Use of the lateral arm in tomosynthesis-guided SCOUT Reflector placement procedures.

Preoperative localization procedures are important for guiding surgical excision of non-palpable findings in the breast. The SCOUT Reflector (Merit Medical, South Jordan UT, USA) is a non-wire-based localization device that has been incorporated into clinical use with great success. SCOUT Reflectors can be placed using several imaging modalities, including tomosynthesis. One drawback to SCOUT Reflector placement under tomosynthesis guidance is an inability to directly visualize the introducer needle tip, a factor that limits precision. In this brief communication, we describe the use of a lateral arm attachment for tomosynthesis guided SCOUT Reflector placement. Precise SCOUT Reflector placement can be achieved using the lateral arm due to the ability to clearly visualize the introducer needle and the SCOUT Reflector within the introducer needle bore prior to deployment.

Using Rubrics to Evaluate E-Learning Tools in Radiology Education.

Recent trends in medical education with an emphasis on active learning strategies and blended learning techniques have resulted in a growing volume and utilization of online educational resources. Integration of online learning tools into medical curricula has been further necessitated during the COVID-19 pandemic. With access to abundant digital radiology education resources, it has become increasingly important for educators to be able to evaluate the efficacy of e-learning tools for use in radiology education. In this manuscript, the authors describe their successful search for a vetted method to evaluate e-learning tools in radiology education. The selected rubric was designed by educational developers supporting technology to be used as a formative tool in higher education. The rubric was applied in condensed and noncondensed formats to 2 existing popular highly subscribed radiology e-learning resources and results were displayed in narrative and visual formats. More widespread application of this rubric would be beneficial to the content creators and learners alike.

Near-Peer Teaching in Radiology Symposia: A Success Story in Residents as Teachers.

INTRODUCTION: Peer learning and near-peer teaching have been described in many specialties, less so in Radiology. We present near-peer teaching whereby residents present a series of didactic sessions at the course outset in the form of "symposia" and perform a scholarly activity in the form of teaching. We aim to demonstrate how near-peer teaching in symposia front-loaded within an introductory radiology course can improve medical student satisfaction. METHOD: A total of 169 students were enrolled over a period of 3 years, 55 before (2017-2018) and 114 (2018-2020) after the introduction of the symposium. Anonymous course evaluations were collected from all students. In addition, 240 fourth-year medical students who also attended symposium lectures received satisfaction surveys in 2019 and 2020. RESULTS: All (169/169, 100%) students taking the course evaluated it. Overall evaluation scores rose from 8.3/10 to 9.0/10 post-symposia. Among student satisfaction surveys, 89/240 (37%) specifically commented on symposia; 91% (80/89) of those found symposia very or extremely informative. 29/71 (41%) of all residents were able to participate in the symposia, 20/29 in multiple years throughout residency, allowing them to fulfill the Accreditation Council for Graduate Medical Education interpersonal and communication skills core competencies and meet scholarly activity requirements. CONCLUSION: Near-peer teaching in the form of resident-taught interactive didactics grouped in symposia can have a positive outcome on medical student satisfaction.

Commentary on Ultrasound Instruction in Undergraduate Medical Education: Perspective from Two Students.

Background: Ultrasound integration in undergraduate medical education (UME) has been a focused endeavor in recent years. According to the American Institute of Ultrasound in Medicine, more than a third of all US medical schools have adopted a focused ultrasound training program for medical students. Medical student perspectives on best practices in ultrasound education are lacking in the literature. Curricula Experiences: Two students' reflections are presented regarding two different didactic approaches, flipped classroom and self-study learning models, to teaching ultrasound in the pre-clinical medical education curriculum. Students present reflections on these didactic approaches to facilitate further improvement in ultrasound education curricula. Discussion: The self-directed learning model enabled students to learn foundational ultrasound exam techniques efficiently in a low-stress environment and subsequently optimized the efficiency of later faculty-led learning events. However, we noted that in both the flipped classroom and self-study learning models of education, the training on basic physical properties of ultrasound, tissue characteristics, and probe manipulation was limited. Conclusion: A self-study learning model ultrasound curricula improves perceived learning efficiency and student confidence, especially when followed by faculty-guided didactics and scanning opportunities. We suggest a framework for ultrasound education curricula that includes components of both formats of ultrasound education alongside faculty-led sessions as an ideal model of ultrasound education. Further, we propose the added benefit of inanimate object scanning to optimize students' knowledge of waveform physics (image acquisition and physical properties of materials) early in the ultrasound education process.

