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Belfi LM, Brook OR, Ho ML, Tan N, Vossen J, Kattapuram T. Leveraging Social Networks for Academic Career Support for Women in Radiology: A Case Study. J Am Coll Radiol 2024; 21:683-687. [PMID: 37820840 DOI: 10.1016/j.jacr.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Lily M Belfi
- Associate Professor of Clinical Radiology, Director of Medical Student Education, Division of Emergency/Musculoskeletal Radiology, Weill Cornell Medicine, New York, New York.
| | - Olga R Brook
- Associate Professor, Harvard Medical School, Section Chief of Abdominal Radiology, Vice Chair of Research, Department of Radiology, Director of Radiology Quality Academy, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Mai-Lan Ho
- Professor of Radiology, Vice Chair of Operations and Innovation, Medical Director of Radiology, Physician Director of Radiology Informatics, Division Director of Neuroradiology, University of Missouri, Columbia, Missouri
| | - Nelly Tan
- Consultant/Associate Professor, Division of Abdominal Radiology, Department of Radiology, Mayo Clinic, Pheonix, Arizona
| | - Josephina Vossen
- Associate Professor of Radiology, Section Chief of Musculoskeletal Imaging and Intervention, Radiology Residency Program Director, Virginia Commonwealth University Health, Richmond, Virginia
| | - Taj Kattapuram
- Radiologist, Norma J. Vinger Center for Breast Care, Gundersen Health System, La Crosse, Wisconsin
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2
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Belfi LM, Averill S, Benefield T, Jordan SG, Slanetz PJ. Understanding the Role of Resilience and Self-Compassion in Radiologist Well-Being. J Am Coll Radiol 2024; 21:528-537. [PMID: 37838188 DOI: 10.1016/j.jacr.2023.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/30/2022] [Accepted: 02/07/2023] [Indexed: 10/16/2023]
Affiliation(s)
- Lily M Belfi
- Director of Medical Student Education, Division of Emergency/Musculoskeletal Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York.
| | - Sarah Averill
- Department of Radiology, Iowa City VA Health Care System, Iowa City, Iowa
| | - Thad Benefield
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Sheryl G Jordan
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Priscilla J Slanetz
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts; is President-Elect of the Association of University Radiologists; and is Subspecialty Chair, ACR Appropriateness Criteria Breast Imaging Panels
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3
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Belfi LM, Slanetz PJ, Cooke EA, Chan S, Frederick-Dyer K, Ataya D, Choe AI, Deitte LA. Creativity, Connection, and Community: Reimagining the Radiology Society Meeting. Acad Radiol 2024; 31:351-359. [PMID: 38401980 DOI: 10.1016/j.acra.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 02/26/2024]
Abstract
RATIONALE AND OBJECTIVES With the shifting needs of radiologists due to escalating healthcare demands, the impetus for an increased focus on wellness and the benefits of the humanities in medicine inspired a novel approach to curricular planning of the 2023 Association of University Radiologists (AUR) annual meeting. In this manuscript, we describe the creative process behind planning and executing this innovative meeting format. MATERIALS AND METHODS Reimagining the annual meeting was a collaborative effort centered around the development of an innovative Arts and Wellness Program, with the goal of integrating opportunities for artistic expression and experiential wellness throughout the meeting. RESULTS Of the 1313 meeting attendees, 423 (32.2%) completed the annual meeting evaluation, of which 244 were in-person and 61 attended virtually. 178 of 423 respondents (42.1%) participated in the arts and wellness programming. 160 of 203 respondents (78.9%) reported that the arts and wellness programming enhanced the overall meeting experience. 164 of 197 respondents (83.2%) gained greater appreciation for the talents of radiology colleagues. 97 of 195 respondents (49.7%) stated that the programming gave them ideas as to how to cope effectively with stress. CONCLUSION The incorporation of art, music, and other wellness activities into a national radiology meeting was well-received by meeting attendees. For many radiologists who participated in the various musical and artistic offerings at the AUR 2023 meeting, sharing artistic talents with the radiology community and colleagues represented the most fundamental way to be fully seen, express authenticity, and connect with others.
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Affiliation(s)
- Lily M Belfi
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, New York, USA (L.M.B.).
| | - Priscilla J Slanetz
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts, USA (P.J.S.)
| | - Erin A Cooke
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA (E.A.C., K.F.D., L.A.D.)
| | - Stephen Chan
- Department of Radiology, Harlem Hospital Center and Columbia University, New York, New York, USA (S.C.)
| | - Katherine Frederick-Dyer
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA (E.A.C., K.F.D., L.A.D.)
| | - Dana Ataya
- Department of Radiology, Moffitt Cancer Center, Tampa, Florida, USA (D.A.)
| | - Angela I Choe
- Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA (A.I.C.)
| | - Lori A Deitte
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA (E.A.C., K.F.D., L.A.D.)
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Averill SL, Gomez EN, Belfi LM, Hui J, Mallak N, Chetlen A. Night and Day, Why Radiologists Need Play. Acad Radiol 2024; 31:360-370. [PMID: 38401981 DOI: 10.1016/j.acra.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 02/26/2024]
Abstract
What is play and why does it matter for radiologists? Play can take many forms in the workplace, including organic, managed, task-related, diversionary, and resistive forms of play, and play may also take the form of authentic self-expression and creation. In this review article, we will discuss the benefits of play including improved problem solving, gaining perspective, and stress reduction, and also provide low-tech and high-tech examples of beneficial play for the radiology team in work and personal contexts.
