learned from advances and challenges

The COVID-19 pandemic has profoundly reshaped postgraduate medical education, driving immediate and significant adaptations in teaching methodologies and educational frameworks. This review examines the multifaceted transformations within medical education environments, particularly in response to the pandemic. Through a structured narrative review of recent literature, we identify key lessons learned and the subsequent shifts in educational practices. Our analysis underscores the critical importance of flexibility in educational delivery, the integration of technology, and the emphasis on mental health and resilience among medical trainees. We also explore the challenges and successes associated with maintaining equality and diversity in a rapidly evolving educational landscape. The findings highlight the necessity for continuous professional development and robust support systems to navigate future challenges effectively. Recommendations are provided for educational institutions to enhance adaptability, foster inclusive learning environments, and prepare for unforeseen global health emergencies. This study aims to contribute to the ongoing discourse on optimizing postgraduate medical education to better prepare health professionals for a dynamic and uncertain future.

Potential Impact of COVID-19 on Medical Career Aspirations of Prospective Students

This article describes the evolving landscape of medical education in the wake of the COVID-19 pandemic, emphasizing the renewed importance of public health, mental well-being, and career choices among medical students. The pandemic has prompted a significant shift in medical student's career aspirations, highlighting the need for mental health support mechanisms within the medical education framework. Medical students' career choices are influenced directly and indirectly by the challenges and experiences of the pandemic era, which are discussed in this article under four key themes: traditional values, global health interests and disparities, developing trends, and digital healthcare. There is an urgent need to adjust medical training to the new reality and share the future directions of the medical education landscape by embracing diverse career paths in medicine, integrating technology into medical training, adapting to the changing context of medicine, and strengthening collaboration and communication. The pandemic underscores the importance of evidence-based patient care, necessitating the preparation of tomorrow's doctors to address the emerging healthcare challenges with resilience, adaptability, and a comprehensive understanding of both local and global health challenges.

Case competition sessions: a global education and academic engagement tool

BACKGROUND

Radiology virtual teaching sessions utilize live video conferencing to promote collaborative learning and engagement by discussing radiology cases. Because of its convenience and flexibility, this mode of education has gained popularity, particularly after the corona virus disease 2019 pandemic.

OBJECTIVE

We describe our experience in organizing a series of "Global Health Imaging Case Competitions" for trainees in low- and middle-income countries (LMICs). These competitions provide the trainees with an opportunity to present unique radiology cases, network with radiologists, learn about various radiology topics, win prizes and potentially publish their case reports in a peer-reviewed journal.

MATERIALS AND METHODS

Planning and execution of the competition involves several steps. First, trainees are invited to participate and submit abstracts discussing unique cases. The organizing committee grades these abstracts; the authors of the 20 abstracts with the highest scores are asked to submit a video presentation of their cases to be presented during the live webinar. During this webinar, presentations are displayed and graded to select winners. Additionally, the audience votes to choose a participant as the people's favorite. We have completed four cycles (Africa, Latin America and the Caribbean, Africa and the Middle East and Asia) and will continue in the same order of rotation.

RESULTS

Attendance totalled 2,510 participants from 50 countries. Pediatric cases represented the majority of cases among finalists. Feedback was positive; 26 out of 29  (90%) participants surveyed indicated that the webinar was "very good" to "excellent" with well-organized and challenging cases. Diversity of participating countries was noted. Limitations included technology barriers such as internet connectivity.

CONCLUSION

This innovative approach emphasizing audience participation engaged trainees from LMICs and fostered locoregional collegiality and mentoring.

Opinions on Remote and in-Person Breast Imaging Work: Survey Results from the Society of Breast Imaging

OBJECTIVE

The coronavirus disease 2019 pandemic accelerated trends in remote radiology work. We evaluated the opinions of Society of Breast Imaging (SBI) members regarding remote and in-person breast imaging work.

METHODS

An institutional review board-exempt anonymous survey was distributed to SBI members. Survey questions included demographics and opinions on remote and in-person work.

