Teaching Radiologists Who Perform Image Guided Interventions Effective Communication Skills Through Simulation

The purpose of this project is to teach radiologists who perform image guided interventions effective communication skills. Complaints related to communication errors between Radiologists and patients during interventional procedures are not uncommon. Communication for Radiologists performing IR procedures can be challenging since they are meeting the patient for the first time on the day of the procedure. Good communication skills are important to foster a good doctor/patient relationship, which can improve clinical outcomes and even decrease litigation.1 There is growing emphasis on communication skills/patient centered care in radiology.2 This is evident given the American College of Radiology\u27s Imaging 3.0 initiative in which the radiologist went from being only involved in reading, dictating, and transcribing the imaging study to being involved in the entire imaging process from initial consult to conveying the results of the imaging study to the patient or clinician. Simulation has been used to allow doctors to practice their communication skills in a safe setting and get feedback on how to improve. Bell et al showed that using simulation with acting patients to teach communication and relations skills was found to be universally valued by all participants and was found to be preferred over simple observation.3 While this study was not focused on radiologists specifically, other studies have suggested that the radiologist can benefit from simulation based communication skills training.4 Additional training in the communication of abnormal results with patients has been shown to result in: greater professional satisfaction, decreased stress for the physician, and improved patient compliance. Allowing physicians to rehearse the actual communication skills through role play allowed for self-reflection which in turn improved physician communication skills.5 Training courses that allowed physicians to practice delivering bad news improved performance and, more importantly, altered attitudes and beliefs about the importance of communication. Effects of this type of training were shown to be evident for as long as 12 months post training.6 Accordingly, we decided the most effective way to train physicians who perform image guided interventions in effective communication skills was through simulation

Determinants of Burnout and Well-Being in Women, Gender-Diverse Radiologists, and Radiologists of Other Underrepresented Minorities

There are many factors contributing to chronic stress at work, but one that most people do not think about is the stress related to being a woman, a person of an underrepresented minority group, or a gender-diverse or lesbian, gay, bisexual, and transgender (LGBTQ) person. In radiology, all these groups are underrepresented, and being a minority in a field can lead to stress on the job because of macro- and microaggressions, discrimination, and unfavorable working conditions. So why should we be concerned about burnout in these populations? For one, these populations bring a diversity of ideas to radiology, and diversity of ideas leads to more innovative patient care and research. Having a diverse group of radiologists can only benefit radiology as a whole. Also, there are major physical and psychological consequences of burnout, such as depression, anxiety, premature aging, susceptibility to chronic medical conditions, and, worst of all, risk for suicide. We need to be aware of factors causing burnout in each of these groups, and we need to mitigate against them by fostering inclusion in radiology

Incidental genitourinary findings on obstetrics/gynecology ultrasound

Ultrasound is the standard-of-care imaging modality for initial imaging in obstetrics and gynecology. Given the close proximity of the genitourinary system to the uterus and adnexa, it is not surprising that these studies can result in the discovery of incidental genitourinary findings such as ureterocele, ectopic ureter, bladder mass, ureteral stones, cystitis, bladder diverticulum, and pelvic kidney. Recognition of the etiology of these findings is important for appropriate diagnosis and, at times, patient care. Many of these findings are truly incidental and clinically unimportant but other times can be related to the patient\u27s chief complaint

Family and Medical Leave for Diagnostic Radiology, Interventional Radiology, and Radiation Oncology Residents in the United States: A Policy Opportunity