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Affiliation(s)
- Sarah L Averill
- Associate Professor of Oncology and Radiology, Roswell Park Comprehensive Cancer Center, 665 Elm Ste, Buffalo, New York, USA (S.L.A.).
| | - Erin N Gomez
- Assistant Professor, Diagnostic Imaging Division, Program Director, Diagnostic Radiology and Molecular Imaging Residencies, Department of Radiology, Johns Hopkins Hospital, Baltimore, Maryland, USA (E.N.G.)
| | - Lily M Belfi
- Associate Professor of Clinical Radiology, Director of Medical Student Education, Division of Emergency/ Musculoskeletal Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, New York, 10065, USA (L.M.B.)
| | - Jessica Hui
- R3 Radiology Resident University of Iowa Hospitals and Clinics, lowa city, lowa, USA (J.H.)
| | - Nadine Mallak
- Associate Professor, Department of Diagnostic Radiology, Molecular Imaging & Therapy, Body Imaging, PET/MRI Clinical Director, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon, 97239, USA (N.M.)
| | - Alison Chetlen
- Professor, Department of Radiology, Division of Breast Imaging, Vice Chair of Education, Department of Radiology, Breast Imaging Division Chief, Academic Radiology Group, Director, 3+5 DR-APPS Accelerated Pathway Program Penn State College of Medicine, Penn State Health, Hershey Medical Center, 30 Hope Drive, Suite 1800, EC 008, Hershey, Pennsylvania, 17033, USA (A.C.)
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Belfi LM, Bartolotta RJ, Averill SL, Bulman JC, Chetlen A, Jay AK, Methratta ST, Deitte LA. The Big Squeeze: Factors Contributing to Moral Distress Among Radiologist Clinician-Educators. Acad Radiol 2024:S1076-6332(23)00707-9. [PMID: 38296741 DOI: 10.1016/j.acra.2023.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 02/02/2024]
Abstract
Moral distress is a term used to describe the cognitive-emotional dissonance that is experienced when one is compelled to act contrary to one's moral requirements. This occurs as a result of systemic constraints that prevent an individual from taking actions that they perceive as morally right, resulting in a perceived violation of one's core values and duties. There has been a growing interest in the prevalence of moral distress in healthcare, particularly as a root cause of burnout. A recent national survey on moral distress in radiology found that 98% of respondents experienced at least some degree of moral distress with 18% of respondents having left a position due to moral distress. One of the scenarios associated with the highest degree of moral distress related to the conflict that arises when one feels unable to fulfill teaching responsibilities due to high clinical demands. Now more than ever, clinician-educators are asked to do more with less time, fewer resources, and in an increasingly demanding work environment that is often discordant with providing quality education to their learners. In this manuscript, we aim to discuss the factors contributing to moral distress in radiologist clinician-educators as a framework to better understand the implications of these drivers, and to offer our perspective on potential mitigating measures.
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Affiliation(s)
- Lily M Belfi
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, New York, 10065, USA.
| | - Roger J Bartolotta
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, New York, 10065, USA
| | - Sarah L Averill
- Department of Radiology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, 14203, USA
| | - Julie C Bulman
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, 02215, USA
| | - Alison Chetlen
- Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, 17033, USA
| | - Ann K Jay
- Department of Radiology, MedStar Georgetown University Hospital, Washington, D.C., USA
| | - Sosamma T Methratta
- Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, 17033, USA
| | - Lori A Deitte
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Belfi LM, Bartolotta RJ, Jordan SG. Using Rubrics to Evaluate E-Learning Tools in Radiology Education. Curr Probl Diagn Radiol 2024; 53:121-127. [PMID: 37741698 DOI: 10.1067/j.cpradiol.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/23/2023] [Indexed: 09/25/2023]
Abstract
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.
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Affiliation(s)
- Lily M Belfi
- Department of Radiology, Weill Cornell Medicine, New York, NY.
| | | | - Sheryl G Jordan
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC
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7
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Yohannes N, Gil HDJ, Babagbemi K, RoyChoudhury A, D'Angelo D, Belfi LM. Supporting underrepresented minority students and advancing educational and health equity: Travelers Summer Research Fellowship (TSRF) program radiology panel. Clin Imaging 2023; 104:109927. [PMID: 37866254 PMCID: PMC10204280 DOI: 10.1016/j.clinimag.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/28/2023] [Accepted: 05/09/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has highlighted the racial disparities in health outcomes within our nation. This is especially relevant in the field of radiology where the lack of minority representation is particularly striking. The purpose of this paper is to describe a pipeline program designed to support underrepresented minority (URM) students and provide a model to bridge URMs to careers in medicine hence cultivating health equity. METHODS We designed a radiology pipeline program within The Travelers Summer Research Fellowship Program (TSRF) to give underrepresented students an opportunity to engage with radiologists. Participants experience a rich inquiry-based curriculum and completed pre- and post-intervention surveys that measured motivational factors for medical education and interest level in medical careers. RESULTS 29 undergraduate students participated in the 2021 TSRF Program. The data comparing the pre- and post-surveys demonstrated that the TSRF program played a positive role in sparking interest in radiology, debunking misperceptions about radiologists, and boosting participant confidence regarding medical school applications. DISCUSSION We created an interactive curriculum for URM students to cultivate a new generation of radiologists that will reflect and better meet the needs of the populations they are serving thereby mitigating the current health disparities in our nation.
