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The purpose of this study is to analyze the significance of specific factors in choosing radiology as a specialty compared to switching to/from a different specialty as reported in the Graduation Questionnaire (GQ) and Matriculating Student Questionnaire (MSQ) data provided by Association of American Medical Colleges.The study cohort included students who completed both the MSQ and GQ questionnaires in the span of 3-5 years. The cohort was divided into three groups-"Committed" (students who chose radiology in both the first and final year of medical school), "Switched Away" (students who chose radiology on the MSQ but later switched to a different specialty, and "Switched-To" (students who chose radiology on GQ after initially selecting an alternate specialty on the MSQ).Of 1965 students who chose radiology between the years 2013 and 2016, 281 were Committed, 625 Switched-Away, and 1059 Switched-To. There were significant differences among the groups for salary, length of residency, and work-life balance factors. In the Switched-Away group, more students were influenced by length of residency (18% vs. 5%, p0.001) and fewer were influenced by salary (21% vs. 30%, p=0.004) or work-life balance (54% vs. 66%, p = 0.001) when compared to the Committed group. The Switched-To group did not significantly differ from the Committed group (all p0.05) for length of residency (6% vs. 5%), salary (30% vs. 30%) and work-life balance (69% vs. 66%).The data provide insight into factors that influence medical students to initially commit to, switch away from, and switch to radiology during medical school. Understanding these dynamics can inform mentors to guide medical students who are interested in a radiology career.

The Association of Program Directors in Radiology (APDR) regularly surveys its members to gather information regarding a broad range of topics related to radiology residency. The survey results provide insight into the opinions of residency program leadership across the country.This is an observational cross-sectional study using a web-based survey posed to the APDR membership in the fall of 2017. The final survey consisted of 53 items, 48 multiple choice questions and five write-in comments. An invitation to complete the survey was sent to all 319 active APDR members.Deidentified responses were collected electronically, tallied utilizing Qualtrics software, and aggregated for the purposes of analysis and reporting at the 66th annual meeting of the Association of University Radiologists. The response rate was 36%.Over the past 16 years, more PDs have assistant and APDs to administer growing residency programs, but the time allocation for these APDs has come from the PD's protected time. An overwhelming majority of PDs consider independent call beneficial to residents and most think a call assistant is desirable. The vast majority of PDs support a unified fellowship match and allow resident moonlighting. Most fourth year residents are actively or moderately involved in clinical work and teaching. The majority of PDs have lost or expect to lose DR training positions to the new IR/DR programs. In a competitive match, PDs do not rely on residency interviews in their selection process.

Rationale and Objectives Competency in ultrasound (US) imaging and US-guided procedures is often difficult for medical students and residents to master. The use of simulation training has been strongly encouraged but the quality of phantom models available for US-guided procedures is limited. As a feasible alternative, we describe the innovative use of a lightly embalmed cadaver for realistic practice of common interventional radiology (IR) procedures prior to direct patient care. Materials and Methods Lightly embalmed cadavers were positioned as patients would be in the IR suite: supine, prone, and erect seated position. Lidocaine was injected and visualized under standard percutaneous techniques and sonographic guidance was used to simulate common US-guided procedures performed in IR including liver biopsy, kidney biopsy, thoracentesis, and vascular access. Results The ability to position cadavers was a key factor that allowed entire procedures to be simulated. Medical students with very limited exposure to US imaging and diagnostic radiology residents with minimal exposure to US imaging successfully completed common US-guided procedures. Arterial and venous vascular access was obtained. Wires were passed and catheters easily placed via both access sites. The texture of the tissue layers provided realistic feedback for the trainees as they advanced the needle or dilated the tissues. Images from each simulated procedure resembled images expected in a living patient. Conclusion Lightly embalmed cadavers are an innovative and feasible tool to simulate common IR US-guided procedures in a realistic fashion for deliberate practice in advance of first-attempt encounters with patients.

