Well-being and Burnout Amongst Interventional Radiologists in the United Kingdom.

PURPOSE: To assess the prevalence of burnout amongst Interventional Radiologists (IRs) in the United Kingdom and identify demographic and practice-related stressors that may adversely affect well-being. MATERIALS AND METHODS: A survey of 36 questions was divided into two sections. Section A consisted of 14 questions that assessed demographics and work characteristics; Section B assessed burnout, utilizing the 22-item Maslach burnout inventory. Four additional open-ended questions were included to allow participants to voice opinions on the biggest contributors to workplace burnout and plans that could be implemented to alleviate this. The questionnaire was distributed to the British Society of interventional (BSIR) members. The study was conducted between August and September 2022. RESULTS: Moderate to severe scores in emotional exhaustion (EE) were recorded in 65% of participants (moderate 26%; severe 39%) of participants r. Moderate to severe depersonalization (DP) scores were recorded in 46% of participants (moderate 23%; severe 23%). Low-moderate levels of personal accomplishment (PA) scores were recorded in 77% of respondents (low 50%; moderate 27%). Weekly hours and out-of-hour IR cover were statistically significant in predicting emotional exhaustion. Age, sex (male), time available for teaching, and weekly hours were statistically significant in predicting the depersonalisation score. Age was a predictive factor for personal accomplishment. The most recurring themes in open response to major contributors of burnout were shortage of IR clinicians and supporting staff as well as the increasing IR workload. CONCLUSIONS: This survey has demonstrated high prevalence of burnout amongst Interventional Radiologists in UK. Urgent measures are required to tackle the workforce shortage, recognition of IR workload and control IR resources.

Work expectations, their fulfillment, and exhaustion among radiologists of all career levels: what can be learned from the example of Germany.

OBJECTIVES: To evaluate work expectations of radiologists at different career levels, their fulfillment, prevalence of exhaustion, and exhaustion-associated factors. METHODS: A standardized digital questionnaire was distributed internationally to radiologists of all career levels in the hospital and in ambulatory care via radiological societies and sent manually to 4500 radiologists of the largest German hospitals between December 2020 and April 2021. Statistics were based on age- and gender-adjusted regression analyses of respondents working in Germany (510 out of 594 total respondents). RESULTS: The most frequent expectations were "joy at work" (97%) and a "good working atmosphere" (97%), which were considered fulfilled by at least 78%. The expectation of a "structured residency within the regular time interval" (79%) was more frequently judged fulfilled by senior physicians (83%, odds ratio (OR) 4.31 [95% confidence interval (95% CI) 1.95-9.52]), chief physicians (85%, 6.81 [95% CI 1.91-24.29]), and radiologists outside the hospital (88%, 7.59 [95% CI 2.40-24.03]) than by residents (68%). Exhaustion was most common among residents (physical exhaustion: 38%; emotional exhaustion: 36%), in-hospital specialists (29%; 38%), and senior physicians (30%; 29%). In contrast to paid extra hours, unpaid extra hours were associated with physical exhaustion (5-10 extra hours: OR 2.54 [95% CI 1.54-4.19]). Fewer opportunities to shape the work environment were related to a higher probability of physical (2.03 [95% CI 1.32-3.13]) and emotional (2.15 [95% CI 1.39-3.33]) exhaustion. CONCLUSIONS: While most radiologists enjoy their work, residents wish for more training structure. Ensuring payment of extra hours and employee empowerment may help preventing burnout in high-risk groups. KEY POINTS: • Most important work expectations of radiologists who work in Germany are "joy at work," a "good working atmosphere," "support for further qualification," and a "structured residency within the regular time interval," with the latter containing potential for improvement according to residents. • Physical and emotional exhaustion are common at all career levels except for chief physicians and for radiologists who work outside the hospital in ambulatory care. • Exhaustion as a major burnout criterion is associated with unpaid extra hours and reduced opportunities to shape the work environment.

Strategies for Well-Being in Interventional Radiology.