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Affiliation(s)
- Nathaniel Yohannes
- Department of Radiology, Weill Cornell Medicine, United States of America.
| | | | - Kemi Babagbemi
- Department of Radiology, Weill Cornell Medicine, United States of America
| | - Arindam RoyChoudhury
- Department of Population Health Sciences, Weill Cornell Medicine, United States of America
| | - Debra D'Angelo
- Department of Population Health Sciences, Weill Cornell Medicine, United States of America
| | - Lily M Belfi
- Department of Radiology, Weill Cornell Medicine, United States of America
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8
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Yun JH, Mills J, Bartolotta RJ, RoyChoudhury A, Wu A, Belfi LM. US Radiology Resident Perceptions of Current Well-Being Programming: A Case Study. J Am Coll Radiol 2023:S1546-1440(23)00963-8. [PMID: 38043631 DOI: 10.1016/j.jacr.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 11/10/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Jung H Yun
- Integrated IR/DR Resident Physician, Department of Diagnostic and Interventional Radiology, Jefferson Einstein Hospital, Philadelphia, Pennsylvania.
| | - Joshua Mills
- Medical Student, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
| | - Roger J Bartolotta
- Chief of Musculoskeletal Imaging, and Associate Professor of Clinical Radiology, Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Arindam RoyChoudhury
- Associate Professor, Faculty Director of Certificate Programs, and Director of Extramural Consulting, Division of Biostatistics, Weill Cornell Medicine, New York, New York
| | - Alan Wu
- Research Biostatistician III, Weill Cornell Medicine, New York, New York
| | - Lily M Belfi
- Associate Professor of Clinical Radiology, and Director of Medical Student Education, Division of Emergency/ Musculoskeletal Radiology, Weill Cornell Medicine, New York, New York
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Averill SL, Woods RW, Desoky SM, Alexandre Frigini L, Chetlen AL, Oliveira AM, Desperito E, Belfi LM. NAM National Plan for Health Workforce Well-being: Applications for Radiology. Acad Radiol 2023:S1076-6332(23)00559-7. [PMID: 38042622 DOI: 10.1016/j.acra.2023.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 12/04/2023]
Abstract
The National Academy of Medicine Plan for Health Workforce Well-Being identifies seven priority areas, including creating positive work environments, addressing burnout and stress, promoting transparency and equity in compensation, providing education and training to promote resilience, enhancing community and social support systems, addressing the stigma associated with seeking help for mental health and substance use disorders and fostering leadership commitment and accountability for workforce well-being. This paper will explore the National Plan for Health Workforce Well-Being, providing an overview of the seven priority areas and offering strategies for implementation in radiology.
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Affiliation(s)
- Sarah L Averill
- Associate Professor of Oncology and Radiology, Roswell Park Comprehensive Cancer Center, 665 Elm St, Buffalo, New York, USA (S.L.A.).
| | - Ryan W Woods
- Associate Professor of Radiology, University of Wisconsin School of Medicine and Public Health, Wisconsin, USA (R.W.W.)
| | - Sarah M Desoky
- Associate Professor of Diagnostic Radiology, OHSU, Portland, Oregon, USA (S.M.D.)
| | - L Alexandre Frigini
- Professor of Radiology, Baylor College of Medicine, Houston, Texas, USA (L.A.F.)
| | - Alison L Chetlen
- Professor of Radiology, Penn State Hershey Medical Center, Pennsylvania, USA (A.L.C.)
| | - Amy M Oliveira
- Associate Professor of Radiology, UMass Chan Medical School-Baystate, Musculoskeletal Radiology Division, Baystate Health System, Worcester, Massachusetts, USA (A.M.O.)
| | - Elise Desperito
- Associate Professor of Radiology, Columbia University, New York, New York, USA (E.D.)
| | - Lily M Belfi
- Associate Professor of Clinical Radiology, Director of Medical Student Education, Division of Emergency/ Musculoskeletal Radiology, Weill Cornell Medicine, New York, New York, USA (L.M.B.)
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10
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Belfi LM, Chetlen A, Frigini A, Jay A, Methratta ST, Robbins J, Woods R, Deitte L. Recovering Joy in the Workplace Requires P.R.A.C.T.I.C.E. Acad Radiol 2023; 30:536-540. [PMID: 35654656 PMCID: PMC9151245 DOI: 10.1016/j.acra.2022.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Lily M. Belfi
- Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, NY,Address correspondence to: L.M.B
| | - Alison Chetlen
- Department of Radiology, Penn State University, Hershey, Pennsylvania
| | | | - Ann Jay
- Department of Radiology, MedStar Georgetown University Hospital, Washington DC
| | | | - Jessica Robbins
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ryan Woods
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Lori Deitte
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee
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Belfi LM, Weissman E, Haramati A. Grit, Gratitude, Grace, and Guidance: Moving Academic Medicine From Crisis to Transformation. Acad Med 2022; 97:1438-1440. [PMID: 35675151 DOI: 10.1097/acm.0000000000004771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Since the beginning of the COVID-19 crisis within the United States, faculty in academic medicine have experienced serious workplace and personal challenges while also exploring unique solutions and innovations in response to these challenges. Despite the global pandemic, social inequality and unrest, and uncertainty about the future, 3 hopeful themes that bind faculty together have emerged: grit, gratitude, and grace. This commentary describes how these qualities are in fact a culmination of ongoing work within academic medicine. While there is still a long way to go, this work is paving a path forward that is leading faculty to have more control over their professional lives. Indeed, these faculty efforts can be enhanced through shared governance, in which faculty participate more fully in the decision making at their institutions. To create thoughtful and enduring solutions, institutional leadership need to collaborate with faculty and provide guidance focused on improving well-being among faculty. This commentary is a call to action that describes how working together through shared purpose and engagement can harness the power of crisis as a catalyst for change and transformation that leads to the betterment of not just faculty, but academic medicine overall.