Rationale and Objectives We created a radiology Escape Room, a competitive game where a team of players must discover clues and solve a mystery to escape a “locked” room. To succeed, players must collaborate and think critically and creatively. Our objectives were to provide a novel team-building activity, teach interesting content about radiology as a specialty, cultivate grit, and share the game with other programs. Materials and Methods Escape Rooms were held during orientation (BOOT Camp) for incoming radiology residents and for upper level residents and faculty with advanced content (four teams totaling 20 residents and faculty). We repeated the Escape Room 27 times for 144 residents from more than 10 countries at Radiological Society of North America (RSNA) 2018. Results Players were engaged and competitive. They were able to connect the activity to their future responsibilities – analyzing knowledge under pressure (being on call), communicating effectively (conveying results and recommendations), having the dexterity and motor skills required for physical puzzles (hand-on procedures), being able to multi-task and come up with differential diagnoses under extreme stress and time pressure (being on call). A post-RSNA survey confirmed satisfaction with the activity, with overall enjoyment receiving the highest rating. Conclusion It is feasible to create a portable, inexpensive Escape Room as a novel educational platform for radiology residents. Combining knowledge-based challenges and technical skills in a live-action game simulated a real-life situation in which vital patient information must be collected and reported concisely and accurately. A Game Guide is available to program directors and medical educators upon request.

Rationale and Objectives The Association of Program Directors in Radiology (APDR) surveys residents' educational experiences, work responsibilities, and benefits to support radiology residency programs and their directors. Materials and Methods This is an observational cross-sectional study using three Web-based surveys posed to the APDR membership in the spring of 2013 (March 7–29, 2013; 44 items), the fall of 2013 (October 24 to November 15, 2013; 36 items), and the spring of 2014 (March 3–21, 2014; 49 items) on the American Board of Radiology (ABR) Core examination, organization of Clinical Competency Committees (CCCs), fellowship match, and interventional radiology (IR)–diagnostic radiology (DR) training programs. Results Responses were collected electronically, results were tallied using SurveyMonkey software, and qualitative responses were tabulated or summarized as comments. Findings were reported during the 60th and 61st annual meetings of the Association of University Radiologists, respectively. The maximal response rate was 35% in the spring 2013, 39% in the fall 2013, and 39% in the spring 2014. Conclusions With the ABR Core examination, radiology educators increasingly included multiple choice questions in teaching conferences. "Boards frenzy" was alive and well. The number of programs with a CCC was growing, chaired primarily by the Program Director (PD), with the most commonly used tool being the rotation evaluation. In view of "fellowship frenzy" in the third year of residency, only a minority of PDs were against a fellowship match in the National Resident Matching Program (NRMP). The majority of respondents replied that the new IR/DR pathway would negatively affect the DR residency.

Transition from the role of passive student to medical practitioner begins with learning the first clinical skill. This transition can be stressful for those experiencing it and to some extent by those coordinating it. Logistically, it requires demonstration of the techniques to the entire class by a single practitioner or to smaller groups of students by multiple practitioners. The former reduces the opportunity for close observation of technique and is less conducive to questions, while the latter requires multiple practitioners, which can be prohibitive given their already dense schedules. To reduce the stress for all involved and to maximize learning opportunities, an innovative approach to teaching the first skill, vital signs measurement, was developed. Small group instruction and practice were facilitated by senior medical student volunteers in a simulated outpatient clinic using actual equipment. Instruction was provided in a relaxed, but guided format. Students were provided with a lesson plan that detailed both, technique and brief physiology points, as well as check sheets to use during the lab and later as a refresher guide. The lesson plan, instructions for facilitators, and student check sheets were developed by a senior medical student and reviewed by the course faculty. Recruitment and briefing of student facilitators and conduct of the lab were also performed by the senior student. The purpose of this trend article is to describe the development of a new course format and to report our experience with implementation of the new format. It is intended to spark interest in applying similar approaches to other curricular issues.

We implemented team building activities to build a better resident during our orientation process and we have refined the choice of activities each year since. Resident satisfaction with their team building actives provided feedback to improve the following years' experience. While there is no definite way to demonstrate the effectiveness of our team building initiative, our expectation is it will improve the residency experience and work environment, and ultimately, result in better patient care. We focus on five aspects of team building - personal history sharing, creativity and imagination, common bonds, cooperation, and shared experience. The purpose of this paper is to recommend activities in each of these areas based on our experience.