Interventional radiologists (IRs) have a massive impact on their patients, communities, and healthcare at large. Yet, IRs have physical and emotional challenges that lead to a high rate of burnout compared with other medical specialties. A Medscape survey in 2013 showed a 37% burnout incidence among radiologists, which increased to 49% in 2015. This ranked radiology 7th out of 26 specialties with respect to burnout. Although the survey did not examine IR specifically, with the increasing demands on those in the profession, this number can only be expected to increase. A survey by Bundy et al demonstrated that interventional radiologists are in the upper range of burnout among physicians with 71.9% presenting with at least 1 manifestation of burnout. This is higher than that reported among surgeons or diagnostic radiologists. We must be proactive in addressing wellness in IR if we are to flourish both individually and as a group. The impact of suboptimal well-being in an IR goes beyond that of the individual, influencing patient care with ripple effects to society at large. At worst, severe burnout can lead to an early exit from medicine, with the cost of recruiting a replacement IR estimated at two to three times an annual physician salary. This is to say nothing of the experience, wisdom, and leadership that are lost when physicians burn out and drop out. Particularly in IR, where the work performed often improves the cost-effectiveness and quality of care, burnout is a threat to the physician workforce and healthcare at large. In this article, our goal is to share some elements of physician well-being and highlight opportunities to support well-being in IR.

Role of Ergonomic Improvements in Decreasing Repetitive Stress Injuries and Promoting Well-Being in a Radiology Department.

RATIONALE AND OBJECTIVES: To determine if ergonomic improvements in a radiology department can decrease repetitive stress injuries (RSIs), advance ergonomics knowledge, and improve well-being. MATERIALS AND METHODS: Radiologists in an academic institution were surveyed regarding physician wellness, workstations, RSIs, and ergonomics knowledge before and after interventions over 1 year. Interventions included committee formation, education, wrist pads and wireless mice, broken table and chair replacement, and cord organization. Mann-Whitney U test was used for analysis. RESULTS: Survey response was 40% preinterventions (59/147), and 42% (66/157) postinterventions. Preinterventions, of radiologists with RSI history, 17/40 (42%) reported the RSI caused symptoms which can lead to burnout, and 15/40 (37%) responded their RSI made them think about leaving their job. Twenty-three of 59 (39%) radiologists had an active RSI preinterventions. Postinterventions, 9/25 (36%) RSI resolved, 13/25 (52%) RSI improved, and 3/25 (12%) RSI did not improve. RSI improvements were attributed to ergonomic interventions in 19/25 (76%) and therapy in 2/25 (8%). Radiologists who thought their workstation was designed with well-being in mind increased from 9/59 (15%) to 52/64 (81%). The percentage of radiologists knowing little or nothing about ergonomics decreased from 15/59 (25%) to 5/64 (8%). After ergonomics interventions, more radiologists thought the administration cared about safety and ergonomics, equipment was distributed fairly, and radiologists had the ability to ask for equipment (p < .01). Fifty-three of 64 (83%) of radiologists after interventions said improving workstation ergonomic design contributed to well-being. CONCLUSION: Ergonomic improvements in radiology can decrease RSIs, advance ergonomics knowledge, and improve well-being.

Imposter phenomenon in radiology: incidence, intervention, and impact on wellness.

PURPOSE: Imposter phenomenon refers to feelings of inadequacy due to inability to internalize evident success. While high achievers such as physicians have been known to exhibit imposter phenomenon, there is limited literature specific to radiologists. Our purpose was to (1) investigate imposter phenomenon in radiologists and assess correlation with burnout, and (2) pilot an intervention aimed at addressing imposter phenomenon through improvisational theater techniques. METHODS: Part 1 - Clinical radiology faculty at a single large academic medical center completed an anonymous survey with questions related to demographics, burnout (derived from the validated Mini-Z assessment tool), and imposter phenomenon. Part 2 - A one-hour interactive workshop on imposter phenomenon was organized for the radiology department at the same institution. The workshop included the Clance Imposter Phenomenon Scale (CIPS). A post-workshop survey rating was also performed. RESULTS: Part 1 - Of 30 clinical radiology faculty who participated in the survey, 83% reported feelings of imposter phenomenon during their career. There was significant (p = 0.024) correlation between imposter phenomenon and burnout. Part 2 - Of 21 members of the Department of Radiology who completed the CIPS in the interactive workshop, 71% exhibited frequent or intense symptoms of imposter phenomenon. On the post-workshop survey asking participants to rate the workshop, the mean score was 4.4 and the mode score was 5 on a scale of 1 (poor) to 5 (excellent). CONCLUSION: Imposter phenomenon affects radiologists and is correlated with burnout. Innovative interventions to address imposter phenomenon such as workshops utilizing medical improvisational techniques are well-received.

Physician Burnout in Radiology: Perspectives From the Field.