RESULTS

The response rate was 12% (307/2561). Overall, 79% of respondents preferred hybrid work, 16% preferred in-person work, and 5% preferred fully remote work. Only 34% of respondents had remote work in current practice. Screening mammograms (97%) and breast MRI (92%) were deemed most suitable for remote work. Most respondents believed barriers for remote work were inability to perform US (80%) and high monitor price (78%). Seventy-six percent of respondents believed remote work improves work-life balance and reduces burnout. Work model preferences were significantly associated with gender (P = .048) and perceived work-related impacts (P <.001). Women were more likely to prefer hybrid work than men (82% vs 73%). Compared to those who preferred in-person work, respondents who preferred hybrid work were more likely to believe remote work improves efficiency (89% vs 3%) and reduces burnout (88% vs 6%) while not negatively affecting career growth (88% vs 3%) or communication (87% vs 4%).

CONCLUSION

Hybrid work is the preferred model among SBI survey respondents. However, a minority have the option for remote work in current practice. Perceived benefits of remote work are efficiency and reduced burnout among breast imaging radiologists while not negatively affecting career growth or communication.

Survey on digital dependency, writing by hand, and group learning as learning styles among Japanese medical students: Assessing correlations between various accomplishments

BACKGROUND

Although digital learning devices have become increasingly more common in medical education settings, it remains unclear how they influence medical student learning styles and various outcome measures. This study aimed to assess student learning styles, specifically as they relate to digital dependency, writing habits, and group learning practices among current medical students.

MATERIALS AND METHODS

This questionnaire study was approved by the Research Ethics Committee of Osaka Medical and Pharmaceutical University. We conducted a questionnaire survey of 109 medical students who were 5th year students during the 2021 school year. Medical students were asked about their level of digital dependency, writing by hand, and group learning practices. We also analyzed the correlation between student learning styles and their respective outcomes on several summative evaluations.

RESULTS

Of the 109 students targeted, we received responses from 62 (response rate, 56.8%). Among the respondents, digital dependency was 83.4 ± 18.6%, while hand writing ratio 39.8 ± 29.9% and group learning ratio 33.5 ± 30.5%. We also assessed correlations between these learning styles and scores on the CBT, OSCE, CC, and CC Integrative Test. Only writing by hand showed a small positive correlation with CC Integrative Test scores.

CONCLUSION

Our questionnaire survey assessed the rates of digital dependency, writing by hand, and group learning practices, and analyzed the correlations between these learning styles and respective outcomes. Current medical students exhibited high digital dependency which was not correlated with performance outcomes.

How Can We Sustain the Training Quality of Radiologic Technology Students During COVID-19 Outbreaks: A Lesson from Vietnam

Radiologic technology training required a substantial amount of practice. The traditional teaching approach includes in-hospital placement along with theory classes. During the COVID-19 outbreaks, clinical rotations become impossible. Direct contact with patients raises safety concerns for staff and students. The COVID-19 pandemic created unprecedented challenges for medical universities worldwide. We developed in-house simulation software that can be used for training in radiologic technology. Our preliminary results yielded good efficacy of this novel teaching approach in training radiologic technology students.

Online Clinical Briefing for Radiologic Technology Students in Covid-19 Pandemic Outbreak: Efficiency, Application, and Feedback of Students

OBJECTIVE

To evaluate students' satisfaction and efficacy of online clinical briefing for radiologic technology students. The study aimed to evaluate the efficiency, the possibility of application, and students' feedback with the new form of clinical briefing during the COVID-19 pandemic outbreak.

METHODS

A cross-sectional survey was conducted on 120 full-time radiologic technology students after participating in online clinical briefing sessions at the Department of Radiology, Hue University of Medicine and Pharmacy Hospital. This training approach was implemented for students from April to July 2021. During the briefing, participants were asked to discuss on cases that were prepared by the previous on-duty nightshift students with the consultant of the senior staff. The discussion focused on the technical aspects, challenges, and clinical implementation of each technique. Descriptive statistics were used to analyze the responses of students using the Likert scale (1. Complete disagree, 2. Disagree, 3. Satisfy, 4. Partial agree, 5. Complete agree).