Rationale and Objectives The Association of Program Directors in Radiology (APDR) conducts an annual survey to monitor and evaluate issues pertaining to radiology residents' educational experiences, work responsibilities, and benefits. Data are used to identify emerging trends and patterns of change to plan and provide resources that support radiology residency programs and their directors. Materials and Methods The APDR Annual Survey Committee selected 59 items for an observational, cross-sectional study using a Web-based survey. Topics of interest included program director satisfaction, resident recruitment, social media, program requirements, curriculum, the new American Board of Radiology exam process, call, and residents-as-teachers programs. All active APDR members (n = 296) were invited to participate in survey between February 20 and March 11, 2011. Results The response rate was 47% (140 of 296). Descriptive results were tallied using SurveyMonkey software, and qualitative responses were tabulated or summarized as comments. Findings were reported during the 59th annual meeting of the Association of University Radiologists. Conclusions Data generated by the annual survey enable the APDR to accrue data pertaining to residents' real-time educational experiences. In 2011, program directors were satisfied with their jobs but not convinced that competency-based program requirements had positive effect on residency training. Programs plan to use the Radiological Society of North America and American Association of Physicists in Medicine Web-based physics training modules. Most radiology programs do not have residents-as-teachers programs, nor do they plan to initiate them. During recruitment, programs use an applicant's location as a proxy for true interest in the program, and interest in the program is important for granting interviews and final ranking. Qualified international medical graduate applicants have access to radiology training in the United States and Canada. Almost half of radiology programs have in-house reading by attending radiologists with residents on call. Residency programs have been slow to embrace social media.

A 48-year-old man with a newly diagnosed acute myeloid leukemia developed purpuric rash on day 6 after chemotherapy. Skin biopsy on day 8 demonstrated Grover disease. Triamcinolone treatment started on day 10 with subjective improvement on day 15. Initial FDG PET/CT on day 12 demonstrated rarely seen diffuse skin uptake that was interpreted as technical artifact and repeated on day 16. Accurately reviewing both PET and CT imaging would prevent confusion between diffuse cutaneous hypermetabolic activity and a technical artifact. Grover disease usually affects the trunk and may be related to the elimination of chemotherapy agents by sweating.

Rationale and Objectives Radiology residents must now participate in a learning activity that involves identification and analysis of system errors and implementation of potential solutions. Evidence of participation must be documented in the resident's learning portfolio. Materials and Methods An activity based on adult learning principles was designed for residents to increase their knowledge of health care systems and problems; gain experience in writing a proposal, conducting an investigation, and reporting results; organize and present information in a supportive environment; and document participation in their portfolio. Postgraduate year 2 residents identify a systems problem. A written proposal is required and must include a “plan” that includes a hypothesis, a methods section that explains what they will “do” as an intervention, a “study” that involves collection and analysis of relevant data, and a systems change or “act.” Proposals approved by the program director are presented to the radiology department. Residents complete projects, evaluate their effectiveness, and present their results by spring of postgraduate year 3. Results Goals, objectives, and guidelines were written. Assessment tools were identified. From 2006 to 2008, nine projects were proposed and conducted by 12 residents. Local and national systems issues were selected, and interventions involved residents, faculty, and medical students. A timeline was imposed to promote sustained effort. Conclusion Opportunities of daily work can be used to teach and learn systems-based practice concepts. Residents can use the scientific method to test effects of change on health care systems. Relevant and practical projects enable residents to learn while improving their clinical and learning environments.

Standardized participants (SPs) can greatly enhance high-fidelity simulation. The educational experience becomes more realistic than by simply using a simulator. There is very limited literature about the use of SPs with high-fidelity simulation. This article provides an overview of SP methodology and offers suggestions for integrating SPs into medical simulation scenarios.

This article describes a longitudinal study that took place in a college of nursing with baccalaureate students between 2002 and 2004 at a university medical center. Its purpose was to provide a climate of success for the students yet challenge them to make additional efforts to complete the program. The qualitative section of the study consisted of students answering the following open-ended questions: (1) Describe ways that faculty can help you be successful in the future and (2) What can you do for yourself to achieve the goal of finishing the program? Students identified what change could be made in the classroom, how increased study time and skills might help, and how self-care would facilitate success. Descriptions were shared with faculty and students in an effort to improve classroom delivery, provide study tips to students, and help students become aware of increased self-care. Students as future nurses, enter practice and care for patients who will need the best care and self-care instruction. Using techniques that students identified to be successful, making efforts through hard work (increased study skills), and realizing how to better care for themselves could assist RNs in providing comprehensive and best care to patients.

