Rationale and Objectives
Radiologists play a pivotal role in patient management, primarily through interacting with referring clinicians. Despite this extensive cross-specialty interaction, radiology resident education rarely involves direct education from clinicians outside the department. We surveyed resident attitudes toward integrated conferences with subspecialty referring physicians both before and after a pilot lecture series at our institution.
Materials and Methods
Three thoracic-themed multidisciplinary conferences were organized, which involved a variety of clinicians lecturing during normal resident conference times. Resident surveys were administered before and after the complete lectures series as well as immediately after each individual lecture.
Results
The prelecture series survey indicated residents felt neutral about their confidence in knowing what clinicians want from radiology reports and the current level of “clinician-focus” in the curriculum. Residents indicated a desire for more clinician involvement in lectures. After completion of the series, residents expressed that the integrated conferences were useful and that they had greater confidence in understanding the clinicians’ expectation of reports. Resident interest in clinician participation in lectures was higher after series completion. Most residents indicated that prespecified, self-identified learning objectives were met by the lectures. After the completion of the series, most residents indicated that they wanted the series to continue, with the most commonly indicated desired frequency being once or twice a month.
Conclusion
Subspecialty clinician participation in a cross-specialty integrated resident lecture series was highly favored and well received. An “Integrated Clinical Lecture Series” may be a beneficial addition to radiology residency curriculums.
Introduction
The interaction between referring clinicians and radiologists is critical to effective patient care because many clinical decisions stem from radiologic interpretation. Educating referring clinicians with respect to appropriate study ordering, and radiologists with respect to communication of key diagnostic information, is essential to optimizing care for the patient. The majority of the radiology-clinician interaction occurs via radiology’s main product, the radiology report . With notable exceptions, including in ultrasound, breast imaging, nuclear medicine, and procedure-based subfields, radiologists’ in-person and telephone interactions tend to be with clinicians more than patients.
Despite the central role played by clinicians, the mainstay of radiology resident education is lectures given by attending radiologists. Further, didactic lectures tend to focus most on imaging findings and interpretation with relatively less attention paid to the clinical implications.
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Materials and methods
Integrated Clinical Lecture Series
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Surveys
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Table 1
Prelecture Series Survey Questions, Answer Choices, and Responses
Question Answer Choices Responses, Mean (SD)
(Unless Otherwise Indicated) What year in training are you? First year (PGY-2)
Second year (PGY-3)
Third year (PGY-4)
Fourth year (PGY-5) First years = 7
Second years = 7
Third years = 4
Fourth years = 4
(Number of respondents) IN GENERAL, how clinician-focused are radiology residency lectures? (meaning, focused on what clinicians want from reports and how they use the information provided) 1 “Not clinician-focused at all”
2 “Not very clinician-focused”
3 “Neutral”
4 “Somewhat clinician-focused”
5 “Very clinician focused” 3.0 (1.0) Do radiology residency lectures need a different level of clinician focus? 1 “Should be much less clinician-focused”
2 “Should be a little less clinician-focused”
3 “Should stay the same level clinician-focused”
4 “Should be a little more clinician-focused”
5 “Should be much more clinician-focused” 4.0 (0.7) Do you want clinicians to participate in radiology residency lectures? 1 “No, I do not want clinicians to participate at all”
2 “No, clinicians participation should be minimal”
3 “Neutral”
4 “Yes, I want clinicians to participate a little”
5 “Yes, I wanted clinicians to participate” 3.9 (0.9) IN GENERAL, do you feel you know what clinicians want from your reports? 1 “No, I have no idea what clinicians want from my reports”
2 “I have very little idea”
3 “Neutral”
4 “I have some idea”
5 “Yes, I know very well what clinicians want from my reports” Mean (all): 3.0 (0.7)
Mean (PGY-2): 2.6 (0.8)
Mean (PGY 3-5): 3.3 (0.6)
Wilcoxon rank-sum test, P = .04 Specifically, do you feel you know what clinicians want in reports regarding the following topic: “Post radiation lung cancer f/u”? 1 “No, I have no idea what clinicians want in reports regarding this topic”
