Simulator Education Initiatives for On-Campus Practical Training in Nuclear Medicine Technology.

Because nuclear medicine diagnostic equipment has not been installed at our educational institution, we had not been able to incorporate nuclear medicine techniques into on-campus training until now. Methods: We have introduced a diagnostic image processing simulator to replace nuclear medicine diagnostic equipment. The simulator was used to conduct on-campus practical training on nuclear medicine technology. We also conducted a questionnaire survey of students regarding their experience with on-campus practical training using the simulators. Results: The survey results revealed that the on-campus practical training using simulators deepened students' understanding of the content they had encountered in classroom lectures. Conclusion: We successfully implemented on-campus practical training in nuclear medicine technology using a diagnostic image-processing simulator. According to the results of our questionnaire, it is possible to provide on-campus practical training to students using simulators that enhance understanding of nuclear medicine technology.

Trends in nuclear medicine and the radiopharmaceutical sciences in oncology: workforce challenges and training in the age of theranostics.

Although the promise of radionuclides for the diagnosis and treatment of disease was recognised soon after the discovery of radioactivity in the late 19th century, the systematic use of radionuclides in medicine only gradually increased over the subsequent hundred years. The past two decades, however, has seen a remarkable surge in the clinical application of diagnostic and therapeutic radiopharmaceuticals, particularly in oncology. This development is an exciting time for the use of theranostics in oncology, but the rapid growth of this area of nuclear medicine has created challenges as well. In particular, the infrastructure for the manufacturing and distribution of radiopharmaceuticals remains in development, and regulatory bodies are still optimising guidelines for this new class of drug. One issue of paramount importance for achieving equitable access to theranostics is building a sufficiently trained workforce in high-income, middle-income, and low-income countries. Here, we discuss the key challenges and opportunities that face the field as it seeks to build its workforce for the 21st century.

Guiding principles on the education and practice of theranostics.

PURPOSE: The recent development and approval of new diagnostic imaging and therapy approaches in the field of theranostics have revolutionised nuclear medicine practice. To ensure the provision of these new imaging and therapy approaches in a safe and high-quality manner, training of nuclear medicine physicians and qualified specialists is paramount. This is required for trainees who are learning theranostics practice, and for ensuring minimum standards for knowledge and competency in existing practising specialists. METHODS: To address the need for a training curriculum in theranostics that would be utilised at a global level, a Consultancy Meeting was held at the IAEA in May 2023, with participation by experts in radiopharmaceutical therapy and theranostics including representatives of major international organisations relevant to theranostics practice. RESULTS: Through extensive discussions and review of existing curriculum and guidelines, a harmonised training program for theranostics was developed, which aims to ensure safe and high quality theranostics practice in all countries. CONCLUSION: The guiding principles for theranostics training outlined in this paper have immediate relevance for the safe and effective practice of theranostics.

Rebooting nuclear medicine specialist education under the COVID-19 pandemic: From plenary lectures to active e-learning.

Despite major reforms of specialist training in the Nordic countries towards concrete learning outcomes and promoting active learning, most specialist courses continue to be based on lectures. We redesigned our mandatory 5-day course in clinical nuclear medicine (NM) that was last held in 2016 towards active learning. Thirty 1-h lectures were replaced with 10 thematic blocks of 3 h each. Each block was taught by a single teacher in a blend of short introductory lectures alternating with small groups of residents reading NM cases from our newly established national case library in diagnostic format. Due to COVID-19, the entire course in 2021 needed to be run on a videoconferencing system rather than in a computer laboratory as had been originally planned. At the end of the course, we conducted the same anonymized survey as in 2016. All 19 course participants responded. 74% fully agreed that the e-course format had been 'good'. One hundred per cent fully agreed that the practical exercises were 'useful' versus 50% in 2016 (p < 0.001). In their free text answers on the merits or downsides of e-learning, 12/12 respondents only mentioned advantages. Our newly established library of anonymized teaching cases within our national health network is an effective tool for organising courses based on active learning. Despite the change towards distance learning enforced by the pandemic, course participants reported the same high levels of satisfaction with active learning in small groups as in the earlier traditional lecture-based course format.