Introduction Simulated learning in medical education has been shown to enhance traditional methods of learning. In a safe simulation environment, learners are exposed to real-world situations in order to gain knowledge and experience. This learning opportunity will provide a uniform foundation in the basics of communication and procedural skills while addressing many ACGME Program Requirements for radiology residents. Methods This resource provides instructors with four pediatric radiology clinical scenarios for use in a simulation lab for radiology residents. The purpose of these simulation scenarios is to provide a realistic experience for residents to acquire competency in the diagnosis, management, and communication regarding common pediatric clinical encounters on call. Through these experiences, residents gain comfort with common but challenging clinical scenarios, including intussusception diagnosis, management plan, and parent consent; gastrojejunostomy (GJ) tube dislodgement treatment plan and parent education; hip effusion consultation with emergency department physician and aspiration plan; and contrast reaction simulation with mannequin. This course relies on standardized participants and advanced simulation equipment, as well as faculty or qualified simulation staff to oversee the simulations. Results In 2012, first-year (n = 6) and second-year (n = 6) residents attended the half-day course early in the academic year. As part of an IRB-approved research project, we evaluated the effectiveness of these simulation cases examining data from the residents, who took 18-item pretest and posttest surveys addressing self-perception of mastery. Comparing composite scores for residents' self-ratings on questions 1-10 between pre− and postsimulation training showed statistically significant improvement (p < .001). The median postsimulation score was 3.80, while the median presimulation score was 3.10. Similarly, the median composite score of 4.00 for basic knowledge items (questions 15-18 completed by residents) postsimulation was significantly improved over the presimulation median score of 3.00 (p = .016). The outcomes from the station checklists comparing first− and second-year residents showed the median GJ tube score was 6.00 for second-year residents, a significant difference from the median score of 3.50 for first-year residents (p = .002), indicating progressed skills for more advanced residents. Discussion These results suggest that this introductory simulation workshop is feasible and is an effective method for teaching initial skills in pediatric radiology to first− and second-year residents. To date, the course hasn1t evaluated the durability of knowledge learned. There is no follow-up testing or review of the skills administered at a later date, which is a potential weakness.

With increasing volumes of complex imaging cases and rising economic pressure on physician staffing, timely reporting will become progressively challenging. Current and planned iterations of PACS and electronic medical record systems do not offer workflow management tools to coordinate delivery of imaging interpretations with the needs of the patient and ordering physician. The adoption of a server-based enterprise collaboration software system by our Division of Nuclear Medicine has significantly improved our efficiency and quality of service.

Background: Training in empathy and compassion can foster altruism in medical students. Description: To use the drama Wit in an experiential learning module for first-year medical students. Students and faculty received tickets to a Wit performance. Students heard a pre-play lecture on end-of-life care and attended a post-play discussion with the cast. Each attendee completed an evaluation survey for the Wit Educational Initiative, and site-specific responses were computed. Students reflected on their experience in an e-mail dialogue with clinical faculty. Students could also earn extra credit by completing a written assignment. Evaluation: Attendance was excellent-99% of the class and 59% of their preceptors. Most rated the performance as "excellent" or "very good" and reported they were moved emotionally. Reflecting on the performance, students admired the "science" of medicine but found the "art" of medicine lacking. Conclusion: When used effectively, theater can be used to promote attitude change.

Background: When empathy was presented in a lecture, medical students did not appreciate the topic or have opportunities to practice empathic techniques. The Patient Navigator Project was designed to foster understanding of a patient’s experiences and encourage empathic communication. Methods: The project uses experiential learning in an outpatient setting in the first year of training. Each student was to “shadow” a patient during a visit to a surgical oncologist and could observe the patient throughout treatment. Patient consent was obtained. Assignments were made before the appointments. Afterward, students met in small groups to reflect on their experiences. Results: Patients were willing to let medical students observe their care. Most students reported a positive learning experience and that they learned to see patients as people, not as numbers or diseases. Conclusions: Requiring individualized patient-centered activities in the preclinical curriculum is challenging owing to the large number of students and the unpredictable nature of patients.

The pool of qualified nuclear medicine (NM) physicians is declining as fewer choose to enter the specialty. In June 2012, we began developing an integrated categorical residency training position satisfying the requirements of both the American Board of Radiology (ABR) and the American Board of Nuclear Medicine (ABNM). Termed "NuRad," this was listed and filled in the 2013 NRMP match. We found it to be more attractive to qualified applicants than our traditional, three year NM residency. This approach may play a significant role in the future in ensuring the training of physicians expert in NM and molecular imaging.

