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Teaching Radiology Trainees From the Perspective of a Millennial

The millennial generation consists of today’s medical students, radiology residents, fellows, and junior staff. Millennials’ comfort with immersive technology, high expectations for success, and desire for constant feedback differentiate them from previous generations. Drawing from an author’s experiences through radiology residency and fellowship as a millennial, from published literature, and from the mentorship of a long-time radiology educator, this article explores educational strategies that embrace these characteristics to engage today’s youngest generation both in and out of the reading room.

Background

MMost of today’s radiology trainees belong to millennial or Generation Y. The term millennial generation was first used by William Strauss and Neil Howe in 1991 . Although precise definitions of the generation vary, demographic studies sometimes categorize Americans born between the years 1982 and 2001 as millennials . My 1

1 Although one of the authors (M.H.S.) technically belongs to a different generation, this article is written primarily by and in the voice of the millennial author (P.-H.C.).

generation grew up with the explosion of technology in daily life, immersed in always-on notifications, social media, and memes, and my childhood memories were punctuated by the 9/11 terrorist attack, the war in Iraq, and school violence. Today, we have entered the workforce en masse , surpassing Generation X to become the largest employed American age group according to Pew Research Center . In academic radiology, my generation now comprises your medical students, residents, fellows, and junior staff.

Millennials crave active engagement, multimedia learning, and continuous feedback . Therefore, much published work exists on how to innovate modern education for these needs. In a flipped classroom, students prepare outside of class and focus in-class learning on critical thinking . An abundance of “podcast” lectures—prerecorded audio or video discussing a focused topic—and educational websites brought to life the promise of massive open online classrooms. Digitized lectures personalize learning to the speed of the learner who can repeat, fast-forward, or skip through content . The availability of low-cost personal computers and smart devices enabled computerized simulation and gamification of learning not only in general education but also specifically in interventional and diagnostic radiology . With a myriad of these learning modalities, engaging my generation to learn would seem easier than ever.

However, an overemphasis on technology without considering the millennial learning pattern can backfire. Increasing data show teaching the millennial learner is more than deploying as many of these novel approaches and technology as possible. A survey of millennial medical students shows that when asked to identify the ideal mix of “flipped vs lecture,” only 8% of respondents prefer a 100% “flipped” learning model; in contrast, a majority of the respondents prefer a predominantly lecture-based system . Additionally, although some prefer to watch lecture videos at 1.5× playback speed, evidence shows that higher playback speed correlates with lower knowledge retention .

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TABLE 1

Summary of Our Approaches to Engage Millennial Trainee

Topic Recommendation(s) Set specific goals

Leverage technology to emphasize relevance

Give formative feedback

Create transparent assessments

Encourage self-development

ACGME, Accreditation Council for Graduate Medical Education; MQSA, Mammography Quality Standards Act; SMART, specific, measurable, attainable, realistic, and time-bound.

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Engaging Millennial Radiology Trainees

Set Specific Goals

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TABLE 2

Example of Specific Goals for First-time Rotation Through Body CT

Required RSNA physics radiation dose in CT Select the protocols for 360 CT examinations Start the Basic GU&GI online quiz (to be completed by June of R1 year) Complete SAM on the topic: Administration of Iodinated Contrast Complete Quiz on Contrast Reaction

Strongly Recommended Complete RSNA physics online module: CT Image Quality and Protocols Review the 20 Must See First Year Cases found in the Body CT rotation packet

CT, computed tomography; GI, gastrointestinal; GU, genitourinary; RSNA, Radiology Society of North America; SAM, self-assessment module.

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Leverage Technology to Emphasize Relevance

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Give Formative Feedback

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Create Transparent Assessments

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Figure 1, Example review charts from our custom-created software. Residents are reminded that the displayed data use only submissions through the software and do not include faculty assessment. (a) Cumulative ACGME Milestones (28) . (b) Demonstration of resident progress in the PBL3 Milestone over time. A full description of the inspiration and software design is available in Reference (18) . Dev, developing; Exc, excels; ICS, interpersonal and communication skills; MK, medical knowledge; PBL, practice-based learning and improvement; PCTS, patient care and technical skills; PROF, professionalism; R, residency year; S, semester; Sat, satisfactory; SBP, system-based practice.

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Figure 2, Automated case log software example chart from the perspective of the trainee user, with (a) cumulative mammography volumes for Mammography Quality Standards Act and Program compliance, (b) day-to-day radiography volumes, and (c) an example second year resident's chest computed tomography volume at midyear, displayed alongside historical aggregate resident volumes at the end of each year of residency and associated confidence intervals. Data are available for trainee review on their own computers. Full description of the software design, capabilities, and survey of trainee reception to the software is available in Reference (29) . Avg, average; MSK, musculoskeletal.

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Encourage Self-development

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What Has Not Changed

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Conclusion

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