The American Board of Medical Specialties recently announced that effective July 1, 2021, member boards with training programs of 2 years or more must “establish requirements for candidates to become eligible for Initial Certification, including standards for training” and have “policies that accommodate reasonable leaves of absence from residency and fellowship training for personal or familial needs”. In preparation for this mandate, the American Board of Radiology (ABR) solicited comments from diverse stakeholders in March 2021—including the Association of Program Directors in Radiology, the Association of Program Directors in Interventional Radiology, and the ABR Initial Certification Advisory Committee for Radiation Oncology—with regards to Residency Service-Time Requirement, including considerations of family and medical leave. These communications included an initial proposed policy suggesting that “Programs may grant up to six weeks Parental, Caregiver and Medical Leave during the residency”. We appreciate the ABR\u27s efforts to seek feedback as it develops an updated policy. The purpose of this piece is to promote transparent discourse and to examine the nuanced issues pertaining to family and medical leave considerations within the broader context of Residency Service-Time Requirement policies for diagnostic radiology (DR), interventional radiology (IR), and radiation oncology (RO) residents, with the shared goal of optimizing both the training of competent clinicians worthy of public trust as well as professional well-being and diversity, equity, and inclusion. Given the rationale provided below, we recommend that the ABR leave policy allow a resident who is in good standing to take 12 weeks of family and medical leave during residency (in addition to 4 weeks of vacation per year), to sit for the Core/Qualifying Examinations on time, and to graduate without extension of training, with additional leave to be considered by the program director on a case-by-case basis

USMLE Step 3 Scores Have Value in Predicting ABR Core Examination Outcome and Performance: A Multi-institutional Study

RATIONALE AND OBJECTIVES: We analyzed multi-institutional data to determine if Step 3 performance tiers can identify radiology residents with increased risk of Core examination failure and submean performance. MATERIALS AND METHODS: We collected Step 3 scores (USMLE Step 3 or COMLEX Level 3) and American Board of Radiology (ABR) Core examination outcomes and scores for anonymized residents from 13 different Diagnostic Radiology residency programs taking the ABR Core examination between 2013 and 2019. Step 3 scores were converted to percentiles based on Z-score, with Core outcome and performance analyzed for Step 3 groups based on 50th percentile and based on quintiles. Core outcome was scored as fail when conditionally passed or failed. Core performance was measured by the percent of residents with scores below the mean. Differences between Step 3 groups for Core outcome and Core performance were statistically evaluated. RESULTS: Data were available for 342 residents. The Core examination failure rate for 121 residents with Step 3 scores \u3c 50th percentile was 19.8% (fail relative risk=2.26), significantly higher than the 2.7% failure rate for the 221 other residents. Of 42 residents with Step 3 scores in the lowest quintile, the Core failure rate increased to 31.0% (fail relative risk=3.52). Core performance improved with higher Step 3 quintiles. CONCLUSION: Step 3 licensing scores have value in predicting radiology resident performance on the ABR Core examination, enabling residency programs to target higher risk residents for early assessment and intervention

Breaking the Stereotype: Interventions Aimed at Changing Medical Student Misperceptions of Radiology and Increasing the Female Match Rate

BACKGROUND: Although nearly half of medical students are female there is still a significant discrepancy in the number of women specializing in radiology. In 2013, 26.9% of US diagnostic radiology residents were female, a 1% increase in 20 years from 25.5% in 1990. PURPOSE: The purpose of this project is to determine the effectiveness of the interventions implemented at a single medical school at decreasing negative attitudes about radiology held by medical students of all genders and whether those same interventions will increase the number of female medical students matching into radiology. METHODS: The interventions were implemented between 2012 and 2016 and included incorporation of radiology into preclinical curriculum, electives in radiology for 3rd year students, a Women in Radiology Panel, and increase in female radiology faculty visibility. First year medical student participants of all genders used a free text box to write their attitudes about radiology, which were categorized into the six most common attitudes about radiology. Fourth year medical student participants used a free text box to write the reasons why they did not choose radiology as a specialty, and those answers were then placed into the same six categories. We then analyzed the data using Fisher\u27s Exact Test to determine whether there was a decrease in the negative misperceptions after exposure to the interventions. We also then determined whether there was an increase in the number of women matching into radiology using Chi-Square analysis. RESULTS: There was a decrease in the negative misperceptions between 1st and 4th years, with the most notable decrease from 51% of 1st years to 0% of 4th years listing radiologists as being antisocial (p \u3c 0.01). There was also a significant increase in the number of female medical students matching into radiology in the years in which students were exposed to 4 years of intervention when compared to three and fewer (0.76%-4.2%, p=0.01). CONCLUSION: Exposure to 4 years of the interventions demonstrated a significant increase in the female match rate into the specialty when compared to female medical students who experienced three or fewer years of intervention. Additionally, it appears that these same interventions decreased the number of students of all genders having some of the common negative misperceptions about the field of radiology

