Generation Y Health Professional Students’ Preferred Teaching and Learning Approaches: A Systematic Review

Generation Y or Millennials are descriptors for those born between 1982 and 2000. This cohort has grown up in the digital age and is purported to have different learning preferences from previous generations. Students are important stakeholders in identifying their preferred teaching and learning approaches in health professional programs. This study aimed to identify, appraise, and synthesize the best available evidence regarding the teaching and learning preferences of Generation Y health professional students. The review considered any objectively measured or self-reported outcomes of teaching and learning reported from Generation Y health professional student perspectives. In accordance with a previously published Joanna Briggs Institute Protocol, a three-step search strategy was completed. Two research articles (nursing and dental hygiene students) and three dissertations (nursing) were critically appraised. All studies were cross-sectional descriptive studies. A range of pedagogical approaches was reported, including lecture, group work, and teaching clinical skills. Based on the Joanna Briggs Institute levels of evidence, reviewers deemed the evidence as Level 3. Some generational differences were reported, but these were inconsistent across the studies reviewed. There is, therefore, insufficient evidence to provide specific recommendations for the preferred educational approaches of health professional students and further research is warrante

Comparison of Synthetic Computed Tomography Generation Methods, Incorporating Male and Female Anatomical Differences, for Magnetic Resonance Imaging-Only Definitive Pelvic Radiotherapy

Purpose: There are several means of synthetic computed tomography (sCT) generation for magnetic resonance imaging (MRI)-only planning; however, much of the research omits large pelvic treatment regions and female anatomical specific methods. This research aimed to apply four of the most popular methods of sCT creation to facilitate MRI-only radiotherapy treatment planning for male and female anorectal and gynecological neoplasms. sCT methods were validated against conventional computed tomography (CT), with regard to Hounsfield unit (HU) estimation and plan dosimetry. Methods and Materials: Paired MRI and CT scans of 40 patients were used for sCT generation and validation. Bulk density assignment, tissue class density assignment, hybrid atlas, and deep learning sCT generation methods were applied to all 40 patients. Dosimetric accuracy was assessed by dose difference at reference point, dose volume histogram (DVH) parameters, and 3D gamma dose comparison. HU estimation was assessed by mean error and mean absolute error in HU value between each sCT and CT. Results: The median percentage dose difference between the CT and sCT was &lt;1.0% for all sCT methods. The deep learning method resulted in the lowest median percentage dose difference to CT at −0.03% (IQR 0.13, −0.31) and bulk density assignment resulted in the greatest difference at −0.73% (IQR −0.10, −1.01). The mean 3D gamma dose agreement at 3%/2 mm among all sCT methods was 99.8%. The highest agreement at 1%/1 mm was 97.3% for the deep learning method and the lowest was 93.6% for the bulk density method. Deep learning and hybrid atlas techniques gave the lowest difference to CT in mean error and mean absolute error in HU estimation. Conclusions: All methods of sCT generation used in this study resulted in similarly high dosimetric agreement for MRI-only planning of male and female cancer pelvic regions. The choice of the sCT generation technique can be guided by department resources available and image guidance considerations, with minimal impact on dosimetric accuracy.</p

Optimisation and validation of an integrated magnetic resonance imaging-only radiotherapy planning solution

Background and purpose: Magnetic resonance imaging (MRI)-only treatment planning is gaining in popularity in radiation oncology, with various methods available to generate a synthetic computed tomography (sCT) for this purpose. The aim of this study was to validate a sCT generation software for MRI-only radiotherapy planning of male and female pelvic cancers. The secondary aim of this study was to improve dose agreement by applying a derived relative electron and mass density (RED) curve to the sCT. Method and materials: Computed tomography (CT) and MRI scans of forty patients with pelvic neoplasms were used in the study. Treatment plans were copied from the CT scan to the sCT scan for dose comparison. Dose difference at reference point, 3D gamma comparison and dose volume histogram analysis was used to validate the dose impact of the sCT. The RED values were optimised to improve dose agreement by using a linear plot. Results: The average percentage dose difference at isocentre was 1.2% and the mean 3D gamma comparison with a criteria of 1%/1 mm was 84.0% ± 9.7%. The results indicate an inherent systematic difference in the dosimetry of the sCT plans, deriving from the tissue densities. With the adapted REDmod table, the average percentage dose difference was reduced to −0.1% and the mean 3D gamma analysis improved to 92.9% ± 5.7% at 1%/1 mm. Conclusions: CT generation software is a viable solution for MRI-only radiotherapy planning. The option makes it relatively easy for departments to implement a MRI-only planning workflow for cancers of male and female pelvic anatomy.</p