Competency based medical education in nuclear cardiology: A tale of two axes.

BACKGROUND: Across medical specialties, including nuclear cardiology, competency based medical education (CBME) changes the emphasis of learning from a time or experiential emphasis to a proficiency focused approached. Plotted on a learning-curve graph the emphasis on learning has shifted from the duration/ volume-based x-axis to the performance-based y-axis. CURRENT STATUS: It has proven difficult to establish y-axis-based standards within nuclear cardiology to assess learning. As such there is a paucity of data to verify current experiential training targets and only recently is data emerging that seeks to find CBME targets by which proficiency (y-axis units) can be evaluated. Initial reports from such CBME-oriented studies indicate that in current nuclear cardiology practice, the number of studies required to achieve competency is dependent upon the chosen measure of competency that is assessed (summed stress score versus % LV ischemia), the case mix, and the modality being learnt (PET versus SPECT). Recent findings have also suggested that prior levels of experiential training may be an underestimation of the number of supervised studies learners need to interpret before they achieve competency. SUMMARY: Nuclear cardiology training has adopted the concept of CBME and is progressing toward a more modern approach to trainee assessment. This brief review provides the background, current requirements and insights into new developments in nuclear cardiology training.

10-year update to the combined 16-month nuclear medicine and diagnostic radiology residency: The NuRad pathway.

BACKGROUND: The decline in nuclear medicine (NM) residencies in the United States has led to a shortage of NM physicians. To help address this, a 16-month NM pathway for diagnostic radiology (DR) residents was developed in 2010. At the University of Arkansas for Medical Sciences, we matched our first resident into the NuRad (NM + DR) pathway in 2013. Despite our success, we remain one of only five programs in the United States that offers a combined training pathway through the National Resident Matching Program. OBJECTIVES: Review our 10-year experience with the NuRad pathway at UAMS and highlight the key components and significance of the 16-month NM pathway. METHODS: Retrospective review of NRMP applicants to the DR and NuRad pathway from 2013 and 2023 at UAMS. Literature and website review of the educational structure of the 16-month NM pathway. RESULTS: We have seen significant increase in the number of applicants to the NuRad pathway at UAMS over the last 10 years with 184 applicants for 1 position in 2023, up from 18 applicants in 2013. Furthermore, we have seen an increase in the USMLE step scores for applicants during this time. CONCLUSIONS: There is a growing need for NM trained physicians in the United States. Over the last 10 years, we have seen increasing interest in the NM 16-month pathway as a part of DR residency. A wider implementation of this combined training pathway is needed, if we are to realize its full potential.

EANM procedural recommendations for managing the paediatric patient in diagnostic nuclear medicine.

PURPOSE: The manuscript aims to characterize the principles of best practice in performing nuclear medicine procedures in paediatric patients. The paper describes all necessary technical skills that should be developed by the healthcare professionals to ensure the best possible care in paediatric patients, as it is particularly challenging due to psychological and physical conditions of children. METHODS: We performed a comprehensive literature review to establish the most relevant elements of nuclear medicine studies in paediatric patients. We focused the attention to the technical aspects of the study, such as patient preparation, imaging protocols, and immobilization techniques, that adhere to best practice principles. Furthermore, we considered the psychological elements of working with children, including comforting and distraction strategies. RESULTS: The extensive literature review combined with practical conclusions and recommendations presented and explained by the authors summarizes the most important principles of the care for paediatric patient in the nuclear medicine field. CONCLUSION: Nuclear medicine applied to the paediatric patient is a very special and challenging area, requiring proper education and experience in order to be performed at the highest level and with the maximum safety for the child.

The integrated nuclear medicine and radiology residency program in the Netherlands: strengths and potential areas for improvement according to nuclear medicine physicians and radiologists.