The Association of Program Directors in Radiology (APDR) surveys residents' educational experiences, work responsibilities, and benefits to support radiology residency programs and their directors.This is an observational cross-sectional study using three Web-based surveys posed to the APDR membership in the spring of 2013 (March 7-29, 2013; 44 items), the fall of 2013 (October 24 to November 15, 2013; 36 items), and the spring of 2014 (March 3-21, 2014; 49 items) on the American Board of Radiology (ABR) Core examination, organization of Clinical Competency Committees (CCCs), fellowship match, and interventional radiology (IR)-diagnostic radiology (DR) training programs.Responses were collected electronically, results were tallied using SurveyMonkey software, and qualitative responses were tabulated or summarized as comments. Findings were reported during the 60th and 61st annual meetings of the Association of University Radiologists, respectively. The maximal response rate was 35% in the spring 2013, 39% in the fall 2013, and 39% in the spring 2014.With the ABR Core examination, radiology educators increasingly included multiple choice questions in teaching conferences. "Boards frenzy" was alive and well. The number of programs with a CCC was growing, chaired primarily by the Program Director (PD), with the most commonly used tool being the rotation evaluation. In view of "fellowship frenzy" in the third year of residency, only a minority of PDs were against a fellowship match in the National Resident Matching Program (NRMP). The majority of respondents replied that the new IR/DR pathway would negatively affect the DR residency.

Active, independent, self-directed learning requires motivation, or a willingness to exert high levels of effort toward educational goals, conditioned by individual need. Motivation may be a function of individual differences or induced by situational constraints. Archer (1994), who used goal orientation to conceptualize university student motivation, theorized that students would exhibit a preference for either mastery orientation (desire to develop competence/increase understanding), performance orientation (desire to demonstrate competence/ability), or academic alienation (no concern for developing competence or demonstrating achievement). The purpose of this study was to identify and validate an instrument that would measure goal orientation preferences of students in health professions programs. The authors administered Archer's survey to a sample of medical, nursing, and pharmacy students to determine if the instrument was appropriate for this population. Results demonstrated that goal orientation preference could be measured in these students and confirmed the instrument's reliability and valid use for these populations.

Introduction ACGME-accredited programs are required to monitor and track graduate performance, but few measures exist beyond board certification examinations. As alumni surveys have been identified as an indicator of the caliber of a program, the Institutional Alumni Survey (IAS) was developed as an additional measure. Postgraduation reflection on one's education, especially in comparison to graduates from other programs, provides a unique assessment of program quality. Graduates who have recently entered practice are able to compare and contrast their training with the realities of medical practice and national standards. The IAS is a GME tool to collect data from physicians who are recent graduates of ACGME-accredited residency and fellowship programs, regardless of medical specialty. Methods The IAS is a self-assessment tool designed for online administration using a commercially available survey sponsor. It measures satisfaction with preparation for practice, adequacy of training, general competence, career satisfaction, and pursuit of nonclinical activities such as teaching and research. Two subscales compose this measure: (1) Preparedness & Training Adequacy, and (2) Confidence & Support. Four free-text questions are included to encourage candid comments about program strengths and weaknesses and to solicit suggestions for improvement. The survey can be completed in approximately 15 minutes. Results Over a 4-year period, the IAS proved to be feasible, cost-effective, and an efficient use of resources. Pooled response data increase the potential for valid and reliable results from the IAS. Internal reliability using Cronbach's alpha was good for the subscales (0.83 and 0.73). Construct validity included use of an expert panel and relating the subscales to the overall career satisfaction question. Discussion The IAS has supported program directors who have limited time and resources to develop new assessment tools. When the sponsoring institution provides the human and technical resources to conduct the survey and report the results, programs needed only to provide a list of targeted alumni with contact information. Descriptive data generated by the IAS during an annual institutional survey can identify training strengths and areas for improvement and inform the educational program improvement process at both the program and institutional levels. The IAS also may function as a tool for institutional oversight, providing tracking data, and evidence of longitudinal quality improvements.