Pitfalls in imaging of female infertility

Imaging plays a crucial role in determining which factors may be involved in female infertility

A Review of Resources and Methodologies Available for Teaching and Assessing Patient-Related Communication Skills in Radiology

ACGME expectations for radiology trainees\u27 proficiencies in communication skills pose a challenge to program directors who wish to develop curricula addressing these competencies. Numerous educational resources and pedagogical approaches have emerged to address such competencies specifically for radiology, but have yet to be systematically catalogued. In this paper, we review and compile these resources into a toolkit that will help residencies develop curricula around patient-centered communication. We describe numerous web-based resources and published models that have incorporated innovative, contemporary pedagogical techniques. In undertaking this compilation, our hope is to kindle discussion about the development of formalized or standardized communication curricula or guides for radiology residencies

Do Interventions Intended to Increase Female Medical Student Interest in Radiology Work? Preliminary Findings

PURPOSE: The purpose of this study is to share the preliminary findings after initiation of interventions at the medical school level, which have been suggested by the literature to increase female medical student interest in radiology at one institution. Additionally, the paper provides discussion of how to better future interventions for increasing female medical student interest. METHODS: Interventions to increase medical student exposure to radiology were implemented at the University of Massachusetts Medical School in 2012. Radiology was incorporated into the preclinical curriculum; flexible clinical experiences stressing patient contact were created for early exposure to radiology during third-year clerkships; and a \u27Women in Radiology\u27 panel was held to promote visibility of female radiologists. In addition, female radiology faculty became more involved in medical school activities and events. RESULTS: Our results suggest that early exposure in the preclinical curriculum and patient-centered electives increase overall student interest in radiology but only minimally increase female interest. Simply offering the patient-centered electives is not enough as it resulted in more male student enrollment than female (60% vs. 40%, respectively). Just one event promoting visibility of female radiologists changed female medical student perception of patient contact within radiology by a statistically significant amount. Examination of current UMass faculty radiologists by gender demonstrates that full-time, junior female radiologists-the demographic suggested to have the biggest impact on female medical students-only accounted for 4% of faculty. CONCLUSION: This article may be informative for radiology departments looking to increase female medical student interest. Required visibility of female radiologists and active publicity of female radiologists from the first preclinical year are likely to have the biggest impact in increasing female medical student interest

Benign Breast Cyst in a Young Male

Simple benign breast cysts are commonly diagnosed in female breasts and may present as palpable masses. However, they are extremely uncommon in the male breast and are rarely reported in the literature. Here, we report a case of a simple benign cyst of the breast in a relatively healthy 37-year-old man. The patient initially presented with a palpable 2-3 mm tender left breast lump. Further evaluation with mammography and ultrasound revealed a mass most consistent with a simple benign cyst. However, considering the rarity of breast cysts in males, the lesion was biopsied to rule out malignancy. Pathology results from ultrasound-guided core needle biopsy demonstrated fibro-adipose tissue with a benign cyst lined by foamy cells with apocrine features, consistent with a diagnosis of a benign epithelial cyst and concordant with the radiological findings. To our knowledge, this is the youngest case of a benign breast cyst in a male that has been reported in the literature. In this case report, we discuss the typical features and presentation of breast cysts in males, associated imaging findings on mammography and ultrasound, and the necessity for pathological confirmation with biopsy in this population