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Affiliation(s)
- Lily M Belfi
- L.M. Belfi is associate professor, Department of Clinical Radiology, and director, Medical Student Education, Division of Emergency and Musculoskeletal Imaging, Weill Cornell Medicine, New York, New York
| | - Eric Weissman
- E. Weissman is senior director, Faculty and Academic Society Engagement, Association of American Medical Colleges, Washington, DC
| | - Aviad Haramati
- A. Haramati is professor of integrative physiology, Departments of Biochemistry, Molecular and Cellular Biology, and Medicine, and director, Center for Innovation and Leadership in Education (CENTILE), Georgetown University School of Medicine, Washington, DC; ORCID: http://orcid.org/0000-0003-1145-5169
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12
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Belfi LM, Dean KE, Jordan SG. I.C.A.R.U.S. in Flight: A Radiology Simulator Teaches Imaging Appropriateness, Anatomy, and Image Interpretation Skills. Acad Radiol 2022; 29 Suppl 5:S94-S102. [PMID: 33896718 DOI: 10.1016/j.acra.2021.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/11/2021] [Accepted: 03/13/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES The Interactive Clinical Anatomy and Radiology Utilization Simulator (ICARUS) was created in 2012 as a novel simulation program with 25 peer reviewed electronic modules combining simulated patient encounters, American College of Radiology appropriateness criteria, radiologic anatomy, and basic imaging interpretation and patient safety topics. ICARUS integrates a gaming approach to improve student engagement. MATERIALS AND METHODS ICARUS modules have been used in the undergraduate medical curriculum at the lead author's institution since its pilot in 2012. Since completion of the full complement of 25 modules, modules have been used in the radiology clerkship (2012- 2015), in the integrated longitudinal curriculum (2015-present), and in various radiology electives (2015-present), including the inaugural virtual radiology electives at all authors' institutions (July 2020-present). Student evaluations were formally solicited in 2014 and again in 2020. RESULTS During the introductory radiology clerkship in 2014, 107 students were enrolled. Students were assigned 4 ICARUS modules. During the 2-week virtual elective from July-October 2020, 26 students were enrolled. Students were assigned all 25 modules. The majority of survey respondents "agreed" or "strongly agreed" that the modules were interactive, enjoyable, and self-directed, fostered critical thinking, provided practical value, met goals and objectives of the course, and seemed practical to their future practice. CONCLUSION ICARUS integrates key educational concepts in radiology with high fidelity simulation of clinical decision support software and PACS simulation image display to create a highly engaging learning environment that most accurately reflects future clinical experiences.
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Belfi LM, Rotman JA, Benefield T, Jordan SG. The Short and the Long of It: Transitioning to a Blended Longitudinal Curriculum in Radiology. J Am Coll Radiol 2022; 19:699-705. [PMID: 35397227 DOI: 10.1016/j.jacr.2022.02.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/30/2022] [Accepted: 02/19/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this study was to demonstrate that the transition from a stand-alone radiology clerkship block to a longitudinally integrated radiology curriculum leverages newer teaching tools favored by today's learners. METHODS In 2013 and 2014, medical students attended a dedicated 1-week radiology clerkship course. In 2015, the block clerkship model for radiology transitioned to a vertically integrated curriculum. By 2019, radiology content was integrated into many of the health illness and disease course blocks. Pre- and postcourse multiple-choice questions tests as well as anonymous surveys were administered for both clerkship and integrated curriculum blocks. The student survey questions assessed perceptions regarding interpretation skills, imaging modality knowledge, and radiologists' roles. RESULTS Among 197 total students in the clerkship block, surveys were completed by 170 respondents, yielding a response rate of 86.3%. Among 106 students in the longitudinal course, surveys were completed by 71 respondents, yielding a response rate of 67%. For both clerkship and longitudinally integrated courses, the average number of correct responses after completion of the courses was significantly greater than the average number of correct precourse responses. Compared with students in the clerkship block curriculum, students in the longitudinal curriculum demonstrated a significantly greater frequency of agreement in response to survey questions regarding significant exposure to radiology, feeling comfortable interpreting CT images, and being familiar with how to use the ACR Appropriateness Criteria. CONCLUSIONS Transitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.