Physician burnout is increasingly recognized as a public health crisis given the impact of burnout on physicians, their families, patients, communities, and population health. The COVID-19 pandemic has superimposed a new set of challenges for physicians to navigate, including unique challenges presented to radiologists. Radiologists from a diversity of backgrounds, practice settings, and career stages were asked for their perspectives on burnout.

Spatial and time domain analysis of eye-tracking data during screening of brain magnetic resonance images.

INTRODUCTION: Eye-tracking research has been widely used in radiology applications. Prior studies exclusively analysed either temporal or spatial eye-tracking features, both of which alone do not completely characterise the spatiotemporal dynamics of radiologists' gaze features. PURPOSE: Our research aims to quantify human visual search dynamics in both domains during brain stimuli screening to explore the relationship between reader characteristics and stimuli complexity. The methodology can be used to discover strategies to aid trainee radiologists in identifying pathology, and to select regions of interest for machine vision applications. METHOD: The study was performed using eye-tracking data 5 seconds in duration from 57 readers (15 Brain-experts, 11 Other-experts, 5 Registrars and 26 Naïves) for 40 neuroradiological images as stimuli (i.e., 20 normal and 20 pathological brain MRIs). The visual scanning patterns were analysed by calculating the fractal dimension (FD) and Hurst exponent (HE) using re-scaled range (R/S) and detrended fluctuation analysis (DFA) methods. The FD was used to measure the spatial geometrical complexity of the gaze patterns, and the HE analysis was used to measure participants' focusing skill. The focusing skill is referred to persistence/anti-persistence of the participants' gaze on the stimulus over time. Pathological and normal stimuli were analysed separately both at the "First Second" and full "Five Seconds" viewing duration. RESULTS: All experts were more focused and a had higher visual search complexity compared to Registrars and Naïves. This was seen in both the pathological and normal stimuli in the first and five second analyses. The Brain-experts subgroup was shown to achieve better focusing skill than Other-experts due to their domain specific expertise. Indeed, the FDs found when viewing pathological stimuli were higher than those in normal ones. Viewing normal stimuli resulted in an increase of FD found in five second data, unlike pathological stimuli, which did not change. In contrast to the FDs, the scanpath HEs of pathological and normal stimuli were similar. However, participants' gaze was more focused for "Five Seconds" than "First Second" data. CONCLUSIONS: The HE analysis of the scanpaths belonging to all experts showed that they have greater focus than Registrars and Naïves. This may be related to their higher visual search complexity than non-experts due to their training and expertise.

To prescribe or not to prescribe? Perceptions of radiation therapists prescribing medications for common radiation therapy side effects.

BACKGROUND: During radiation therapy treatments patients may require medications to manage radiation toxicities. Since patients are assessed daily by Radiation Therapists (RTs) it would be optimal and timely for patients to receive medication prescriptions for relief of common radiation side effects from the RTs. OBJECTIVES: The purpose of this study was to determine the perceptions that RTs and Radiation Oncologists (ROs) have of frontline treatment RTs prescribing medications to patients for treatment-related side effects. METHODS: A qualitative and quantitative survey consisting of twenty-five questions on a five-point Likert scale, one open-ended question, and three demographic questions was designed. While the survey sought to examine the perceptions that RTs and ROs have of RTs prescribing medications, the survey also proposed eight different medications that RTs could potentially prescribe. The medications that were proposed are commonly prescribed to radiation therapy patients and included anti-emetic, topical anti-bacterial, hydrocortisone cream, topical anaesthetic, anti-diarrheal, anti-spasmodic, urinary analgesic and anti-fungal medications. After the survey was approved by the Research Ethics Board, RTs and ROs at a large, academic cancer centre were invited to complete the survey. To analyze the survey results, several statistical tests were performed separately for the RTs' surveys and the ROs' surveys. The chi-squared test was used to determine if the sample RT and RO populations were representative of the actual RT and RO populations (p < 0.05). Additionally, the Sign test for medians was used to analyze statistically the responses to the Likert scale questions (p < 0.05), while the Kruskal-Wallis test was used to compare the responses to the Likert scale questions across the demographic groups identified in the demographic questions (p < 0.05). RESULTS: The response rate was 34% (31/90) for the RT population and 42% (10/24) for the RO population. The statistical analysis of the RT population's surveys showed that the majority of the RTs shared positive perceptions towards having RTs prescribe medications, while some respondents highlighted negative perceptions in the open-ended qualitative question. The majority of the RTs agreed that RTs should prescribe five of the eight proposed medications, excluding anti-spasmodic, urinary analgesic, and anti-fungal medications. In contrast to the RTs, there was no statistically significant consensus from the ROs on RTs prescribing medications. Furthermore, the ROs had varying opinions on RTs prescribing the eight proposed medications. CONCLUSIONS: Although the sample size in this study was small, the results from the RT population's surveys supported RTs prescribing medications. The positive results from the RTs and the equivocal response from the ROs suggest that future research should be conducted. Additionally, a future pilot study could be implemented where RTs prescribe one or more of the five medications that were supported to prescribe by the RTs. By having RTs prescribe medications to patients in a pilot study, the effectiveness on patient care could be measured.