The Australian BreastScreen workforce: a snapshot

Purpose: BreastScreen Australia programmes employ qualified, skilled radiographers who provide radiologists with high quality mammographic images for interpretation. Workforce issues are a key factor in productivity and capacity, particularly in light of the aging of the population and the possible expansion of the target age group. The purpose of this paper is to provide a snapshot of the demographics and current working practices of radiographers currently employed by BreastScreen Australia. Methods: A questionnaire was distributed to radiographers employed in BreastScreen Australia Services. This paper reports on responses to questions relating to demographics and current working practices. Results: Two hundred and fifty three questionnaires were returned. Of radiographers within Australian BreastScreen programmes 53% are over 50 years old, 69% were trained in Australia and have been undertaking mammography for 10 years or more. Radiographers under 35 years old make up 12% of the current workforce. Of the BreastScreen workforce, 63% are employed part time. Conclusion: An estimated 78% response rate implies that the data obtained from Australian radiographers currently working in BreastScreen is representative. Within the next five to ten years it is estimated that 30% of BreastScreen radiographers may retire. Strategies are needed to increase workforce numbers, in order to cope with increased participation rates due to population growth and an increased target age range

Assessment of the willingness of radiographers in mammography to accept new responsibilities in role extension: part one - quantitative analysis

Purpose : The success of skill development amongst radiographers in the UK over the last 30 years has stimulated discussion about similar developments in Australia. The introduction of flexible roles and responsibilities may well improve the recruitment and retention issues facing radiographers in mammography by increasing the level of job satisfaction and professional confidence. The main purpose of this study was to investigate the attitudes of BreastScreen Australia radiographers toward mammography screen reading and to determine other areas of interest in role extension. Methods and materials: Questionnaires were sent to radiographers working within Australian BreastScreening programs. The emphasis for this study was on image interpretation, although different areas of role expansion were discussed. The radiographers were asked whether there were any barriers preventing them from becoming screen readers and the levels of supervision and training they thought appropriate for different tasks.They were asked to discuss possible benefits and disadvantages of additional responsibilities. The involvement of radiographers with routine screening was explored as well as the possibility of further training leading to more diversity in their careers. Results: The results highlight the interest that radiographers working in Australia have for role extension in mammography. The radiographers indicated they would feel reasonably confident to undertake image interpretation, but two areas gave them cause for concern – a lack of prior images, and the prospect of no radiologist reading with them. The majority (79%) of radiographers were prepared to undertake extra training and demonstrated that the importance of increased pay for these extra responsibilities (39%) lagged behind the importance of increased professional equity (47%) and increased enjoyment and interest in mammography (66%). The possibility of role expansion being a cause of division in the workforce (pressure to comply) was seen as a problem by only 15% of respondents. Conclusion: This study reports on the thoughts and perceptions of Australian radiographers on many aspects of role expansion within BreastScreen Australia and shows their support for advanced practice

Development of a training package to increase the performance of radiographers in assessing screening mammograms

Purpose: Due to a lack of any formal training in mammographic image interpretation for radiographers in Australia, a training package was developed specifically for radiographers who were to undertake a trial of screening mammogram assessment. Methods: A PowerPoint presentation was developed and included topics such as: how best to prepare to screen read, methods of checking all areas of the breast tissue, and examples of benign and malignant lesions. The training package was made available after completion of a pilot study, and pre-post testing was conducted on the same mammograms to determine the effectiveness of training. Results: There was an overall increase in sensitivity (73-78%) with five of seven radiographers improving. The average specificity was relatively constant (71-70%), with three radiographers showing improvement. Again, overall accuracy remained constant (72%) with four radiographers improving, one remaining constant and two decreasing in accuracy. Conclusion: Guidelines for preparing and systematically checking mammogram images were helpful to most of the radiographers, with the training package helping to improve sensitivity and accuracy for the majority of participants

