Pediatric magnetic resonance imaging training versus job-readiness: using education research tools to re-align.

BACKGROUND: Fellows begin MRI training with variable experience and expertise. To better serve patients, pediatric radiology fellows should gain competence in MRI that enables seamless transition to independent practice. OBJECTIVE: We implemented a needs assessment survey and conducted a focus group discussion to identify knowledge gaps and inform creation of a curriculum for pediatric body MRI. MATERIALS AND METHODS: We electronically distributed a comprehensive anonymous needs assessment survey in October 2016 to current fellows and recent (<5 years) graduates from Accreditation Council for Graduate Medical Education (ACGME)-accredited pediatric radiology fellowships, with follow-up in January 2017. We conducted a focus group discussion among current fellows at our institution in October 2017 to inform a better understanding of the results. RESULTS: Eighty-one pediatric radiologists (8 fellows/73 attendings) completed the survey (24%); 5 current fellows participated in the focus group. The technical issues most commonly identified with limited or no instruction during training included setting up an MR service, accessory equipment (coil) selection and MRI field inhomogeneity correction. Areas needing increased attention and inclusion within the curriculum included coil choice/patient positioning (n=42, 52%), contrast agents (n=40, 49%), field strength (n=33, 41%) and strategies for motion correction (n=33, 41%). Most fellows were uncomfortable with setting up an MR service (n=57, 70%), correcting field inhomogeneity (n=56, 69%) and improving image quality (n=50, 62%). The focus group showed consensus that there was insufficient MR training in residency to prepare them for fellowship. The group also preferred shorter lectures and streaming via video education/tutorials. CONCLUSION: While traditional instruction emphasizes image interpretation, trainees in pediatric radiology need a curriculum that also emphasizes technical and non-interpretive aspects of MRI.

'Walk in my shoes': intradepartmental role shadowing to increase workplace collegiality and wellness in a large pediatric radiology department.

BACKGROUND: Our nearly 500-member department implemented the shadowing program "Walk in My Shoes" to improve intradepartmental relationships and build a stronger sense of community. The program provides both clinical and non-clinical employees an opportunity to shadow colleagues in their various roles and learn more about one another's contribution to the overarching mission of caring for children and their families. The goal of this study was to understand the impact of the shadowing program on employee perceptions of various roles. OBJECTIVE: To bridge the gap of understanding among colleagues in order to strengthen workplace interrelatedness, increase understanding of various roles, and decrease preconceived notions about roles, through shadowing. MATERIALS AND METHODS: A preliminary survey distributed to our department in August 2018 assessed the level of interest in new wellness initiatives, including the shadowing program. The survey gauged which roles participants were interested in shadowing. The survey results revealed that 67 employees were interested in the shadowing program. We selected 39 participants and matched them to a coworker in their area of interest. The roles for shadowing included administrator, Child Life specialist, information technologist, medical assistant, nurse, radiologist, researcher and technologist. Participants were required to complete pre- and post-shadowing surveys to assess their experience. Individuals who hosted the shadow experience also completed a survey. RESULTS: A total of 39 clinical and non-clinical staff members participated in the program. We summarized the pre- and post-survey data using median and interquartile range (IQR) and compared the results using the Wilcoxon signed-rank test. The distribution of preconceived notions about each role was not significantly different between the pre- and post-surveys (P=0.094). However, participants' value, understanding of the role they shadowed, and understanding of how the roles relate to each other were significantly greater (P<0.001). In addition, participants showed great interest in shadowing the specific role again (82%) and shadowing another role (92%). Furthermore, almost all hosts would repeat the experience (96%). CONCLUSION: Our study showed that intradepartmental shadowing can improve clinical and non-clinical staff employees' perceptions and understanding of each other's roles in overall patient care, which in turn contributes to the broader initiative of workplace wellness. The enthusiasm and willingness of the hosts were essential for sustainability of the program and demonstrated that this type of program is feasible in a large, busy department.