Classic illustrations of benign and malignant phyllodes breast tumors in two patients.

Phyllodes tumors, World Health Organization fibroepithelial tumors, are classified as benign, borderline, or malignant based on histopathology. Phyllodes must be distinguished from benign fibroadenomas, also WHO fibroepithelial tumors. The distinction of phyllodes from fibroadenomas can be challenging clinically, as these tumors may mirror one another. Here, we present 2 cases, classic clinical and imaging examples of benign and malignant phyllodes, to review the current epidemiology, classification, diagnosis, and treatment of phyllodes tumors.

A rare case of myofibroblastoma in an older male.

Myofibroblastoma is a rare benign breast stromal tumor comprised of fibroblasts and myofibroblasts, most commonly presenting in postmenopausal women and older men. This report discusses the case of a 69-year-old male diagnosed with myofibroblastoma after mammography, targeted ultrasound, and core needle biopsy of a retroareolar mass. The features of myofibroblastoma are presented.

Mentoring Medical Education Research: Guidelines from a Narrative Review.

Mentorship is critical to develop research scholars. Current literature provides mentorship guidance for biomedical research; however, mentorship for educational research is scarce. We explored literature to offer evidence-based guidance for medical education research mentors. A librarian searched peer-reviewed literature from 2001 to 2021 to identify guidelines for research mentors. Thirty-five articles were included in this narrative review. Our results identified attributes of mentors, overlapping roles, and barriers and benefits of mentoring. The structures and processes related to mentoring are reviewed and applicability to medical education research mentorship is summarized. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-022-01565-2.

The Short and the Long of It: Transitioning to a Blended Longitudinal Curriculum in Radiology.

PURPOSE: The aim of this study was to demonstrate that the transition from a stand-alone radiology clerkship block to a longitudinally integrated radiology curriculum leverages newer teaching tools favored by today's learners. METHODS: In 2013 and 2014, medical students attended a dedicated 1-week radiology clerkship course. In 2015, the block clerkship model for radiology transitioned to a vertically integrated curriculum. By 2019, radiology content was integrated into many of the health illness and disease course blocks. Pre- and postcourse multiple-choice question tests as well as anonymous surveys were administered for both clerkship and integrated curriculum blocks. The student survey questions assessed perceptions regarding interpretation skills, imaging modality knowledge, and radiologists' roles. RESULTS: Among 197 total students in the clerkship block, surveys were completed by 170 respondents, yielding a response rate of 86.3%. Among 106 students in the longitudinal course, surveys were completed by 71 respondents, yielding a response rate of 67%. For both clerkship and longitudinally integrated courses, the average number of correct responses after completion of the courses was significantly greater than the average number of correct precourse responses. Compared with students in the clerkship block curriculum, students in the longitudinal curriculum demonstrated a significantly greater frequency of agreement in response to survey questions regarding significant exposure to radiology, feeling comfortable interpreting CT images, and being familiar with how to use the ACR Appropriateness Criteria. CONCLUSIONS: Transitioning from a single clerkship block to a more integrated format allows a more effective patient-centered clinical approach to medical imaging.

Medical Education Research Design.

As with clinical care, radiology education benefits when stakeholders collaborate to gather and analyze data to answer questions and solve issues. Just as importantly, radiology educators benefit academically and professionally when they demonstrate a portfolio of published scholarship to promotion committees and department leaders. The principles and techniques used in the design of medical education research are not well understood by many radiology educators because educational scholarship methodologies have received little attention in our literature. Lack of familiarity and inexperience with research methodologies, particularly qualitative research, are barriers that education researchers can address with knowledge acquisition and practice. This overview surveys the landscape and offers suggested medical education research resources to help researchers explore topics to increase understanding of quantitative, qualitative, mixed-methods, survey, and educational design methodologies.

Great Question! The Art and Science of Crafting High-Quality Multiple-Choice Questions.