Toward a Platform for Structured Data Acquisition in Oncology: A Pilot Study on Prostate Cancer Screening.

INTRODUCTION: Physicians spend an ever-rising amount of time to collect relevant information from highly variable medical reports and integrate them into the patient's health condition. OBJECTIVES: We compared synoptic reporting based on data elements to narrative reporting in order to evaluate its capabilities to collect and integrate clinical information. METHODS: We developed a novel system to align medical reporting to data integration requirements and tested it in prostate cancer screening. We compared expenditure of time, data quality, and user satisfaction for data acquisition, integration, and evaluation. RESULTS: In a total of 26 sessions, 2 urologists, 2 radiologists, and 2 pathologists conducted the diagnostic work-up for prostate cancer screening with both narrative reporting and the novel system. The novel system led to a significantly reduced time for collection and integration of patient information (91%, p < 0.001), reporting in radiology (44%, p < 0.001) and pathology (33%, p = 0.154). The system usage showed a high positive effect on evaluated data quality parameters completeness, format, understandability, as well as user satisfaction. CONCLUSION: This study provides evidence that synoptic reporting based on data elements is effectively reducing time for collection and integration of patient information. Further research is needed to assess the system's impact for different patient journeys.

Interventional Radiology in the Coronavirus Disease 2019 Pandemic: Impact on Practices and Wellbeing.

PURPOSE: To report the impact of the coronavirus disease 2019 (COVID-19) pandemic on interventional radiology (IR). MATERIALS AND METHODS: A 78-question survey was distributed to practicing interventional radiologists and IR trainees. The survey consisted of demographic and practice environment queries. Anxiety symptoms were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) screener, and coping strategies were assessed using the Brief-Coping Orientation to Problems Experienced (Brief-COPE) questionnaire. RESULTS: There were 422 respondents including 333 (78.9%) attending interventional radiologists and 89 (21.1%) interventional radiologists-in-training from 15 counties. Most respondents were from academic medical centers (n = 218; 51.7%). A large majority (n = 391; 92.7%) performed a procedure on a patient with confirmed COVID-19 infection. An N95 mask was the most common (n = 366; 93.6%) safety measure employed. Cancellation or limitation of elective procedures were reported by 276 (65.4%) respondents. Many respondents (n = 177; 41.9%) had self-reported anxiety (GAD-7 score >5) with an overall mean GAD-7 score of 4.64 ± 4.63 (range: 0-21). Factors associated with reporting anxiety included female gender (p = 0.045), increased call coverage (p = 0.048), lack of adequate departmental adjustments (p <0.0001), and lack of adjustments in a timely manner (p <0.0001). The most utilized coping strategy was acceptance (mean of 5.49 ± 1.88), while the most employed dysfunctional coping strategy was self-distraction (mean of 4.16 ± 1.67). The odds of reporting anxiety increased by >125% with adoption of dysfunctional strategies. CONCLUSION: The COVID-19 pandemic induced practice alterations and high rates of self-reported anxiety in IR. Female gender, increased call coverage, and lack of adequate or timely departmental adjustments were associated with increased anxiety levels.

Medical app minefield: radiologists use of medical apps for education and reporting and do they require regulation?