2 “I have very little idea”
3 “Neutral”
4 “I have some idea”
5 “Yes, I know very well what clinicians want in reports regarding this topic” 2.9 (0.7) Specifically, do you feel you know what clinicians want in reports regarding the following topic: “Interstitial Lung Disease”? 1 “No, I have no idea what clinicians want in reports regarding this topic,”
2 “I have very little idea”
3 “Neutral”
4 “I have some idea”
5 “Yes, I know very well what clinicians want in reports regarding this topic” 3.4 (0.9) Specifically, do you feel you know what clinicians want in reports regarding the following topic: “Pulmonary Infections”? 1 “No, I have no idea what clinicians want in reports regarding this topic”
2 “I have very little idea”
3 “Neutral”
4 “I have some idea”
5 “Yes, I know very well what clinicians want in reports regarding this topic” 3.6 (0.8)
Table 2
Post-Individual Lecture Survey Questions, Answer Choices, and Responses
Question Answer Choices Responses, Mean (SD)
(Unless Otherwise Indicated) What year in training are you? First year (PGY-2)
Second year (PGY-3)
Third year (PGY-4)
Fourth year (PGY-5) Rad Onc:
First years = 7
Second years = 8
Third years = 3
Fourth years = 5
ILD:
First years = 9
Second years = 6
Third years = 4
Fourth years = 3
PI:
First years = 10
Second years = 7
Third years = 5
Fourth years =0
(Number of respondents) Was this conference useful? 1 “Not useful”
2 “Minimal use”
3 “Neutral”
4 “Some use”
5 “Very useful” Rad Onc: 4.3 (0.8)
ILD: 4.5 (0.7)
PI: 4.1 (0.6)
Total: 4.3 (0.7) Will this conference change how you interpret and/or dictate studies? 1 “No, this will not change how I interpret and/or dictate studies”
2 “Minimal impact”
3 “Moderate impact”
4 “More than moderate impact”
5 “Yes, this will definitely change how I interpret and/or dictate studies.” Rad Onc: 3.7 (1.1)
ILD: 3.8 (1.0)
PI: 3.2 (0.9)
Total: 3.6 (1.0) Do you feel you know what clinicians want in reports regarding the topic reviewed today? 1 “No, I have no idea what clinicians want from my reports”
2 “I have very little idea”
3 “Neutral”
4 “I have some idea”
5 “Yes, I know very well what clinicians want from my reports” Rad Onc: 4.1 (0.6)
ILD: 4.1 (0.7)
PI: 3.5 (0.8)
Total: 3.9 (0.7) Do you want clinicians to participate in radiology residency lectures? 1 “No, I do not want clinicians to participate at all”
2 “No, clinicians participation should be minimal”
3 “Neutral”
4 “Yes, I want clinicians to participate a little”
5 “Yes, I wanted clinicians to participate” Rad Onc: 4.3 (0.8)
ILD: 4.5 (1.0)
PI: 4.0 (1.1)
Total: 4.3 (1.0) In the pre-conference survey, you indicated one topic you would like to learn today. Did you learn about this topic? - “I cannot remember the topic I indicated”
1 “I did not at all learn about the topic at all”
2 “I mostly did not learn about the topic”
3 “Neutral”
4 “I learned about the topic somewhat”
5 “I learned about the topic I indicated.” Rad Onc: 4 (0.9)
ILD: 4.1 (1.1)
PI: 3.3 (1.0)
Total: 3.8 (1.0)
ILD, A Multidisciplinary Approach to Interstitial Lung Disease lecture; Rad Onc, Radiology Oncology and Radiology lecture; PI, A Multidisciplinary Approach to Pulmonary Infections lecture.
Table 3
Postlecture Series Survey Questions, Answer Choices, and Responses
Question Answer Choices Responses, Mean (SD)
(Unless Otherwise Indicated) How many of the clinical lecture series conferences did you attend (Tuesdays at noon this month)? 1 Conference
2 Conferences
3 Conferences 1 Conference = 1 (6%)
2 Conferences = 6 (35%)
3 Conferences = 10 (59%)
Number of respondents (%) Was the integrated clinical lecture series educational? 1 “Not at all”
2 “Mostly not”
3 “Neutral”
4 “Somewhat”
5 “Very much so” Mean 4.4 (SD 0.7) Would you recommend continuation of the clinical lecture series? 1 “Not at all”
2 “Mostly not”
3 “Neutral”
4 “Somewhat”
5 “Very much so” Mean 4.4 (SD 0.7) In your opinion, what would be the ideal frequency for conferences such as this? “Never”
“Few times a year”
“Once to twice a month”
“Once a week”
“Multiple times a week” 0 (0%)
3 (18%)
11 (65%)
3 (18%)
0 (0%)
Number of respondents (%)
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Statistical Analysis
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Results
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Prelecture Series Survey
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Postlecture Surveys
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Postlecture Series Survey
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Comparisons between the Pre- and Postlecture Surveys
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Discussion
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Conclusions
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