Assessment of medical knowledge is essential to determine the progress of an adult learner. Well-crafted multiple-choice questions are one proven method of testing a learner's understanding of a specific topic. The authors provide readers with rules that must be followed to create high-quality multiple-choice questions. Common question writing mistakes are also addressed to assist readers in improving their item-writing skills.

It Takes a Village: A Multimodal Approach to Addressing Radiologist Burnout.

Burnout is a significant issue confronting the medical profession, to which radiology is no exception. Addressing burnout demands a full-spectrum response, in keeping with its complexity, prevalence, and significance. This manuscript brings together key techniques at the individual, peer, and institutional levels to offer a multifaceted approach to ameliorating radiologist burnout. Such an approach would begin by equipping physicians with the skillset necessary to identify signs of burnout in themselves and others. Institutions can work to validate the radiologists they employ and work toward mitigating the impact of occupational stressors. Lastly, engaging in conversations about burnout throughout the course of one's medical career can affect a sea change in the way burnout is envisioned, and treated.

I.C.A.R.U.S. in Flight: A Radiology Simulator Teaches Imaging Appropriateness, Anatomy, and Image Interpretation Skills.

RATIONALE AND OBJECTIVES: The Interactive Clinical Anatomy and Radiology Utilization Simulator (ICARUS) was created in 2012 as a novel simulation program with 25 peer reviewed electronic modules combining simulated patient encounters, American College of Radiology appropriateness criteria, radiologic anatomy, and basic imaging interpretation and patient safety topics. ICARUS integrates a gaming approach to improve student engagement. MATERIALS AND METHODS: ICARUS modules have been used in the undergraduate medical curriculum at the lead author's institution since its pilot in 2012. Since completion of the full complement of 25 modules, modules have been used in the radiology clerkship (2012- 2015), in the integrated longitudinal curriculum (2015-present), and in various radiology electives (2015-present), including the inaugural virtual radiology electives at all authors' institutions (July 2020-present). Student evaluations were formally solicited in 2014 and again in 2020. RESULTS: During the introductory radiology clerkship in 2014, 107 students were enrolled. Students were assigned 4 ICARUS modules. During the 2-week virtual elective from July-October 2020, 26 students were enrolled. Students were assigned all 25 modules. The majority of survey respondents "agreed" or "strongly agreed" that the modules were interactive, enjoyable, and self-directed, fostered critical thinking, provided practical value, met goals and objectives of the course, and seemed practical to their future practice. CONCLUSION: ICARUS integrates key educational concepts in radiology with high fidelity simulation of clinical decision support software and PACS simulation image display to create a highly engaging learning environment that most accurately reflects future clinical experiences.

Web-Based Radiology Learning Module Design: The Author Perspective.

RATIONALE AND OBJECTIVES: Over recent years, e-learning has become an integral component of radiology education. While demands for innovative, interactive e-learning resources have increased, the availability of viable solutions have not kept pace. As a result, many educators are authoring their own e-learning content. This study describes the six-year experience of faculty clinician educators and residents who participated in this authoring process. MATERIALS AND METHODS: From 2014 to 2020, 62 radiology faculty and residents created a total of 89 peer reviewed web-based learning modules. Authors were given instructions and materials to support their design process. Following completion of their module(s), authors were asked to complete an anonymous and voluntary survey on their perspective. RESULTS: Hundred percent of survey respondents reported that they enjoyed creating their module and 97.8% would recommend the experience to others. Reported educational value of authoring a learning module was 4.18 per 5, with 65% of resident authors reporting that they felt more likely to retain the information they learned through authoring a module rather than reading a chapter on the same topic. A total of 77.3% of respondents reported that the experience would make them more likely to teach medical students in the future. CONCLUSION: With the appropriate resources and support, radiology faculty and residents succeed in authorship of innovative e-learning modules for medical student learners. In addition to enhancing subject matter knowledge and satisfying Accreditation Council for Graduate Medical Education requirements for teaching and scholarly activity, authorship provides mentoring opportunities and cultivates interest in medical student education.

Online Hide and Seek: Allopathic US Medical Schools' Radiology Education Virtual Presence.