Residency recruitment is a critical and expensive process. A program's Web site may improve recruitment, but little is known about how applicants use program sites or what constitutes optimal content. The importance of an interview day and interactions with a program's residents has been described, but candidate preferences for various activities and schedules have not been widely reported. We investigated contemporary use and perceived utility of information provided on radiology program Web sites, as well as preferences for the interview day experience.Using an anonymous cross-sectional survey, we studied 111 candidates who were interviewed between November 1, 2012 and January 19, 2013 for a diagnostic radiology residency position at our institution. Participation in this institutional review board-approved study was entirely voluntary, and no identifying information was collected. Responses were sealed and not analyzed until after the match.A total of 70 candidates returned a completed survey (63% response rate). Optimal content considered necessary for a "complete" Web site was identified. The most important factor in deciding where to apply was geographical connection to a program. "AuntMinnie" was the most popular source of program information on social media. Candidates overwhelmingly preferred one-on-one faculty interviews but had no preference between a Saturday and weekday schedule. The ideal interview experience should include a "meet and greet" with residents off campus and a personal interview with the program director. The overall "feel" or "personality" of the program was critical to a candidate's rank order decision.Our findings offer insight into what factors make programs appealing to radiology applicants. This information will be useful to medical educators engaged in career counseling and recruitment.

The Association of Program Directors in Radiology (APDR) conducts an annual survey to monitor and evaluate issues pertaining to radiology residents' educational experiences, work responsibilities, and benefits. Data are used to identify emerging trends and patterns of change to plan and provide resources that support radiology residency programs and their directors.The APDR Annual Survey Committee selected 59 items for an observational, cross-sectional study using a Web-based survey. Topics of interest included program director satisfaction, resident recruitment, social media, program requirements, curriculum, the new American Board of Radiology exam process, call, and residents-as-teachers programs. All active APDR members (n = 296) were invited to participate in survey between February 20 and March 11, 2011.The response rate was 47% (140 of 296). Descriptive results were tallied using SurveyMonkey software, and qualitative responses were tabulated or summarized as comments. Findings were reported during the 59th annual meeting of the Association of University Radiologists.Data generated by the annual survey enable the APDR to accrue data pertaining to residents' real-time educational experiences. In 2011, program directors were satisfied with their jobs but not convinced that competency-based program requirements had positive effect on residency training. Programs plan to use the Radiological Society of North America and American Association of Physicists in Medicine Web-based physics training modules. Most radiology programs do not have residents-as-teachers programs, nor do they plan to initiate them. During recruitment, programs use an applicant's location as a proxy for true interest in the program, and interest in the program is important for granting interviews and final ranking. Qualified international medical graduate applicants have access to radiology training in the United States and Canada. Almost half of radiology programs have in-house reading by attending radiologists with residents on call. Residency programs have been slow to embrace social media.

Mentoring, long recognized as a catalyst for successful careers, is particularly important to the career development of underrepresented minority (URM) faculty. In academic medicine, mentor-protege relationships are seriously threatened by increased clinical, research, and administrative demands and an emphasis on scholarship over citizenship. New mentoring models are needed, and they should be adaptable to a medical school's unique structure and mission. The Peer-Onsite-Distance (POD) model, developed in 2002 by the authors and introduced at the College of Medicine at the University of Arkansas for Medical Sciences, is a targeted, multilevel mentoring prototype that is built on a solid research foundation and tailored to the unique needs of URM medical school faculty. The mentee's individual needs for guidance related to career goals, resources, and the content and interaction skills that are known to be critical to successful academic careers are targeted for development. The multilevel approach provides a unique network of peer and faculty mentors who provide site-specific career guidance. Also in the network are leaders in their fields who can provide access to accurate information, cautions, predictions, and announcements of future resources or potential restrictions in academic medicine. Mentor commitments are clearly defined and time contributions are maximized. The POD model aims to promote retention and advance the careers of URM faculty by wrapping them in a protective cushion of interpersonal and intrapersonal support. The flexibility of the design allows for adaptation to any institution's unique structure and mission.

Rationale and Objectives Systems-based practice (SBP) has been the most difficult competency to implement in radiology residency programs, and methods for teaching and learning SBP concepts are needed. Because systems problems are usually multifactorial, a multidisciplinary approach is required. In our institution, survey data indicated patient dissatisfaction with emergency care. Prolonged wait times for radiology procedures were identified as a systems problem. When hospital administration asked the emergency medicine and radiology departments to work together to improve patient care, residents had a “real-world” opportunity to achieve the SBP competency. Materials and Methods Systems problems were identified and categorized. Data on patient transport were collected. Accurate time logs documenting when studies were ordered, performed, and interpreted were maintained. Data were analyzed at interdepartmental meetings and three improvements were planned and implemented. Results A direct line of communication was established between radiology and emergency medicine via a dedicated cellular telephone. A joint emergency medicine/radiology teaching conference was established. Additional transport personnel were employed. Residents in both departments increased their understanding of their role in the health care system, demonstrated an ability to identify systems problems and appropriately implement improvements, and enhanced their professional relationships. Conclusion This innovative method integrated educational goals with patient care goals, was grounded in “real-life” experience, and held residents accountable for results. Competence in SBP, patient care, professionalism, and interpersonal and communication skills were demonstrated. We recommend this approach as an efficient and effective way to integrate SBP into everyday clinical practice.