RESULTS

Our findings show that 76.5% of students were very satisfied and/or satisfied with the online clinical briefing. In particular, the mean score for satisfaction with teaching resources and platforms, and assessment tools were 4.21; less fear in giving feedback than on-site briefings were 3.57; satisfaction with faculty accessibility and availability in giving feedback as well as answering questions for students was 4.29; satisfaction with student's performance and final grade was 3.55. 94.2% of students were willing to continue studying online during the COVID-19 breakout or similar circumstances.

CONCLUSION

Online clinical briefing is an appropriate teaching approach during a prolonged COVID-19 breakout. However, it cannot completely replace traditional teaching methods in providing essential clinical skills for radiologic technology students due to the unique characteristics of medicine and medical imaging teaching which require a substantial amount of clinical practice.

A Bibliometric Analysis of COVID-19 Scientific Literature From the English-Speaking Caribbean

The COVID-19 pandemic has led to a global crisis and has affected the Caribbean islands, leading to significant health and socioeconomic consequences in this region. Efforts to mitigate the burden of this disease have led to an accelerated amount of research in the English-speaking Caribbean (ESC). This bibliometric analysis aimed to evaluate the COVID-19-related scientific literature from the ESC nations. A total of 175 articles were included and analyzed from an initial PubMed search (n = 638) for COVID-19-related scientific literature from the ESC nations published between January 1, 2020, and June 30, 2022. Microsoft Excel 2016 (Microsoft Corporation, Redmond, Washington) and the VOSviewer (version 1.6.18) were used to characterize countries, authorship, journals, affiliations, and keywords of the COVID-19-related articles. Trinidad and Tobago (38%), Jamaica (22%), Barbados (20%), and Grenada (15%) contributed to the greatest number of publications. The University of the West Indies (UWI) campuses in Trinidad and Tobago, Jamaica and Barbados, and St. George's University in Grenada were the most prolific institutions. Srikanth Umakanthan from the UWI was the most prolific author. Cureus, SN Comprehensive Clinical Medicine, and Frontiers in Public Health were the first three most productive journals; 59% of the 175 articles had either the first or last author affiliated with an institution in the ESC, and 19% of the articles were country-focused: Trinidad and Tobago (16/175), Jamaica (9/175), Barbados (5/175), and Antigua and Barbuda (2/175). Among the top themes of research, 27% were outbreak response and rearrangements, epidemiological studies (23%), clinical management (23%), and medical education (13%). Over the last two years, an interest stimulated by the pandemic has expanded the research in ESC countries. However, gaps in the knowledge exist, especially in the epidemiology of COVID-19 complications in the sub-populations of chronic non-communicable diseases, post-COVID syndrome, and the long-COVID syndrome in the region. Hence, there is enormous scope for more research across the region.

Students' perspective of the teaching-learning process of oral radiology before and during the COVID-19 pandemic

The SARS-Cov-2 (COVID-19) pandemic changed the educational structure of dentistry courses and highlighted the importance of online tools. Understanding students' perception regarding these changes is essential to establishing future teaching-learning strategies to accommodate students' needs in higher education. The aim of this study was to assess students' perceptions of the Oral Radiology teachinglearning process before and during the COVID-19 pandemic. The sample consisted of students (n = 111) of the 2nd, 4th and 6th semesters of the dentistry course, who answered a questionnaire with 21 items: A) Students' demographic data (5 questions); B) Students' teaching-learning experiences during the pre-pandemic period (8 questions); and C) Students' teaching-learning experiences during the post-pandemic period (8 questions). Stuart-Maxwell tests revealed statistically significant differences between students' opinions before and during the pandemic when they were asked about the structure of the Oral Radiology module (p = 0.008); their previous experience with e-learning and teaching (p < 0.001); their thoughts about the importance of e-learning in Oral Radiology (p < 0.05); and the time they spent online for academic purposes (p < 0.05). Students seem to prefer on-campus activities (before COVID-19), but the pandemic increased their awareness of the importance of e-learning, the time they spent on online studies, and their knowledge of online educational tools.

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.