Framed and Reframed! The Art of Using Cognitive Behavioral Techniques to Combat Burnout.

The incidence of burnout among radiologists has been increasing exponentially, largely attributed to increased work volumes, expectations for more rapid turn-around times and decreasing interpersonal interactions. While personal wellness activities have been described in the literature, there is little information on the role of cognitive behavioral therapy strategies to mitigate burnout. This manuscript will describe the value of naming automatic negative emotions which can lead to burnout and will provide an overview of strategies that can be used to combat them, using cognitive behavioral therapy techniques.

Perspective on the New IR Residency Selection Process: 4-year Experience at a Large, Collaborative Training Program.

Interventional Radiology (IR) was officially approved by the American Board of Medical Specialties in 2012 and the Accreditation Council of Graduate Medical Education as a unique, integrated residency in 2014. Its establishment and distinction from diagnostic radiology was compelled by the increasing emphasis on clinical care delivery by IRs. The shift in the IR training paradigm, as exemplified in the Integrated IR residency programs, appeals to a distinct cohort of applicants, prompting the need to re-evaluate the recruitment and selection process. This article discusses selection criteria for identifying ideal candidates for the new IR training model (focusing on Integrated IR residency training), highlights the importance of collaboration between the IR and DR selection committees, and illustrates the changes made at a single institution over the course of 4 selection cycles prior to the COVID-19 pandemic as well as significant changes in the current climate of the global pandemic.

RSNA International Trends: A Global Perspective on the COVID-19 Pandemic and Radiology in Late 2020.

The coronavirus disease 2019 pandemic has challenged and changed health care systems around the world. There has been a heterogeneity of disease burden, health care resources, and nonimaging testing availability, both geographically and over time. In parallel, there has been a continued increase in understanding how the disease affects patients, effectiveness of therapeutic options, and factors that modulate transmission risk. In this report, radiology experts in representative countries from around the world share insights gained from local experience. These insights provide a guidepost to help address management challenges as cases continue to rise in many parts of the world and suggest modifications in workflow that are likely to continue after this pandemic subsides.

Adjusted Citation Rate, an Alternative Metric to Measure the Impact of General Radiology Journals.

RATIONALE AND OBJECTIVES: The journal impact factor (JIF) is often used to assess the prestige of scientific journals. Citations from original articles and reviews as well as citations from noncitable items contribute to the numerator in these calculations. However, since noncitable articles are not included in the denominator, the JIF may be skewed by the types of articles and not accurately reflect the prestige of the journal. The purpose of our study was to develop an alternative and complementary metric by which journals may be assessed. This "adjusted citation rate metric" is based on citations that originate only from citable items in the journal. MATERIAL AND METHODS: We tabulated the number of citations and citable items for original articles from the Web of Science Core Collection for 5 consecutive years (2010-2014) for 20 general radiology journals. The adjusted citation rates (CR) per original article and reviews were calculated using only citations that originated from citable items. RESULTS: The adjusted CR in 2015 was similar to the JIF in 14 of the 20 journals, higher in four journals, and lower in two journals. Using this system, Radiology, Investigative Radiology, and European Radiology remained first, second, and third respectively among journals published in the field of general radiology. To allow for equal distribution of original articles vs reviews among general radiology journals, we calculated the adjusted CR where the standard distribution of original articles is 50%. CONCLUSION: Adjusted citation rate is an objective index for assessing journal impact that can serve as an alternative and complementary metric with which to measure the journal impact.

Establishing a Surgical Preliminary Year in the IR Residency: Keys to Success.

The training paradigm of the interventional radiologist has quickly evolved with the approval of the integrated interventional radiology (IR) residency by the American Board of Medical Specialties and the Accreditation Council of Graduate Medical Education. Prior to appointment in an integrated IR program, a resident must complete a preliminary clinical year, which may be surgical, medical, or transitional. The unique procedural- and clinical-based skillset required of the IR resident is best aligned with a surgical preliminary year. The following is a review of the steps to successful creation of a surgical preliminary year based on a single institution's experience.

Lessons on Leadership.

Leadership is increasingly recognized as a distinct set of trainable skills that are different from the skills of management. Dedicated attention to these skills by future leaders and the people who hire them is necessary to stem the tide of failed leadership that continues to remain all too common. Effective leaders prioritize others over self and are skilled communicators. They integrate information from disparate parties, encourage collaborative engagement, create a sense of urgency, and set the organizational vision. Never complacent, effective leaders look for disruptive influences and confront them without fear. Effective leaders are change agents. If you wish to be a leader but believe that you first need a title, think again. The most effective leaders do not need one. Practice, train, and emphasize your colleagues and organization above yourself, and the rest will take care of itself. ©RSNA, 2018.

Environmental Impacts of Abdominal Imaging: A Pilot Investigation.

PURPOSE: Clinical decision making regarding the use of imaging is appropriately centered on diagnostic efficacy and individual patient factors. However, health policy and imaging guidelines may incorporate other inputs, such as cost-effectiveness and patient preference. In the context of climate change and resource scarcity, the environmental impacts of imaging modalities including ultrasound, CT, and MRI will also become relevant. The purpose of this study was to estimate the environmental impacts of various abdominal imaging examinations. METHODS: Using commercially available software (SimaPro) and data from user manuals and field experts, a streamlined life cycle assessment was performed to estimate multifactorial environmental impacts of the production and use of ultrasound, CT, and MRI per abdominal imaging examination. RESULTS: Ultrasound consumed less energy in both production and use phases (7.8 and 10.3 MJ/examination, respectively) than CT (58.9 and 41.1 MJ/examination) or MRI (93.2 and 216 MJ/examination). Ultrasound emitted fewer CO2 equivalents in production and use phases (0.5 and 0.65 kg/examination) than CT (4.0 and 2.61 kg/examination) or MRI (6.0 and 13.72 kg/examination). Potential human health effects from pollutant emissions were found to be smallest with ultrasound in both production and use phases. CONCLUSIONS: Among the three imaging modalities, ultrasound was found to have the least environmental impact, by one or more orders of magnitude in various domains. This analysis provides an initial framework for comparing environmental impacts across imaging modalities, which may provide useful inputs for cost-effectiveness analyses and policymaking.