Rationale and Objectives
A national needs assessment of radiology program directors was performed to characterize grand rounds (GR) programs, assess the perceived educational value of GR programs, and determine the impact of the recent economic downturn on GR.
Materials and Methods
A 28-question survey was developed querying the organizational logistics of GR programs, types of speakers, content of talks, honoraria, types of speakers invited, response to the economic downturn, types of speaker interaction with residents, and perceived educational value of GR. Questions were in multiple-choice, yes-or-no, and five-point Likert-type formats. The survey was distributed to the program directors of all radiology residencies within the United States.
Results
Fifty-seven of 163 programs responded, resulting in a response rate of 36%. Thirty-eight programs (67%) were university residencies and 10 (18%) were university affiliated. Eighty-two percent of university and 60% of university-affiliated residencies had their own GR programs, while only 14% of community and no military residencies held GR. GR were held weekly in 18% of programs, biweekly in 8%, monthly in 42%, bimonthly in 16%, and less frequently than every 2 months in 16%. All 38 programs hosting GR reported a broad spectrum of presentations, including talks on medical education (66%), clinical and evidence-based medicine (55%), professionalism (45%), ethics (45%), quality assurance (34%), global health (26%), and resident presentations (26%). All programs invited speakers from outside the institution, but there was variability with regard to the frequency of visits and whether invited speakers were from out of town. As a result of recent economic events, one radiology residency (3%) completely canceled its GR program. Others decreased the number of speakers from outside their cities (40%) or decreased the number of speakers from within their own cities (16%). Honoraria were paid to speakers by 95% of responding programs. Most program directors (79%) who had their own GR programs either strongly agreed or agreed that GR are an essential component of any academic radiology department, and this opinion was shared by a majority of all respondents (68%). Almost all respondents (97%) either strongly agreed or agreed that general radiologic education of imaging subspecialists is valuable in an academic radiology department. A majority (65%) either strongly agreed or agreed that attendance at GR should be expected of all attending radiologists.
Conclusions
GR programs among radiology residencies tend to have similar formats involving invited speakers, although the frequency, types of talks, and honoraria may vary slightly. Most programs value GR, and all programs integrate GR within resident education to some degree. The recent economic downturn has led to a decrease in the number of invited visiting speakers but not to a decrease in the amounts of honoraria.
The first grand rounds (GR) in medicine is thought to have been developed by Sir William Osler at Johns Hopkins School of Medicine. The format involved the presentation of a live patient interview with the gradual unfolding of patient symptoms, and diagnosis, through audience participation . This interactive approach was gradually replaced by the lecture format with which many are familiar today, particularly in radiology. To date, there have been no published articles in the medical literature characterizing the format or content of GR in radiology departments or the degree of integration into radiology residency education.
Many large academic radiology departments have some form of GR or departmental lecture program, although the format and frequency vary. The GR target audience has traditionally been the general radiology department, including attending radiologists, fellows, and residents. A recent (August 7, 2011) Google search of the GR calendars of major academic centers across the country, using the keywords “radiology grand rounds,” yielded postings with both invited national and local in-house speakers. The content was wide ranging, including resident presentations, radiology education, evidence-based medicine, clinical and basic science research, quality assurance, teaching rounds, ethics, and professionalism. Given that the term “grand rounds” is in common use, and appears to be commonly understood to imply the meaning as defined above, it seems appropriate to use this term. In some smaller programs, the term “grand rounds” may not be used at all; they may instead have visiting speaker series.
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Materials and methods
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Results
Frequency of GR Programs
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Table 1
Respondents Sorted by Type of Program and Size of Residency
Type of Program Number of Residents Total Respondents ( n = 57) <12 13–24 25–36 37–48 >49 University 1 (3%) 9 (24%) 14 (37%) 10 (26%) 4 (11%) 38 (67%) University affiliated 2 (20%) 4 (40%) 2 (20%) 2 (20%) 0 10 (18%) Community 2 (29%) 3 (43%) 2 (29%) 0 0 7 (12%) Military 0 1 (50%) 1 (50%) 0 0 2 (4%)
Table 2
Correlation of GR Programs with Type of Residency Program
Type of Program Has Its Own GR Program Goes to Another Institution for GR Does Not Have a GR Program Total ( n = 57) University 31 (82%) 1 (3%) 6 (16%) 38 University affiliated 6 (60%) 4 (40%) 10 Community 1 (14%) 6 (86%) 7 Military 1 (50%) 1 (50%) 2
GR, grand rounds.
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Types of Presentations and Speakers and Logistics
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Types of Speaker Interactions
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Attitudes Toward Medical Education
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Table 3
Program Directors’ Views of GR and Radiologic Education
Survey Statement Strongly Agree Agree Neutral Disagree Strongly Disagree GR is an essential component of any academic radiology department 21 (36.8%) 18 (31.6%) 11 (19.3%) 7 (12.3%) 0 General education of subspecialists is important 26 (46.5%) 29 (50.9%) 2 (3.5%) 0 0 Faculty attendance at GR should be expected 12 (21.1%) 25 (43.9%) 10 (17.5%) 8 (14.0%) 2 (3.5%)
GR, grand rounds.
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Response to Economic Climate and Monetary Considerations
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Discussion
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Conclusions
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Acknowledgments
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References
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