PURPOSE: To evaluate the Dutch integrated nuclear medicine and radiology residency program from the perspective of nuclear medicine physicians and radiologists. METHODS: A survey was distributed among nuclear medicine physicians and radiologists in hospitals that participate in the Dutch integrated nuclear medicine and radiology training program. RESULTS: A total of 139 completed questionnaires were included. Nuclear medicine physicians (n = 36) assigned a mean score of 5.7 ± 2.0, and radiologists (n = 103) assigned a mean score of 6.5 ± 2.8 (on a 1-10 scale) to the success of the integrated training program in their hospital. On multiple regression, female gender of the survey participant (B = 2.22, P = 0.034), musculoskeletal radiology as subspecialty of the survey participant (B = 3.36, P = 0.032), and the survey participant's expectancy of resident's ability to handle workload after completion of residency were significantly associated with perceived success of the integrated training program (B = 1.16, P = 0.023). Perceived strengths of the integrated training program included broadening of expertise, a better preparation of future imaging specialists for hybrid imaging, increased efficiency in training residents, and increased efficiency in multidisciplinary meetings. Perceived weaknesses of the integrated training program included reduced exposure to nuclear medicine, less time for research and innovation, and concerns about its international recognition. CONCLUSION: This study provided insights into the experiences of nuclear medicine physicians and radiologists with the Dutch integrated nuclear medicine and radiology residency program, which may be helpful to improve the program and similar residency programs in other countries.

Satisfying Program-Level Outcomes by Integrating Primary Literature into the Online Classroom.

Because of the coronavirus pandemic, there has been a paradigm shift from traditional classroom instruction to remote online modalities. To provide the most current and relevant information on nuclear medicine technology to students without access to traditional resources on a college campus, it has become imperative that primary literature within the field be made readily accessible. Nuclear medicine technology students at Bronx Community College are being taught to use the Journal of Nuclear Medicine Technology as the basis for their required presentations, which span the curriculum. Guided by instructors who are armed with a rubric ultimately used as a formative assessment tool, the students are required to explore current articles from the Journal of Nuclear Medicine Technology and ultimately present their findings to their cohort. By design, this article-share project has successfully been implemented as a principal metric in satisfying the program accreditation requirements of the Joint Review Committee on Nuclear Medicine Technology while also being conducive to increasing oral presentation skills and cohort socialization.

COVID-19 Vaccination: An Overview and Education Tool for Nuclear Medicine Technologists.

Some nuclear medicine technologists may be called on to administer COVID-19 vaccines, but many may have never administered a vaccine. This article summarizes COVID-19 vaccination procedures and provides links to additional information, training, and self-assessment.

An Evaluation of the Content of Canadian and American Nuclear Medicine Fellowship Websites.

BACKGROUND: Radiology trainees frequently use the Internet to research potential fellowship programs across all subspecialties. For a field like nuclear medicine, which has multiple training pathways, program websites can be an essential resource for potential applicants. This study aimed to analyze the online content of Canadian and American Nuclear Medicine fellowship websites. MATERIALS AND METHODS: The content of all active Canadian and American Nuclear Medicine fellowship websites was evaluated using 26 criteria in the following subdivisions: application, recruitment, education, research, clinical work, and incentives. Fellowships without websites were excluded from the study. Scores were summed per program and compared by geographic region and ranking. RESULTS: A total of 42 active Canadian and American Nuclear Medicine fellowship programs were identified, of which 39 fellowships had dedicated fellowship websites available for the analysis. On average, fellowship websites contained 34.4% (9 ± 3.3) of the 26 criteria. Programs did not score differently on the criteria by geographical distribution (P = .08) nor by ranking (P = .18). CONCLUSION: Most Canadian and American Nuclear Medicine fellowship websites are lacking content relevant to prospective fellows. Addressing inadequacies in online content may support programs to inform and recruit residents into fellowship programs.