Rationale and Objectives
To improve resident oral case communication and preparatory skills by providing residents an opportunity to prepare for and conduct a new interdisciplinary Radiology-Pathology (Rad-Path) conference series.
Materials and Methods
To assess whether conference goals were being achieved, we surveyed trainees and attendings in the radiology and pathology departments. Percentages were examined for each variable. Mann-Whitney U test for ordinal variable significance was applied to determine statistical significance between radiology trainee and attending survey responses.
Results
Most surveyed radiology trainees (57.1%) strongly agreed or agreed with: “I wish I felt more comfortable with oral presentations.” Sixty-five percent of radiology attendings (34 of 52) either agreed or strongly agreed that the residents should be more comfortable with oral case presentations. Of resident Rad-Path conference presenters, 69% (9 of 13) either agreed or strongly agreed that the conference improved their confidence and/or ability to present case information orally. Of responders who attended at least one Rad-Path conference in person, 83% of residents (19/23) and 61% (17/28) of attendings agreed or strongly agreed that the conference improved their ability to formulate a differential diagnosis. Using the Mann-Whitney U test, no significant difference was found between radiology trainees and attendings’ responses.
Conclusions
Our Rad-Path correlation conference was specifically designed and structured to provide residents with focused experience in formal oral case preparation and presentation. We consider our conference a success, with 69% of resident presenters reporting that the Rad-Path conference improved their confidence and/or ability to present case information orally.
Introduction
Communication skills, and specifically the art of case presentation, have been a focus of resident education throughout the history of the field of radiology. Indeed, the oral board examination format was previously a test of those skills. With the recent shift to an exclusively “written” board examination format, resident teaching and preparatory activities, particularly those targeting senior residents, have taken a different form both at our institution and anecdotally, nationwide. At a time when our value as radiologists hinges not on the number of reports we produce but rather on our ability to improve patient outcomes by communicating more effectively with patients and referring clinicians, there is an increasing need for focused educational activities to strengthen these skills in our residents.
In the Fall of 2014, we initiated a Radiology-Pathology (Rad-Path) correlation conference series specifically designed to provide residents an opportunity to independently prepare for and conduct an interdisciplinary conference. The major goal was to improve resident case communication skills and case preparatory skills. Expected secondary goals were to expand our residents’ ability to formulate differential diagnoses and to promote their appreciation of radiology and pathology as interrelated and often codependent disciplines.
Materials and Methods
Conference Organization
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Conference Preparation
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Table 1
Resident Rad-Path Conference Responsibilities
Organizing Radiology Resident (PGY3) Literature Review Radiology Resident (PGY3 or 5) Pathology Resident Presenting Radiology Resident (PGY 5) One month prior to conference Selects cases and prepares PowerPoint presentation
Meets with subspecialty radiology faculty mentor NA Receives case information from the organizing resident
Prepares pathology case slides, differential diagnosis, and discussion
Meets with the designated subspecialty pathology faculty mentor NA One week prior to conference NA Meets with faculty mentor to finalize and practice presentation Meets with faculty mentor to finalize and practice presentation Blinded to the case diagnosis: receives anonymized PowerPoint from the organizing resident
Prepares case discussion and differential diagnosis
Meets with conference chair to finalize and practice presentation Conference day Serves as conference moderator; mediate discussion Presents scholarly discussion for each case Presents pathology slides, differential diagnosis, discussion, and the final pathology diagnosis Provides a focused, clear discussion of each case with a weighted differential diagnosis, including most common or likely diagnosis, and “zebras”
Receives questions and feedback from audience
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The Conference
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Assessment
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Table 2
Radiology Attendings and Trainees’ Experience with Rad-Path Conference
Questions Number PercentBoth attendings and traineesHave you attended the Rad-Path conference? Yes 51 59 No 36 41What is your level of training? PGY2 9 10.3 PGY3 6 6.9 PGY4 7 8.0 PGY5 6 6.9 Fellow 7 8.0 Attending 52 59.8Rad-Path conference increased my appreciation for the field of radiology. Strongly agree 16 31.4 Agree 22 43.1 Neither 8 15.7 Disagree 3 5.9 Strongly disagree 2 3.9Rad-Path conference increased my appreciation for the field of pathology. Strongly agree 11 21.6 Agree 28 54.9 Neither 8 15.7 Disagree 3 5.9 Strongly disagree 1 2.0Rad-Path conference helped me learn about formulating a differential diagnosis. Strongly agree 8 15.7 Agree 28 54.9 Neither 11 21.6 Disagree 4 7.8 Strongly disagree 0 0Rad-Path conference increased my confidence or ability to speak with clinicians. Strongly agree 5 9.8 Agree 15 29.4 Neither 22 43.1 Disagree 5 9.8 Strongly disagree 4 7.8Trainees onlyRad-Path is a “resident ran” conference, meaning that I had a significant amount of autonomy in devising the presentation. Strongly agree 7 53.8 Agree 4 30.8 Neither 2 15.4 Disagree 0 0 Strongly disagree 0 0Participating in Rad-Path conference increased my confidence and/or ability to present case information orally. Strongly agree 6 46.1 Agree 3 23.1 Neither 3 23.1 Disagree 1 7.7 Strongly disagree 0 0I wish I were more comfortable giving oral presentations. Strongly agree 5 14.3 Agree 15 42.9 Neither 10 28.6 Disagree 5 14.3 Strongly disagree 0 0Attendings onlyThe residents ought to be more comfortable giving oral presentations. Strongly agree 20 38.5 Agree 14 26.9 Neither 16 30.8 Disagree 2 3.8 Strongly disagree 0 0
Rad-Path, Radiology-Pathology.
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Results
Respondents
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Context
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Table 3
Radiology Attendings and Trainees’ Perceived Competence by Board Format
How Has the New Radiology Board Examination Format (ABR Core Examination) Altered the Ability of 4th Year Residents to Take Cases? Number Percent Significantly LESS capable than oral board preparation 11 28.9 Slightly LESS capable than oral board preparation 17 44.7 About the same as oral board preparation 10 26.3 Slightly MORE capable than oral board preparation 0 0 Significantly MORE capable than oral board preparation 0 0
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Participants
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Attendees
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Discussion
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Acknowledgments
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References
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2. Linaker K.L.: Pedagogical approaches to diagnostic imaging education: a narrative review of the literature. J Chiropr Humanit 2015; 22: pp. 9-16.
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5. Jafri N.F., Nadgir R., Slanetz P.J.: Student-facilitated radiology-pathology correlation conferences: an experiential educational tool to teach multidisciplinary patient care. J Am Coll Radiol 2010; 7: pp. 512-516.