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Affiliation(s)
- Lily M Belfi
- Director of Medical Student Education, Department of Radiology, Weill Cornell Medicine, New York, New York.
| | - Jessica A Rotman
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Thad Benefield
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Sheryl G Jordan
- Director of Undergraduate Medical Education and Diversity Liaison, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina; CME Course Director, American College of Radiology
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14
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Belfi LM, Jordan SG. Web-Based Radiology Learning Module Design: The Author Perspective. Acad Radiol 2022; 29:584-590. [PMID: 33836944 DOI: 10.1016/j.acra.2021.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 11/01/2022]
Abstract
RATIONALE AND OBJECTIVES Over recent years, e-learning has become an integral component of radiology education. While demands for innovative, interactive e-learning resources have increased, the availability of viable solutions have not kept pace. As a result, many educators are authoring their own e-learning content. This study describes the six-year experience of faculty clinician educators and residents who participated in this authoring process. MATERIALS AND METHODS From 2014 to 2020, 62 radiology faculty and residents created a total of 89 peer reviewed web-based learning modules. Authors were given instructions and materials to support their design process. Following completion of their module(s), authors were asked to complete an anonymous and voluntary survey on their perspective. RESULTS Hundred percent of survey respondents reported that they enjoyed creating their module and 97.8% would recommend the experience to others. Reported educational value of authoring a learning module was 4.18 per 5, with 65% of resident authors reporting that they felt more likely to retain the information they learned through authoring a module rather than reading a chapter on the same topic. A total of 77.3% of respondents reported that the experience would make them more likely to teach medical students in the future. CONCLUSION With the appropriate resources and support, radiology faculty and residents succeed in authorship of innovative e-learning modules for medical student learners. In addition to enhancing subject matter knowledge and satisfying Accreditation Council for Graduate Medical Education requirements for teaching and scholarly activity, authorship provides mentoring opportunities and cultivates interest in medical student education.
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Dallaghan GLB, Belfi LM, Houston KM, Jordan SG. See One, Do One, Share One - Introducing Visual Abstracts in Journal Publication. Acad Radiol 2022; 29:591-597. [PMID: 34219011 DOI: 10.1016/j.acra.2021.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022]
Abstract
The visual abstract, read with ease and speed, is a logical evolution for today's journals to attract and maintain readers. However, many faculty have not yet constructed visual abstracts. This manuscript is a means to consolidate theory and commentaries into a cohesive explanation of why and how to develop a visual abstract. Tremendous growth opportunity exists for this innovation in the medical landscape, with current and future applications in journal publications, summary and dispersal of practice guidelines, and delivery of educational and training materials.
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Belfi LM, Jordan SG, Chetlen A, Deitte LA, Frigini LA, Methratta ST, Robbins J, Woods R, Benefield T, Jay AK. Self-Care and Storytelling for Radiologists: A Feasibility Study. Curr Probl Diagn Radiol 2022; 51:445-449. [PMID: 34334224 PMCID: PMC9701313 DOI: 10.1067/j.cpradiol.2021.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 06/17/2021] [Indexed: 12/14/2022]
Abstract
RATIONALE AND OBJECTIVES Physician wellness and burnout mitigation strategies have become priority practices in recent years. Despite these efforts, however, physicians living with the psychological effects of the current COVID-19 global pandemic, political stressors, and social injustices, face ever increasing threats to their personal and professional well-being. This manuscript investigates the process of storytelling as a self-care practice for radiologists. MATERIALS AND METHODS The AUR Well Being Ad-Hoc Committee introduced and approved Storytelling Geek Week, a virtual workshop held by The Moth, a Peabody award-winning storytelling nonprofit group. Nineteen AUR members applied and were selected for participation in the workshop which occurred over 5 days in November 2020. Anonymous electronic surveys were sent to participants before and after the workshop to gather feedback on their experience. RESULTS Of the 19 AUR member participants, 12 (63%) completed the pre-workshop survey and 8 (42%) completed the post-workshop survey. Participant current state of well-being was found to be increased between the pre- and post-course surveys, with a statistically significant adjusted P-value of 0.017. All 8 post-workshop respondents reported that they would recommend the workshop to others. With regard to how participation in the workshop impacted their wellbeing, representative free text responses include, "helped with processing emotions," and "felt more connected to strangers." Regarding shifts in perspective as a result of workshop participation, representative free text responses include, "more empathetic" and "started focusing on hope and gratitude rather than sadness and anxiety." CONCLUSION Participants in a storytelling workshop reported a positive impact on their perceived sense of well-being. Respondents also reports shifts in their sense of empathy and connectedness to others. This type of intervention may help to mitigate burnout and build community during challenging times.
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Affiliation(s)
- Lily M. Belfi
- Department of Radiology, Weill Cornell Medicine, New York, NY,Reprint requests: Lily M. Belfi, MD, Department of Radiology, Weill Cornell Medicine, 525 East 68th Street, Room F-054, New York, NY 10065
| | - Sheryl G. Jordan
- Department of Radiology, University of North Carolina School of Medicine, NC
| | - Alison Chetlen
- Department of Radiology, Penn State Health, Hershey Medical Center, PA
| | - Lori A. Deitte
- Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN
| | | | - Sosamma T. Methratta
- Department of Radiology, Penn State Health, Milton S. Hershey Medical Center, Hershey, PA
| | - Jessica Robbins
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Ryan Woods
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Thad Benefield
- Department of Radiology, University of North Carolina School of Medicine, NC
| | - Ann K Jay
- Department of Radiology, MedStar Georgetown University Hospital, Washington, DC
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Belfi LM. Letter to the Editor: Response. Clin Imaging 2021; 80:438. [PMID: 34560515 DOI: 10.1016/j.clinimag.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/13/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Lily M Belfi
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68th Street, New York, NY 10065, United States of America.
