Rationale and Objectives
The aims of our study were (1) to describe a new educational intervention for first-year medical students that gave a substantial, early exposure to radiology and (2) to examine how this early exposure was received by the students.
Materials and Methods
Our new curriculum incorporated a new 2-week course very early in the M1 year entitled Foundations of Diagnostics and Therapeutics. Among other topics, the course included a substantial introduction to radiology primarily through small-group seminars and online materials, administered using a flipped-classroom approach. The students were given pre- and postcourse surveys that assessed the degree to which they felt prepared to learn about radiology, as well as their interest in radiology. Results were analyzed using the Wilcoxon signed-rank test.
Results
Survey responses were obtained from 170 students before the course and 65 students afterward. Upon completing the course, students showed significantly increased academic interest in radiology ( P = .008) and a heightened perception of the effect of radiology on patient care ( P = .04), without a significant change in interest in pursuing radiology as a career. Students showed an overwhelmingly positive response to the course, although some noted that previous anatomy training would have been helpful. Eighty percent agreed or strongly agreed that the flipped-classroom structure was an effective educational model.
Conclusions
Our study demonstrated that students were very excited to gain exposure to radiology early in their medical school curriculum, and such exposure led to an improved perception of the field.
Introduction
Medical school curricula regularly undergo review and revision to stay current and relevant, a process necessitated by a growing body of scientific knowledge, evolving roles of medical providers, and expansion of technology within health-care delivery. The curriculum at the University of Michigan Medical School was recently revamped, enabling the inclusion of increased exposure to radiology, particularly in the first and second years of the 4-year program.
Traditionally, at most American medical schools, students do not receive significant exposure to radiology until their later clinical years, when they may enroll in an elective radiology rotation, as only a small number of schools have required medical imaging content taught by radiologists . However, previous research suggests that basic attitudes concerning radiology are created early in medical school and remain mostly unchanged throughout despite a later radiology elective . Furthermore, despite the increasing use of imaging for patient care, completing a rotation in radiology is required in only about 25% of US medical schools . Nevertheless, a majority of students express the desire to learn how to interpret radiographs and cross-sectional imaging studies . As the growing importance of and the desire for medical student proficiency in diagnostic radiology are recognized, there is much interest in the development of effective models for earlier and more robust incorporation of radiology within the medical school curriculum. This can be challenging, however, as radiology is an interdisciplinary subject, sitting at the intersection of anatomy, physiology, and pathology, and preclinical medical students may not have the background in these other related disciplines to appreciate the role of imaging.
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Methods
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Course Design
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Quiz and Examination
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Data Collection and Analysis
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Results
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Precourse Survey
Baseline Knowledge
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TABLE 1
Precourse Survey Establishing Baseline Knowledge of Study Participants
Precourse Survey ( n = 170) How much do you know about the specialty radiology? I’ve never heard of radiology. 0 (0.0%) I have barely been introduced to radiology. 81 (47.7%) I am about as familiar with radiology as with any other specialty. 80 (47.1%) I know a lot about radiology. 8 (4.7%) I know more about radiology than any other specialty. 1 (0.6%)
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Pre- and Postcourse Survey Comparison
Perceived Preparedness
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TABLE 2
Comparison of Pre- and Postcourse Survey Results for Parallel Questions
Comparative Pre- and Postquestions Pre ( n = 170) Post ( n = 65)P Value* How ready do you feel to tackle clinical radiology topics as part of the “Diagnostics and Therapeutics” course? I need more background knowledge before studying clinical radiology. 49.4% 46.9% I have sufficient background knowledge. 4.1% 53.1% .873 I’m not sure. 46.5% NA How interesting is the subject matter in radiology? It is worthless to me. 0.0% 0.0% It is dull but important. 8.2% 3.1% It is interesting only as it relates to other areas of medicine. 32.9% 12.3% .008 It is interesting in its own right. 53.5% 69.2% It is downright fascinating. 5.3% 15.4% Are you considering radiology as a career? Not a chance. 5.9% 1.5% Probably not. 44.1% 43.1% Unsure. 32.4% 26.2% .112 I’m considering it. 16.5% 23.1% It is one of my top choices. 1.2% 6.2% How much of an impact does radiology have on patient care? Not important to patient care. 0.0% 1.5% Marginally important to patient care. 1.2% 1.5% .04 Very important to patient care. 49.1% 23.1% Essential to patient care. 49.7% 73.9%
NA, not applicable.
Wilcoxon signed-rank test.
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Academic Interest
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Career Consideration
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Impact on Patient Care
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Postcourse Survey
Curriculum Elements
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TABLE 3
Assessing the Effectiveness of Diagnostics and Therapeutics Course Curriculum Elements
Postcourse Survey Reviewing the online radiology modules and videos beforehand made the classroom sessions more valuable. ( n = 65) Strongly disagree 1 (1.5%) Disagree 3 (4.6%) Neutral 5 (7.7%) Agree 37 (56.9%) Strongly agree 19 (29.2%) The classroom sessions were a valuable way to reinforce and apply the online radiology material. ( n = 65) Strongly disagree 1 (1.5%) Disagree 1 (1.5%) Neutral 6 (9.2%) Agree 31 (47.7%) Strongly agree 26 (40.0%) Overall, the use of both online resources and classroom sessions was more valuable than a traditional lecture. ( n = 65) Strongly disagree 2 (3.1%) Disagree 3 (4.6%) Neutral 8 (12.3%) Agree 28 (43.1%) Strongly agree 24 (36.9%) Relative to other materials in medical school, how difficult did you find topics in radiology? ( n = 64) Easier than most other materials 14 (21.9%) About the same as most other materials 43 (67.2%) More difficult than most other materials 7 (10.9%)
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Examination Results
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Thematic Analysis
Precourse Survey
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Postcourse Survey
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Discussion
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Preclinical Student Preparedness for Learning Radiology
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Innovative Curriculum Elements
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Thematic Analysis of Free-text Survey Responses
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Limitations of the Study
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Conclusions
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