Onward: Creating Conditions for Transformation in a Parapandemic World.

This article discusses pathways for personal transformation in the context of physician burnout and the collective trauma related to the COVID-19 pandemic. The article explores polyagal theory, posttraumatic growth concepts, and leadership frameworks as pathways for change. It is both practical and theoretical in its approach and offers a paradigm for transformation in a parapandemic world.

Burnout and Posttraumatic Stress Disorder in the Coronavirus Disease 2019 (COVID-19) Pandemic: Intersection, Impact, and Interventions.

The coronavirus disease 2019 (COVID 2019) pandemic has presented myriad challenges to an underprepared health care system. Health care providers are facing unprecedented acute workplace stress compounded by a high baseline rate of physician burnout. This article discusses the relationship between acute stress disorder, posttraumatic stress disorder, and burnout through a literature review focusing on the mental health impact on health care providers after prior epidemics and natural disasters. We offer both a framework for understanding the mental health impact of the COVID-19 epidemic on physicians while proposing a systems based model to respond to these challenges.

Cultivating Meaningful Work in Healthcare: A Paradigm and Practice.

The socioeconomic dynamics of the current healthcare system can challenge physicians to remain engaged with meaningful work, which is problematic given its role in mitigating burnout. In Man's Search For Meaning, Victor Frankl proposes that meaningful work is a prerequisite for a meaningful life. This article provides a road map for radiologists by applying key guiding principles outlined by Frankl as they intersect with current evidence in the field of physician burnout.

Raising the BAR: Challenges, Opportunities, and Hidden Gems in Radiology Education.

RATIONALE AND OBJECTIVES: Medical student education in radiology has long been underrepresented in the curriculum despite the increased use of imaging in clinical medicine. MATERIALS AND METHODS: The Beginning to Advanced Radiology Lab, was created with the dedicated purpose of integrating digital technology and interactive teaching methods into the UME curriculum in radiology. RESULTS: Results: Development of a novel educational space at the University of Colorado allowed us to identify unforeseen challenges in medical student education while exploring new opportunities CONCLUSIONS: Conclusion: Curriculum revision in UME radiology education creates both challenges and opportunities and this paper explores these issues in the context of the current paradigm change in medical education.

Strategies for Increasing Radiologist Efficiency.

Radiologists experience higher than average rates of burnout. Contributing factors include job tedium, a lack of a sense of autonomy, and decreasing compensation in the context of practices closely monitoring relative value unit output. Increasing radiologist efficiency may be a strategy for mitigating burnout, as freeing up time may allow radiologists to focus their attention on the aspects of their job that they enjoy and find most meaningful. In this work we propose several strategies of distraction minimization and time optimization that radiologists may employ to increase their efficiency.

CT imaging of complications of aortic intramural hematoma: a pictorial essay.

Aortic intramural hematoma (IMH) is a pathologic process with a clinical presentation identical to aortic dissection and associated with significant morbidity and mortality. Radiologists must be familiar with the imaging appearances of IMH as computed tomography (CT) plays a critical role in both diagnosis and patient management. The course of IMH is variable and the process may regress, remain stable, or progress in extent and therefore imaging findings associated with a negative prognosis must be recognized and included in the formal radiology report. Potentially life-threatening complications and findings associated with IMH include hemopericardium and cardiac tamponade, coexisting aortic dissection, ulcer-like projection, intramural blood pool, and extension of hematoma along the pulmonary or coronary arteries, which are identifiable with aortic protocol CT. The purpose of this pictorial review is to provide the reader with an image-based review of the diagnostic criteria, related complications, and associated critical prognostic features in patients presenting with aortic IMH.

Radiographic Review of Current Therapeutic and Monitoring Devices in the Chest.

Chest radiographs are obtained as a standard part of clinical care. Rapid advancements in medical technology have resulted in a myriad of new medical devices, and familiarity with their imaging appearance is a critical yet increasingly difficult endeavor. Many modern thoracic medical devices are new renditions of old designs and are often smaller than older versions. In addition, multiple device designs serving the same purpose may have varying morphologies and positions within the chest. The radiologist must be able to recognize and correctly identify the proper positioning of state-of-the-art medical devices and identify any potential complications that could impact patient care and management. To familiarize radiologists with the arsenal of newer thoracic medical devices, this review describes the indications, radiologic appearance, complications, and magnetic resonance imaging safety of each device. ©RSNA, 2018.

Cultivating Physician Character in Diagnostic Radiology Through Virtuous Caring and Collaborative Professionalism.

In the contemporary environment of patient- and value-centered care, it is no longer sufficient to limit the definition of an "excellent radiologist" to someone who is skilled at image interpretation. Since diagnostic radiologists are physicians, they are held to a certain character standard expected of a physician, whose primary objective is to serve the best interest of patients. An "excellent radiologist," then, is better defined as one who is both skilled at interpreting medical imaging and embodies the attributes of physician character. The concept of physician character can be understood as the interplay between the practice of the care-related virtues, such as empathy, compassion, and kindness, and cooperative efforts with nonradiologist health care team members, termed collaborative professionalism. The very nature of the work of diagnostic radiology, aided by advances in technology, increasingly isolates the radiologist from both patients and other care providers, making it difficult to find opportunities for virtuous care and collaborative professionalism. Using the moral intuitionist model of character development as a conceptual framework, we first delineate the challenges that diagnostic radiologists face in demonstrating virtuous caring and collaborative professionalism. Then, we explore strategies that diagnostic radiologists can employ to overcome these barriers, thereby cultivating their own physician character and setting an example for other radiologists, medical students, and trainees. Finally, we will examine some of the limitations of applying this theoretical model to the real world.

A Picture of Burnout: Case Studies and Solutions Toward Improving Radiologists' Well-being.

This article uses case fictional case vignettes as a vehicle to discuss the complex way organizational and individual factors contribute to physician burnout. The article incorporates a review of the current literature on physician burnout focusing on work place inefficiency and ineffective leadership.

Behavioral Interviewing: Integrating ACGME Competency-Based Questions Into the Radiology Resident Selection Process.

The practice of radiology is continually evolving with external pressures increasing the involvement of the radiologist as an integrated member of the multidisciplinary care delivery team and not just image interpreters working in isolation. Radiologists need to be comfortable interacting directly with patients and practicing "patient and family-centered care" and "value-based medicine." Despite this evolving role of the radiologist, medical training and the residency selection process have not significantly adapted to accommodate these new demands. In order to develop and hire radiologists who can excel in this role, the selection and interview process must be adapted to prospectively identify those candidates who can thrive in this changing role. Behavior-based interviewing is a tool that can help identify those candidates who may excel in the future.1-3 Though there are reports of it being used in the United States medical schools and residency programs across the nation, it has not become a mainstay for medical residency and professional medical interviewing.

Driving Innovation in Radiology: A Summary of the 2015 Intersociety Committee Summer Conference.

The membership of the Intersociety Committee convened to consider how best to continue to stimulate, nurture, and support innovation in radiologic research and education in the face of ever increasing clinical demands and financial constraints. The topic was chosen in recognition that the growth and success of radiology over the past 50-plus years have been driven by spectacular technological developments in imaging and intervention and that the future relevance of the specialty will hinge on how the specialty continues to evolve. To keep radiology a dynamic and vital component of the health care enterprise will require continued innovation in technology and the requisite education that goes with it.