Towards in vivo TLD dosimetry in mammography

While TLDs are used for quality control assessment of the mammography unit, in vivo dose measurements are necessary to account for the variation in size and composition of the female breast. The use of thermoluminescent dosimeters (TLDs) in mammography has been limited due to TLD visibility. The aim of this current investigation was to access the suitability of a paper-thin LiF:Mg,Cu,P TLD (GR-200F) for in vivo dosimetric mammography measurements. The visibility of GR-200F has been directly compared with LiF:Mg,Cu,P TLDs (GR-200A) using a number of commercially available phantoms. The phantoms of thickness 2–5 cm were imaged over the range of tube potentials (24–28 kVp) used clinically. Both types of TLD were placed on the surface of the phantoms allowing assessment of visibility, entrance surface dose (ESD) and field homogeneity. In vivo assessment of ESD and visibility was also carried out on a volunteer undergoing a routine mammography examination. The positions of the GR-200F TLDs were not identified either on the image of the Leeds TOR(MAM) phantom or the patient mammograms. The average ESD for the Leeds phantom was 8.8 mGy, while the patient ESD was 13 mGy. It is now possible to perform in vivo measurements with the potential of increasing the accuracy of the doses measured for women that do not conform to a standard breast thickness or density

A retrospective pilot study of the performance of mammographers in interpreting screening mammograms

Purpose: This paper provides pilot data from one Breast Screening Program on whether mammographers have the ability to review mammograms with similar accuracy to screen readers. Methods: The participant group consisted of 11 mammographers (experienced in assessing images for technical adequacy, but no specialised training for detecting abnormalities) and three current screen readers employed at Hunter BreastScreen. Fifty sets of mammograms performed during 2003 were used in the retrospective study. The mammograms were chosen to represent a range of review outcomes. Each participant reviewed each set of mammograms using the BreastScreen Australia assessment scale; these results were then categorised into two groups – Rescreen or Recall. The consensus review outcome of the original screen readers was used as the “Gold Standard”. Patient outcome was assessed by following up on the results of any histology or pathology tests in 2003 or the 2006 screening results. Results: Compared with the Gold Standard outcomes, the three current screen reader participants had sensitivity values of 67%, 83% and 94%; mammographer sensitivity values ranged from 61% to 89%. Specificity for the screen reader participants was 81%, 84% and 87% and mammographers ranged from 45% to 97%. Accuracy for the three screen readers was 76%, 84% and 90% while the mammographers attained between 55% and 86%. Conclusion: Without any training, the sensitivity obtained by three mammographers and the specificity obtained by six mammographers were similar to those of the current screen reader participants. Accuracy rates of the mammographers indicate that screen reading by selected and appropriately trained mammographers may be feasible

Towards in vivo TLD dosimetry in mammography

While TLDs are used for quality control assessment of the mammography unit, in vivo dose measurements are necessary to account for the variation in size and composition of the female breast. The use of thermoluminescent dosimeters (TLDs) in mammography has been limited due to TLD visibility. The aim of this current investigation was to access the suitability of a paper-thin LiF:Mg,Cu,P TLD (GR-200F) for in vivo dosimetric mammography measurements. The visibility of GR-200F has been directly compared with LiF:Mg,Cu,P TLDs (GR-200A) using a number of commercially available phantoms. The phantoms of thickness 2–5 cm were imaged over the range of tube potentials (24–28 kVp) used clinically. Both types of TLD were placed on the surface of the phantoms allowing assessment of visibility, entrance surface dose (ESD) and field homogeneity. In vivo assessment of ESD and visibility was also carried out on a volunteer undergoing a routine mammography examination. The positions of the GR-200F TLDs were not identified either on the image of the Leeds TOR(MAM) phantom or the patient mammograms. The average ESD for the Leeds phantom was 8.8 mGy, while the patient ESD was 13 mGy. It is now possible to perform in vivo measurements with the potential of increasing the accuracy of the doses measured for women that do not conform to a standard breast thickness or density