AIM: To evaluate the use of apps in radiology and consider advised changes to practice. MATERIALS AND METHODS: A survey was conducted of all radiology consultants and specialty trainees within Devon and Cornwall. The responses were collated, including the list of all medical applications used. These were assessed using the Medicine & Healthcare Products Regulatory Agency (MHRA) "Medical device stand-alone software including apps" guidance. RESULTS: The response rate was 88/150 (59%) radiologists who responded with the majority 48/88 (54.4%) using apps. Forty-four of 66 (67%) states that they did not assess the reliability or accuracy of these devices prior to use with 71/81 (88%) indicating that they were unaware of any regulations. Thirty-three items were identified of which 27 functioning apps were identified and three of these were considered medical devices and did not have complete and recognisable CE marking as required by the MHRA. CONCLUSION: This study highlights that application use is widespread. The vast majority of these applications are not considered medical devices; however, there are some devices that, according to the MHRA flow chart, are used in a way that classifies them as medical devices and should therefore be CE marked. This highlights the need for guidance and regulation of the medical application market with recommendations provided.

The Medical Malpractice Deposition: A Review for Radiologist-Defendants.

Depositions are critical components of any medical malpractice lawsuit and seek to help uncover the facts of the case to allow justice to be served. Depositions often create considerable anxiety for physician-defendants, including radiologists. Defendants unfamiliar with the rules of questioning or interviewing techniques used by plaintiffs' attorneys may fail to appreciate important and nuanced details of questions from the plaintiff's attorney, which in turn could impact the outcome of the case. Thorough and informed deposition preparation is thus essential. Highlighting issues relevant to radiologist-defendants, we discuss the role and structure of medical malpractice depositions as well as common scenarios, lines of questioning, and attorney strategies.

Performance and educational training of radiographers in lung nodule or mass detection: Retrospective comparison with different deep learning algorithms.

ABSTRACT: The aim of this investigation was to compare the diagnostic performance of radiographers and deep learning algorithms in pulmonary nodule/mass detection on chest radiograph.A test set of 100 chest radiographs containing 53 cases with no pathology (normal) and 47 abnormal cases (pulmonary nodules/masses) independently interpreted by 6 trained radiographers and deep learning algorithems in a random order. The diagnostic performances of both deep learning algorithms and trained radiographers for pulmonary nodules/masses detection were compared.QUIBIM Chest X-ray Classifier, a deep learning through mass algorithm that performs superiorly to practicing radiographers in the detection of pulmonary nodules/masses (AUCMass: 0.916 vs AUCTrained radiographer: 0.778, P < .001). In addition, heat-map algorithm could automatically detect and localize pulmonary nodules/masses in chest radiographs with high specificity.In conclusion, the deep-learning based computer-aided diagnosis system through 4 algorithms could potentially assist trained radiographers by increasing the confidence and access to chest radiograph interpretation in the age of digital age with the growing demand of medical imaging usage and radiologist burnout.

Students' and Qualified Radiographers' Perspectives and Understanding on Occupational Dose Monitoring and Prevention Strategies.

ABSTRACT: Effective implementation and ongoing monitoring of occupational radiation safety and protection is key for radiographers as prolonged exposure to ionizing radiation can increase the risk of long-term ill health effects. It is important that radiographers are aware of what is required of them to remain within the permitted dose limit. Topics and training on dose monitoring and occupational practice safety and practice are embedded in both undergraduate and postgraduate courses and ongoing as part of continuous professional development. However, whether these are accurately, effectively implemented and adhered too in practice needs to be monitored. This study aimed to investigate students and radiographers' awareness, observations, and understandings of their compliance to occupational radiation safety and protection and monitoring thereof in the clinical setting. A cross sectional survey design with a questionnaire consisting of closed and open-ended items were used. The data were analysed with the use of SPSS statistical software tool. The response rates for student radiographers were 62% and qualified radiographers 23.19%. Most participants indicated that they were knowledgeable on best practice methods regarding radiation protection and safety. However, regarding the importance of personal monitoring devices, the responses varied and there were some inconsistencies. The perspectives of participants on rotating through different imaging examination types revealed that of least importance was the occupational exposure. Students were focused as part of their training on acquiring the necessary skills to conduct imaging examinations. Qualified radiographers focused on upkeeping their skills when it came to their rotation between the general and specialized imaging examinations. To overcome some of these inconsistencies it is recommended that standardized practice guidelines be reviewed by both the academic institution and the clinical training sites enforcing the importance of dose monitoring and radiation safety and best practice principles.

Evaluation of stress and anxiety caused by the coronavirus disease 2019 (COVID-19) pandemic in pediatric radiology.