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Belfi LM, Dean KE, Sailer DS, Kesler T, Jordan SG. Virtual Journal Club Beyond the Pandemic: An Enduring and Fluid Educational Forum. Curr Probl Diagn Radiol 2021; 51:450-453. [PMID: 34600795 PMCID: PMC8425288 DOI: 10.1067/j.cpradiol.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/18/2021] [Accepted: 07/18/2021] [Indexed: 11/28/2022]
Abstract
Objective Since its inception, journal club has been a cornerstone to the life-long process of medical education. The virtual journal club (VJC), initiated as a robust solution to many educational challenges encountered during COVID-19 pandemic-related distance learning, provides an enduring and fluid forum for multilevel teaching and learning. Materials and Methods In this manuscript we share our institutions' reasoning and methods to implement a VJC for multi-level learners. A standardized format applicable to all VJC sessions was adopted to ensure reproducibility from presenter to presenter. Sessions were held via video conference platforms. Pedagogy regularly emphasized in undergraduate medical education was adopted. Informal assessment of each session's strengths and areas for improvement was performed. Results A total of 30 sessions were held prior to manuscript submission, including discussion of 36 refereed journal articles from March 26, 2020, to April 20, 2021. The virtual journal club was very well received by all participants. The medical students and residents found the information current and engaging. The fellows stated that the journal club strengthened their knowledge base and enhanced communication and teaching skills. The attendings learned from its encouraged frank discussion of differing practice patterns. The format of these sessions offers an ideal setting to teach medical students and residents how to evaluate and employ evidence-based medicine and meets multiple LCME and ACGME requirements. Conclusions This VJC forum allows for development of essential nonclinical skills including lifelong active learning and analysis, peer collaboration, and technology adaptation and usage.
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Affiliation(s)
- Lily M Belfi
- Department of Radiology, Weill Cornell Medicine, New York, NY.
| | - Kathryn E Dean
- Department of Radiology, Weill Cornell Medicine, New York, NY
| | - David S Sailer
- Department of Radiology, University of North Carolina School of Medicine, New York, NY
| | | | - Sheryl G Jordan
- Department of Radiology, University of North Carolina School of Medicine, New York, NY
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Belfi LM, Dean KE, Bartolotta RJ, Shih G, Min RJ. Medical student education in the time of COVID-19: A virtual solution to the introductory radiology elective. Clin Imaging 2021; 75:67-74. [PMID: 33497880 PMCID: PMC7816883 DOI: 10.1016/j.clinimag.2021.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 12/16/2022]
Abstract
Rationale and objectives During the COVID-19 pandemic, medical educators and students are facing unprecedented challenges while navigating the new virtual landscape that social-distancing policies mandate. In response to these challenges, a new virtual introduction to radiology elective was established with unique online resources and curriculum. Materials and methods A previously in-person 2-week introductory radiology elective was converted into a completely virtual experience using an internally developed, open-source, peer-reviewed, web-based teaching modules combined with virtual lectures, interdisciplinary conferences, and readout sessions of de-identified cases loaded to a DICOM viewer. Students from the first four months of course enrollment completed a multiple choice pre- and post-course knowledge assessments and a 5-point Likert Scale survey as part of their educational experience. Results In total, 26 4th-year medical students participated over 4 separate 2-week sessions from July to October of 2020. This included 12 students from the home intuition and 14 visiting students. On average, students scored 62.2% on the 55-question pre-test and 89.0% on the same test upon completion of the course, a statistically significant increase (p < 0.001). All 26 students felt engaged throughout the course. All 26 agreed (23 “strongly agreed”) that they were more comfortable looking at imaging studies following the course. All 26 also agreed (21 “strongly agreed”) that the course helped them prepare for their future clinical rotations and careers. Conclusion Initial pilot program using unique web-based resources and student encounters during a two-week virtual introductory radiology elective proved to be a positive educational experience for the first 26 students enrolled.
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Affiliation(s)
- Lily M Belfi
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68(th) Street, New York, NY 10065, United States of America.
| | - Kathryn E Dean
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68(th) Street, New York, NY 10065, United States of America.
| | - Roger J Bartolotta
- Department of Radiology, University of Colorado School of Medicine, 12401 E. 17th Avenue, Aurora, CO 80045, United States of America
| | - George Shih
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68(th) Street, New York, NY 10065, United States of America.
| | - Robert J Min
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medicine, 525 East 68(th) Street, New York, NY 10065, United States of America.