RATIONALE AND OBJECTIVES: To highlight radiology's merits and boost appeal to medical students in the digital era, it is increasingly important for radiology departments to be readily accessible to medical students. We report the results of a multivariate analysis of the virtual presence of radiology medical student education of 152 allopathic United States (US) medical schools, the first report of its kind to the authors' knowledge. We detail eight elements to include when optimizing a radiology medical student education website. METHODS: In August 2020, the Department of Radiology websites at 152 allopathic US medical schools were assessed for the presence of a medical student radiology education website and accessibility of collated information about preclinical and clinical course offerings, radiology interest groups, and outreach initiatives in the form of student radiology mentorship, shadowing, and research opportunities. RESULTS: 65.1% (99/152) of allopathic US medical schools' radiology departments have a dedicated medical student radiology education website, one of which was excluded from further review due to password protected content. 58.2% (57/98) of departmental websites include information about preclinical radiology coursework and 90.8% (89/98) of departments provide information about clinical courses. Details about interest groups were found on 26.5% (26/98) of departmental websites. Information about mentorship and shadowing was identified on less than half of departmental websites. 51% (50/98) of Department of Radiology websites provide information about research opportunities for students. CONCLUSIONS: This study demonstrates that the majority of allopathic US medical schools' radiology departments lack full information of relevance to medical students. To engage today's and tomorrow's medical learners digitally, there is opportunity and need to improve the online availability of information about preclinical and clinical radiology courses, student interest groups, shadowing opportunities, student mentorship, and student research. We detail eight elements to include when optimizing a radiology medical student education website. In most instances, this can be accomplished by revising an existing radiology department website in a manner that engages, educates, and recruits medical students. As a specialty, radiology must expand our digital footprint to reach tomorrow's colleagues and leaders.

Structured Reports and Radiology Residents: Friends or Foes?

Structured reports offer overall improvement in quality and safety, largely centered upon more effective communication. Structured reporting is helpful to trainees as a method to develop organized search patterns and include pertinent positive and negative findings. However, limitations of structured report use include lack of development of individualized search patterns and failure to recognize key elements of the report to be formulated in the impression. Instruction on the value of a structured reporting approach, its impact on patient care and clinical service, and compliance with billing requirements must be balanced with early and consistent feedback on appropriate use and reporting errors. It is incumbent upon radiology educators to integrate and optimize structured reporting in the learning environment. This manuscript addresses the impact of structured reporting on radiology education, reviewing quality and safety considerations, detailing benefits and drawbacks for trainees, and offering strategies for optimizing the use of structured reporting/templates in the training environment.

ACGME Diagnostic Radiology Milestones 2.0: the Time is Now.

The Accreditation Council for Graduate Medical Education oversees graduate medical education in the United States. Designed to provide broad based training in all aspects of imaging, the diagnostic radiology residency program must provide educational experiences that not only provide technical, professional, and patient centered training, but also meet accreditation standards. With the breadth of material to cover during training, carefully orchestrated educational experiences must be planned. This manuscript offers residency program leaders resources to meet the challenges of the new Accreditation Council for Graduate Medical Education Diagnostic Radiology Milestones 2.0 and highlights potential opportunities for future educational endeavors.

Strengthening the Clinical Learning Environment by Mandate-Implementing the ACGME Common Program Requirements.

RATIONALE: Three years ago, the Accreditation Council for Graduate Medical Education (ACGME) introduced updated Common Program Requirements in recognition of the need to further promote resident and faculty member well-being and patient safety. The ACGME acknowledged residencies would need time to comply with new requirements. This grace period, however, concluded as of July 1, 2019, and programs now risk citations for failure to implement new requirements. METHODS AND RESULTS: The authors, members of the Association of Program Directors in Radiology Common Program Requirements Ad Hoc committee, developed downloadable resources provided in the Appendix delineating the 2019 Common Program Requirements and offering sample resources as compliant solutions. CONCLUSION: The resources offer a national standardized approach to educating trainees in these essential skills and should be especially helpful to programs with access to fewer resources. In addition to achieving compliance, incorporation of these resources into residency training will ensure the next generation of radiologists are equipped to add value while remaining physically and emotionally healthy.