BACKGROUND: Work-related stress and burnout were documented to be high among pediatric radiologists prior to the coronavirus disease 2019 (COVID-19) pandemic. New challenges arose from the COVID-19 pandemic, potentially introducing new stressors and anxieties. OBJECTIVE: To evaluate potential sources of stress and anxiety for pediatric radiology faculty during the early phase of the COVID-19 pandemic. MATERIALS AND METHODS: We conducted a survey of attending physician members of the Society for Pediatric Radiology in North America from April 27, 2020, to May 22, 2020. The response rate was 21% (251/1,206). Survey questions included demographic information and questions regarding working remotely, personal protective equipment, redeployment, personal wellness, wellness resources and financial concerns. A psychometrician reviewed the questions to ensure minimal risk of misinterpretation. RESULTS: Median age of respondents was 48 years (range 33-70 years) with median number of years in practice of 14 (range 1-45 years). Fifty-three percent of respondents were women and 46% were men. Because of an increase in remote work, 69% of respondents endorsed feeling more isolated from a lack of regular interaction with colleagues. Fifty-three percent of respondents indicated that it is challenging to work remotely while overseeing home schooling for children. In comparison to men, women reported overall higher work-related stress and anxiety (P=0.02), higher feelings of guilt from radiology staff (i.e. technologists and nurses) being more exposed to COVID-19 (P=0.02) and higher levels of stress providing for dependents (P=0.04). Most respondents thought that departmental leadership was effective and respondents were not concerned about meeting financial obligations or job loss. CONCLUSION: The early phase of the COVID-19 pandemic caused additional stress and anxiety for pediatric radiology faculty and disproportionally affected women. Given the continuously evolving state of the COVID-19 pandemic, these results could aid in planning and implementation of future strategies to combat burnout in radiology. Specific attention should be directed to different stressors experienced by female versus male radiologists, especially in regard to dependent care.

ai-corona: Radiologist-assistant deep learning framework for COVID-19 diagnosis in chest CT scans.

The development of medical assisting tools based on artificial intelligence advances is essential in the global fight against COVID-19 outbreak and the future of medical systems. In this study, we introduce ai-corona, a radiologist-assistant deep learning framework for COVID-19 infection diagnosis using chest CT scans. Our framework incorporates an EfficientNetB3-based feature extractor. We employed three datasets; the CC-CCII set, the MasihDaneshvari Hospital (MDH) cohort, and the MosMedData cohort. Overall, these datasets constitute 7184 scans from 5693 subjects and include the COVID-19, non-COVID abnormal (NCA), common pneumonia (CP), non-pneumonia, and Normal classes. We evaluate ai-corona on test sets from the CC-CCII set, MDH cohort, and the entirety of the MosMedData cohort, for which it gained AUC scores of 0.997, 0.989, and 0.954, respectively. Our results indicates ai-corona outperforms all the alternative models. Lastly, our framework's diagnosis capabilities were evaluated as assistant to several experts. Accordingly, We observed an increase in both speed and accuracy of expert diagnosis when incorporating ai-corona's assistance.

Work satisfaction among neuroradiology staff after receiving follow up reports of thrombectomy stroke patients.

BACKGROUND AND PURPOSE: During a period of 6 months, we provided our entire neuroradiological staff including physicians, radiographers, and researchers with systematic feedback via email on the further clinical course of stroke patients who underwent mechanical thrombectomy. We analyzed the effects of this feedback on work satisfaction, work meaningfulness and valuation of the therapy among our staff. METHODS: Our staff completed two self-reported questionnaires before and after the period of six months with systematic feedback. RESULTS: Employees with higher work meaningfulness and higher work satisfaction valuated endovascular stroke therapy as more useful (p<0.001). A good clinical outcome was regarded more motivating than a good interventional outcome (p<0.001). Receiving systematic feedback did not increase work satisfaction (p = 0.318) or work meaningfulness (p = 0.178). Radiographers valuated the usefulness of interventional therapy the worst of all employees (p≤ 0.017). After the feedback period, 75% of radiographers estimated stroke as a more severe disease than before. Also, their desire for feedback decreased significantly (p = 0.007). Primarily patient cases with unfavorable outcomes were remembered by the staff. CONCLUSIONS: Systematic email feedback does not per se enhance work satisfaction or work meaningfulness among employees. However, receiving feedback is educative for the staff. Evaluating work satisfaction and the perception of treatment may help to identify unexpected issues and may therefore help to find specific measures that increase work satisfaction and motivation.