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Affiliation(s)
- Roger J Bartolotta
- Weill Cornell Medical College, New York, NY; Department of Radiology, NewYork-Presbyterian Hospital, New York, NY.
| | - Lily M Belfi
- Weill Cornell Medical College, New York, NY; Department of Radiology, NewYork-Presbyterian Hospital, New York, NY
| | - Alice S Ha
- Department of Radiology, University of Washington, Seattle, WA
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Minkowitz S, Leeman K, Giambrone AE, Kherani JF, Belfi LM, Bartolotta RJ. Emergency Radiology "Boot Camp": Educating Emergency Medicine Residents Using E-learning Radiology Modules. AEM Educ Train 2017; 1:43-47. [PMID: 30051008 PMCID: PMC6001497 DOI: 10.1002/aet2.10002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/20/2016] [Accepted: 09/23/2016] [Indexed: 06/08/2023]
Abstract
OBJECTIVES There is an overall paucity of literature on the radiologic education of emergency medicine (EM) clinicians. Given the fact that many EM clinicians preliminarily review images for their patients, we hypothesized that a brief imaging curriculum could be efficacious in teaching basic and relevant radiologic interpretation. METHODS We designed a 4-hour "radiology boot camp" for a group of 20 EM residents (from all years of training) covering several subject specific e-learning modules. They completed precourse and postcourse quizzes to evaluate the efficacy of these modules. These modules included interactive PowerPoint-based tutorials, games, and imaging decision support simulators. Matched results from the pre- and posttests were analyzed using paired t test. An additional questionnaire was administered to the EM residents to evaluate their perception of the educational experience. RESULTS The precourse and postcourse quizzes demonstrated a statistically significant level of improved knowledge due to the educational modules (p < 0.0001). In addition, all of the participants believed the modules were a useful learning experience (100%) and a vast majority described them as a valuable resource for future reference (95%). CONCLUSION We demonstrate a model for providing an easy and effective means of educating EM residents on basic imaging interpretation and utilization, using e-learning modules.
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Affiliation(s)
- Shlomo Minkowitz
- Department of RadiologyNew York‐Presbyterian Hospital‐Weill Cornell MedicineBrooklynNY
| | - Kristen Leeman
- Department of RadiologyNew York‐Presbyterian Hospital‐Weill Cornell MedicineBrooklynNY
| | - Ashley E. Giambrone
- Department of Biostatistics and EpidemiologyWeill Cornell MedicineBrooklynNY
| | - Jennifer F. Kherani
- Department of Emergency MedicineNew York‐Presbyterian Hospital‐Weill Cornell MedicineBrooklynNY
| | - Lily M. Belfi
- Department of RadiologyNew York‐Presbyterian Hospital‐Weill Cornell MedicineBrooklynNY
| | - Roger J. Bartolotta
- Department of RadiologyNew York‐Presbyterian Hospital‐Weill Cornell MedicineBrooklynNY
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Belfi LM, Bartolotta RJ, Giambrone AE, Davi C, Min RJ. "Flipping" the introductory clerkship in radiology: impact on medical student performance and perceptions. Acad Radiol 2015; 22:794-801. [PMID: 25592027 DOI: 10.1016/j.acra.2014.11.003] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/27/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES Among methods of "blended learning" (ie, combining online modules with in-class instruction), the "flipped classroom" involves student preclass review of material while reserving class time for interactive knowledge application. We integrated blended learning methodology in a "flipped" introductory clerkship in radiology, and assessed the impact of this approach on the student educational experience (performance and perception). MATERIALS AND METHODS In preparation for the "flipped clerkship," radiology faculty and residents created e-learning modules that were uploaded to an open-source website. The clerkship's 101 rising third-year medical students were exposed to different teaching methods during the course, such as blended learning, traditional lecture learning, and independent learning. Students completed precourse and postcourse knowledge assessments and surveys. RESULTS Student knowledge improved overall as a result of taking the course. Blended learning achieved greater pretest to post-test improvement of high statistical significance (P value, .0060) compared to lecture learning alone. Blended learning also achieved greater pretest to post-test improvement of borderline statistical significance (P value, .0855) in comparison to independent learning alone. The difference in effectiveness of independent learning versus lecture learning was not statistically significant (P value, .2730). Student perceptions of the online modules used in blended learning portions of the course were very positive. They specifically enjoyed the self-paced interactivity and the ability to return to the modules in the future. CONCLUSIONS Blended learning can be successfully applied to the introductory clerkship in radiology. This teaching method offers educators an innovative and efficient approach to medical student education in radiology.
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Belfi LM, Bartolotta RJ, Loftus ML, Wladyka C, Hentel KD. Benign osseous and articular abnormalities of the pelvis: a review of CT imaging findings. Clin Imaging 2014; 39:186-93. [PMID: 25433854 DOI: 10.1016/j.clinimag.2014.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 08/09/2014] [Indexed: 11/29/2022]
Abstract
Computed tomography (CT) has become the standard of care for evaluation and follow-up for a wide range of abdominal and pelvic pathology. Many incidental osseous and articular abnormalities of the pelvis are detected on these studies, most of which have a benign etiology. However, most of these studies are interpreted by nonmusculoskeletal radiologists, who may not be familiar with the CT appearances of these benign musculoskeletal abnormalities. Uncertainty often leads to mischaracterization or unnecessary follow-up, resulting in increased health care costs and patient anxiety. This article reviews the CT appearance of the benign musculoskeletal entities that occur in pelvis.
