Undergraduate radiology education: foundation doctors' experiences and preferences.

AIM: To assess foundation doctors' experiences of undergraduate radiology teaching within the UK and preferences for radiology teaching delivery. MATERIALS AND METHODS: This was a retrospective multicentre study of foundation doctors. A questionnaire, designed using the Royal College of Radiologists Undergraduate Radiology Curriculum, was completed to determine how prepared foundation doctors felt in image interpretation by their undergraduate teaching. For this, agreement with statements was graded using a five-point Likert scale. Open and closed questions were used to assess preferences for teaching delivery. RESULTS: The study involved 150 foundation doctors from 29 medical schools. The majority "strongly agreed" or "agreed" that undergraduate training gave them confidence in interpreting most basic chest and abdominal radiographs. Confidence was less for skeletal radiographs and trauma computed tomography (CT). Seventy-seven percent wished they had had more radiology teaching. The three most important topics to be included in teaching were chest radiograph, CT, and abdominal radiograph interpretation. Small group teaching and integration into clinical teaching received the highest number of votes for preferred teaching delivery method. Ninety-two percent felt radiologists were best suited to deliver teaching. CONCLUSION: In general, foundation doctors felt undergraduate teaching prepared them well for chest and abdominal radiograph interpretation, but less so for skeletal radiography and CT. The majority felt more undergraduate radiology teaching would be beneficial, and that this should be delivered by radiologists in either small group sessions or integrated into clinical teaching.

Reducing interruptions during duty radiology shifts, assessment of its benefits and review of factors affecting the radiology working environment.

AIM: To investigate and reduce the number of inappropriate interruptions to the duty radiology registrar, as well as subjectively assess the effect of reducing interruptions and identify other methods of improving the duty working environment. MATERIALS AND METHODS: A pre- and post-intervention prospective quantitative study and post-intervention retrospective qualitative study of duty radiology registrars was performed at a tertiary referral centre. The first cycle of the quantitative study was performed prior to implementation of a telephone triage system. The second cycle and qualitative study were performed afterwards. RESULTS: The average number of interruptions per day dropped by 43.7% after the intervention. Moreover, inappropriate interruptions dropped from one in three to one in five interruptions. Improvement was demonstrated following the intervention for perceived patient safety, workload, reporting efficiency, reporting accuracy, work satisfaction, and stress. The most common hindrance to a good working environment was interruptions (36%). The most common suggestion for improvement was improved comfort (33%). CONCLUSION: The present study demonstrates that a telephone triage system can substantially reduce the number of interruptions to the duty radiologist. It also demonstrates that reducing interruptions in radiology has the potential to improve the working environment in many ways.

A comparison of computer-assisted detection (CAD) programs for the identification of colorectal polyps: performance and sensitivity analysis, current limitations and practical tips for radiologists.

AIM: To directly compare the accuracy and speed of analysis of two commercially available computer-assisted detection (CAD) programs in detecting colorectal polyps. MATERIALS AND METHOD: In this retrospective single-centre study, patients who had colorectal polyps identified on computed tomography colonography (CTC) and subsequent lower gastrointestinal endoscopy, were analysed using two commercially available CAD programs (CAD1 and CAD2). Results were compared against endoscopy to ascertain sensitivity and positive predictive value (PPV) for colorectal polyps. Time taken for CAD analysis was also calculated. RESULTS: CAD1 demonstrated a sensitivity of 89.8%, PPV of 17.6% and mean analysis time of 125.8 seconds. CAD2 demonstrated a sensitivity of 75.5%, PPV of 44.0% and mean analysis time of 84.6 seconds. CONCLUSION: The sensitivity and PPV for colorectal polyps and CAD analysis times can vary widely between current commercially available CAD programs. There is still room for improvement. Generally, there is a trade-off between sensitivity and PPV, and so further developments should aim to optimise both. Information on these factors should be made routinely available, so that an informed choice on their use can be made. This information could also potentially influence the radiologist's use of CAD results.

Prevalence and significance of anaemia in patients receiving long-course neoadjuvant chemoradiotherapy for rectal carcinoma.

AIM: The study aimed to assess the prevalence and significance of anaemia during long-course neoadjuvant radiotherapy for rectal cancer at our centre. METHOD: Hospital coding and a prospective oncology database were used to identify all patients undergoing long-course neoadjuvant radiotherapy for rectal cancer at our centre between 2004 and 2009. A retrospective review of computerized records was used to extract individual patient data. Anaemia was defined as a haemoglobin level of < 11.5 g/dl for women and of < 13 g/dl for men. Downstaging was assessed by comparing radiological stage (rTNM) with histological stage (ypTNM). Tumour regression after radiotherapy was assessed using the Rectal Cancer Regression Group (RCRG) scores of 1-3. The results were analysed using Gnu PSPP statistical software. RESULTS: There were 70 patients (51 men) of median age 66 (interquartile range 60-72.75) years. Of these, 24 were anaemic. Two (3%) had no haemoglobin level recorded and were excluded. Forty-two per cent of anaemic patients demonstrated mural (T) downstaging compared with 68% of nonanaemic patients (P = 0.03). There was no difference in nodal downstaging between the groups. The RCRG scores showed more tumour regression in nonanaemic patients than in anaemic patients, as follows: RCRG 1, 59%vs 30%; RCRG 2, 11%vs 17%; and RCRG 3, 38%vs 46% (P < 0.001). CONCLUSION: The prevalence of anaemia in patients undergoing long-course neoadjuvant radiotherapy was 35%. Anaemia during long-course neoadjuvant radiotherapy was associated with significant reductions in tumour downstaging and regression.