Training in empathy and compassion can foster altruism in medical students.To use the drama Wit in an experiential learning module for first-year medical students. Students and faculty received tickets to a Wit performance. Students heard a pre-play lecture on end-of-life care and attended a post-play discussion with the cast. Each attendee completed an evaluation survey for the Wit Educational Initiative, and site-specific responses were computed. Students reflected on their experience in an e-mail dialogue with clinical faculty. Students could also earn extra credit by completing a written assignment.Attendance was excellent--99% of the class and 59% of their preceptors. Most rated the performance as "excellent" or "very good" and reported they were moved emotionally. Reflecting on the performance, students admired the "science" of medicine but found the "art" of medicine lacking.When used effectively, theater can be used to promote attitude change.

Purpose A project to reinforce the professional values that our medical students pledged to uphold at orientation, during their White Coat Ceremony, was undertaken at the University of Arkansas for Medical Sciences. Summary An Introduction to Clinical Medicine (ICM) pin was designed and awarded to students at the end of their 1st year. Three words beginning with the letters ICM were chosen to portray the essential elements of professionalism. The words overlay the symbol of Asclepius, representing "healing," on a red background, which is associated with love, respect, joy, passion, health, and energy. To date, three classes of students and their faculty have received ICM pins. Conclusions Much concern has been expressed about desirable attributes for medical students and physicians, and medical educators have been challenged to help students acquire or change their attitudes related to these attributes. The ICM pin serves as a tangible reminder of this professional development

It is no secret that transitions inmedical education are challengingand inherently stressful. New in-ternsstrugglewithalackofmedicalknowledge, poor organizationalskills, inadequate ability to reflectand self-assess, and underdevelo-ped professionalism, most oftenattributed to a lack of thoroughpreparation in medical school [1-3]. Then, after a year of clinicalpracticeinmedicineorsurgeryoratransitional year, the transition toradiology residency presents a newsetofchallenges.Theradiologyres-ident is no longer the the primarycontact in direct patient care anddecisionmaking,butisexpectedtobe an imaging consultant, operat-ing largely behind the scenes in anunfamiliar specialty [4-6]. Few res-idents gain skills and experienceswith imaging modalities and stud-ies during medical school and in-ternship, so they find themselves asnovices once again [7]. Additionalstresses are created by having toadapt to a hospital-based learningenvironmentand,often,anewpro-gram director and set of peers. Ourspecialty’s reliance on the internetanddigitaldevicesforaccessinged-ucational material requires a highlevel of technological savvy [8,9].Thevolumeandcomplexityofnewinformation to be assimilated canparalyze and demoralize any newradiology resident.Research on “resident readiness”suggests the usefulness of focusededucationalinterventionstoimprovethe clinical orientation process andincrease residents’ confidence [2,6,7,10-13].Asmallbutgrowingcollec-tion of literature has focused on“boot camps,” which are being usedin graduate medical education tomaximize fundamental teachingtime while fostering team building[5,11].Colloquially, “boot camp” refersto military recruit training as anabrupt,oftenshockingtransitiontoanew way of life, with strict disciplineand an emphasis on hard work andphysical conditioning. Companiesalso use boot camps to immerse re-cruitsinbothtechnicalskillsandcor-porateculture.Asaresult,therecruitsdevelop strong bonds to their peersand the organization [14]. Havingpeerstheycanrelyonhelpsresidentscopeandalleviatessomeofthenega-tive effects of high stress levels.The literature on preparation andreadiness for radiology is sparse butemerging. One program’s lecture se-ries designed specifically for incom-ing residents resulted in an increasein residents’ confidence (althoughclinical performance improvementcould not be demonstrated) [7].Inanotherprogram,theadditionofres-ident-to-resident role-oriented pre-sentations decreased anxiety andincreased role awareness more thanlectures alone [6].