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Affiliation(s)
- Lily M Belfi
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA.
| | - Roger J Bartolotta
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA
| | - Michael L Loftus
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA
| | - Christopher Wladyka
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA
| | - Keith D Hentel
- Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA
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Sheikh K, Belfi LM, Sharma R, Baad M, Sanelli PC. Evaluation of acute cervical spine imaging based on ACR Appropriateness Criteria®. Emerg Radiol 2011; 19:11-7. [PMID: 22057542 DOI: 10.1007/s10140-011-0994-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Accepted: 10/12/2011] [Indexed: 11/27/2022]
Abstract
The objectives of this study were to determine the rate of acute blunt cervical spine injury at an academic urban level 1 trauma center and to evaluate the utilization of cervical spine imaging based on the established American College of Radiology (ACR) Appropriateness Criteria®. We retrospectively reviewed all radiography and CT imaging of the cervical spine performed over a year period in adult patients presenting with acute blunt cervical spine trauma. Exclusion criteria were children ≤17 years, non-acute trauma of ≥72 h, and penetrating trauma. Any fracture, dislocation, or ligamentous instability demonstrated by diagnostic imaging and requiring stabilization or specialized follow-up was defined as clinically significant cervical spine injury. A total of 1,325 cervical spine studies were reviewed in 1,245 patients; 32.7% (433/1,325) were cervical spine radiographs and 67.3% (892/1,325) were CT examinations. Approximately 1.5% (19/1,245) of the patients demonstrated clinically significant acute cervical spine injury. There were 6.4% (80/1,245) patients who received both cervical spine radiographs and CT as imaging evaluation. Based on the ACR Appropriateness Criteria®, all of the cervical spine radiographs performed (433) were determined to be "inappropriate" imaging in the setting of acute cervical spine injury.
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Affiliation(s)
- Kiran Sheikh
- Department of Radiology, NewYork-Presbyterian Hospital-Weill Cornell Medical College, New York, NY 10065, USA.
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Abstract
STUDY DESIGN A retrospective radiographic study involving analysis of abdominal and pelvic computed tomography (CT) scans obtained on patients presenting with clinical conditions other than back pain. OBJECTIVE To determine the incidence of spondylolysis and spondylolisthesis in patients requiring inpatient or emergency department CT evaluation for unrelated abdominal and pelvic conditions. SUMMARY OF BACKGROUND DATA Spondylolysis and spondylolisthesis are part of a disease process that is thought to be resultant from biomechanical stresses related to bipedal locomotion. The incidence is estimated to be 3% to 10% in the general population. Many of these cases occur without associated symptoms. To our knowledge, there is a relative paucity of data on the use of CT to evaluate the prevalence of these 2 entities in patients seeking medical attention for unrelated conditions. METHODS Five hundred ten consecutive abdominal and pelvic multi-detector CT scans obtained on a single scanner (Philips MX8000; Eindhoven, The Netherlands) were reviewed. These patients presented with such complaints as abdominal pain and fever, or were imaged as part of their inpatient evaluation for conditions unrelated to lumbar spine pathology. A board certified radiologist and a radiology resident retrospectively evaluated CT scans for lumbar spondylolysis, spondylolisthesis, and associated degenerative changes. A neuroradiologist confirmed all positive cases. RESULTS Of the 510 cases examined, there were 29 cases of spondylolysis at L5, corresponding to a prevalence of 5.7%. Twenty-three of the cases demonstrated bilateral spondylolysis and 6 unilateral. Sixteen of the 23 cases of bilateral spondylolysis also had spondylolisthesis, 13 of which were grade I, and 3 of which were grade II. In patients 45 years old and younger who did not have spondylolysis or spondylolisthesis, we observed a 32.2% incidence of sclerosis involving the L5 lumbar pedicles. CONCLUSIONS This study demonstrates a 5.7% prevalence of spondylolysis and a 3.1% prevalence of spondylolisthesis in patients undergoing CT scans of the abdomen and pelvis for unrelated reasons, corresponding to the rate of spondylolysis and spondylolisthesis detected in prospective plain radiographic studies. We observed a 1.2% incidence of unilateral spondylolysis, and approximately 67% of these demonstrated contralateral sclerosis. It is suggested in the literature that sclerosis of the contralateral pedicle seen in cases of unilateral spondylolysis may be a compensatory response to mechanical stresses on an unstable lumbar vertebral body.
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Affiliation(s)
- Lily M Belfi
- Department of Radiology, Winthrop-University Hospital, Mineola, NY 11501, USA.
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Abstract
Microtubules, composed of tubulin and microtubule-associated proteins (MAPs), can be isolated using routine procedures from homogenates of vertebrate brain. Often, it is necessary then to purify the tubulin from the MAPs, and normally this purification is effected by standard techniques of ion-exchange chromatography. However, such procedures can be expensive, both in the consumption of buffers and other expensive components (e. g. GTP) and in investigator time. Here, we demonstrate that membrane ion exchangers mounted in syringe filter cartridges can be used to separate tubulin from MAPs in a matter of minutes, compared to the several hours that are normally required for typical chromatographic procedures using phosphocellulose orDEAE. The resulting tubulin is competent to assemble into microtubules upon either addition of the purified MAPs or addition of the microtubule-stabilizing drug Taxol. Thus, the procedure should be useful to investigators requiring a rapid and effective purification of tubulin for use in assembly studies or in vitro motility assays.
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Affiliation(s)
- R D Sloboda
- Department of Biological Sciences, Dartmouth College, Hanover, New Hampshire, 03755, USA.
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