Rationale and Objectives
Studies show that problems with interprofessional collaboration can result in adverse patient outcomes. These problems are common in the field of radiology, where technology has decreased opportunities for direct communication and collaboration with referring physicians. To our knowledge, critical reflection has not been studied as an intervention to better understand one’s own and/or others’ roles in the context of an interprofessional team, or more specifically, to improve interprofessional collaboration between radiologists and other physicians.
Materials and Methods
We trialed a reflective journaling assignment in our fourth year medical student general radiology elective. Student journal content was scored by percentage of comments reflecting on elective experiences versus recounting events. Content was categorized as “reflection” using an established measurement tool. Reflective content was evaluated to identify common themes.
Results
A total of 31 journals (178 entries and 26,749 words) were analyzed. Reflective content accounted for 43% of overall content and was subdivided into three categories: insight into one’s own role and responsibilities as an ordering physician (20%), insight into a radiologist’s role and responsibilities (12%), and thoughts on improving interprofessional collaboration with radiologists (11%).
Conclusions
Reflective writing allows students to explore their own role and responsibilities in the context of an interprofessional team and may improve interprofessional teamwork with radiologists.
Diminished collaboration between radiologists and other physicians is an unfortunate side effect of computer-based interpretation via picture archiving and communications systems, systems which are now commonplace in most health care systems . Radiologists and other members of the health care team no longer need to gather in the same location to review films, given they are now readily accessible online. Imaging examination results are also increasingly communicated electronically . These trends have caused concern amongst radiologists who worry that their decreased visibility is harming interprofessional collaboration and communication with their physician colleagues . The problem is further exacerbated by the overall poor penetration of radiology education in medical school curricula in the United States ; medical students do not consistently learn about the role of radiologists on the health care team during their education, and that knowledge gap can carry over into clinical practice .
Many studies have demonstrated that problems with interprofessional collaboration can result in adverse patient outcomes . Recognized barriers to effective interprofessional collaboration include 1) problematic power dynamics, 2) poor communication patterns, and 3) lack of understanding of one’s own and/or others’ roles and responsibilities . Studied interventions to improve interprofessional collaboration, such as interprofessional rounds, have focused predominately on improving communication among team members .
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Materials and methods
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Results
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Table 1
Comparison of Planned Residency Specialization for Students Completing the Reflective Writing Assignment
Future Specialty Classroom-Based Elective ( n = 10), n (%) Reading Room–Based Elective ( n = 21), n (%) Anesthesiology 2 (20) 2 (9.5) Emergency medicine 2 (20) 2 (9.5) Medicine 3 (30) 6 (28.6) Obstetrics/Gynecology 0 (0) 1 (4.8) Otolaryngology 0 (0) 4 (19) Orthopedics 1 (10) 0 (0) Pediatrics 1 (10) 1 (4.8) Radiology 0 (0) 4 (19) Surgery 1 (10) 1 (4.8)
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Table 2
Summary of the Content of the Reflective Writing Assignment Categorized by Word Count
Content Categories/Subcategories Classroom Based, n = 10, n (%) Reading Room Based, n = 21, n (%) Total, n = 31, n (%) Reflection 3604 (40) 7963 (45) 11,567 (43) Own role 1466 (16) 3840 (22) 5306 (20) Radiologists’ role 1237 (14) 1981 (11) 3218 (12) Collaboration 901 (10) 2142 (12) 3043 (11) Recounting 4056 (44) 8527 (49) 12,583 (47) Didactic 3619 (39) 4056 (23) 7675 (29) Reading room 437 (5) 4471 (26) 4908 (18) Other 1495 (16) 1104 (6) 2599 (10) Total word count 9155 (100) 17,594 (100) 26,749 (100)
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Discussion
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