Purpose: In 2012-13, 27% of Radiology residents and 15% of VIR fellows were women. Survey data from the ACR show that 3.1% of all practicing radiologists who consider IR their primary specialty are women. The percent of current women members in the SIR is 9%. A recent article in Academic Radiology by Blake et al recommended that IR rotations for residents be limited during pregnancy as accumulated exposure from these cases may be unpredictable. This recommendation is based on information regarding institutional policies rather than exposure data. A literature review revealed no quantitative data regarding exposure to female IR workers to support or refute this recommendation. The purpose of this study is to investigate radiation exposures in our busy academic IR/neuroIR practice to determine whether exposures for pregnant and non-pregnant female IR workers exceed allowable values. Materials and Methods: A two-year retrospective review of radiation exposures to declared pregnant and nonpregnant female IR workers was performed. This study was IRB exempt as the exposure records are mandatorily collected and de-identified by the Radiation Safety Officer. Exposures to the outside collar and inside waist badges were examined. Results: There were 12 declared pregnancies, 10 in nonphysicians, and 2 in a full-time IR physician, during the review period. The average collar and waist badge exposures over the entire 10 months of pregnancy for all nonphysicians were 310 mrem (138-467 mrem) and 18.6 mrem (3-38 mrem) respectively. The average collar and waist badge exposures for the physician were 2507 mrem and 47.5 mrem respectively. During the review period, there were 10 non-pregnant female workers – 9 non-physicians and 1 physician. The average monthly collar exposure over this period was 46.9 mrem (1-372 mrem) for non-physicians and 864.9 mrem (2-2022 mrem) for the physician. Conclusion: Data from this study demonstrate that no pregnant or non-pregnant female IR workers exceeded allowable radiation exposure limits suggesting that IR rotations do not need to be limited for pregnant residents due to radiation concerns. To our knowledge, this is the only study to report actual exposure data for female IR workers.

Objective Although residents are expected to assume teaching responsibilities, the traditional medical school curriculum does not formally prepare students for the teaching role. In 1999 an elective was developed to provide senior medical students with opportunities to acquire instructional and leadership skills by participating in clinical education activities as a clinical skills center attending. This elective also allowed the senior student to explore academic medicine as a potential career choice. Description During the four-week elective, a senior student acted as an attending in the clinical skills center (CSC), a state-of-the-art facility that is designed and equipped for teaching and testing medical skills. (The CSC has ten fully operational patient examining rooms for student-patient interaction, and each room is equipped with dual cameras and two-way audio response capability.) The participating student spent approximately 40 hours per week teaching clinical skills to freshmen, sophomore, and junior medical students and assisting with testing activities for the Colleges of Medicine, Pharmacy, and Nursing. A specific requirement for full credit was writing an objective standardized clinical examination (OSCE) case. The case format required development of a checklist for minimal competencies of the examinee and suggested techniques for evaluating those competencies. Another specific requirement was that the senior student participate in the training of standardized patients to portray one or more OSCE cases. Other activities were tailored to meet the needs of the senior student and/or users of the CSC. Two course co-directors provided guidance for all students. Evaluation was on a "pass/fail" basis. There were no written or oral exams. The purpose of the elective was achieved through individual research and completion of the assigned activities. Discussion This elective was first offered to senior medical students at during 1999-2000. Each student participated in an average of ten teaching sessions or assessments. To date, six senior students, five women and one man, have completed the elective. These students entered family medicine, pediatrics, internal medicine, psychiatry, and surgery residencies. Participants were asked to rate the elective using a five-point Likert-type scale with 5 signifying "strong agreement." The response rate was 67%. These students felt the requirements were adequate (4.75) and said they would recommend it to other senior students (4.75). They agreed that the objectives were clear and attainable (4.5) and that it better prepared them to teach as resident (4.25). Areas of weakness identified were the elective's ability to increase the student's understanding of medical education (3.75) and meet the student's expectations (4.0). The organization of the elective (4.0) could be improved as well. Most participants were interested in academic medicine before (4.25) and after (4.75) the experience. We plan to follow these students over time to see what careers they eventually pursue. Although our experience is limited and the student population is small, we believe the elective is an effective method for developing teaching skills and helping the upper-level medical student who is interested in education to better understand the nature and function of academic clinical medicine.