- Email: [email protected]
04-25 How well does applicant rank order predict radiology resident performance?
C o n c l u s i o n : On-call radiology residents have a very low rate (0.8%) of significant misinterpretations of neuroradiology CTs, and it is very rare (0.08%) for patient outcome to potentially be affected.
04-22 Developing an Ethics C u r r i c u l u m S p e c i f i c a l l y Designed for Radiology Brad H. T h o m p s o n , MD, University of Iowa Hospitals & Clinics, Iowa City, IA, Heather J. Ohrt, M D , S a m u e l K. Payne, M D P u r p o s e : There are ethical d i l e m m a s that are unique to radiology. Issues such as the allocation of scarce resources (nonionic contrast material) and reporting of i m a g i n g results to patients are classic examples. These ethical d i l e m m a s are further complicated by the radiologist's primary role as a consultant. Resident participation in a radiology-based ethics course would provide the intellectual foundation required to formulate rational ethical positions and arguments. Materials/1Vlethods: A survey presenting 19 ethical issues was given to radiology residents (n = 27) at T h e University o f Iowa before and after incorporating formal ethics instruction into the residency program. R e s u l t s : Resident r e s p o n s e s tended to vary significantly (from gold standard) regarding issues about a d v a n c e d directives, resource allocation, patient a u t o n o m y / D M C , and informed consent. Following formal instruction, resident responses indicate that the ethics curriculum greatly assisted in establishing rational ethical positions and arguments to a variety o f clinical situations. C o n c l u s i o n : W e believe the incorporation o f formal ethics curr i c u l u m specific to radiology should be included in radiology resident training programs. This paper will specifically discuss the composition and format o f our ethics curriculum.
04-23 Effectiveness of Resident-prepared C o n f e r e n c e for T e a c h i n g Radiology Residents Imaging Utilization Guidelines M a r t h a Beretta Mainiero, Rhode Island Hospital, Providence, RI, Jannette Collins, M D , MEd, Steven L. Primack, M D P u r p o s e : To determine if resident-prepared conferences are an effective m e a n s to teach radiology residents i m a g i n g utilization guidelines. M a t e r i a l s a n d M e t h o d s : B r o w n University radiology residents gave 61 presentations on i m a g i n g utilization guidelines. T h e residents were e x a m i n e d on topics presented and were surveyed about their familiarity with the A C R appropriateness criteria, issues o f cost-effectiveness and degree o f confidence in providing i m a g i n g consultation. T h e s a m e e x a m i n a t i o n and survey were administered to Wisconsin and O H S U residents as controls. Scores were c o m pared u s i n g linear regression and W i l c o x o n rank s u m test. Results: Controlling for years in residency, Brown residents scored on average 16.0% (SE = 2.2%) higher than residents at the other universities (P = .000). Controlling for this institution, residents in the third or fourth year scored on average 7.4% (SE - 2.1%) points higher than residents in the first and second year (P = .001). B r o w n residents expressed m o r e familiarity with the A C R appropriateness criteria and more exposure to cost-effectiveness issues in conferences than control residents (P < .005) but no difference in the level o f confidence in providing i m a g i n g consultation. C o n c l u s i o n : R e s i d e n t - p r e p a r e d c o n f e r e n c e s are an effective m e a n s o f t e a c h i n g i m a g i n g utilization guidelines, but confidence in i m a g i n g consultation was not d e p e n d e n t on h a v i n g attended s u c h conferences.
04-24 Routine Online H a n d h e l d Photography of T e a c h i n g Cases R a y A. Blinker, MD, Medical College of Ohio, Toledo, OH P u r p o s e : (1) Can a hand-held midrange digital camera take highquality photographs o f images on the viewbox during routine teaching sessions? (2) H o w complex is processing (PhotoShop®) and incorporation (PowerPoint®) of these p h o t o g r a p , h ~ t o a lecture? (3) Are these images comparable to "c~tu~e~i~ll~' ~'~kles from a dedicated radiology p h o t p . .J.~ 4- -~-l-~- o- ~ l ~ _ _ . . , ~ " " Methods: A J ' was " -hel-d ir M a y 1998 c o m p a r ing, side b y side, d 35 m m slide and a digital projected image. Since June o f 1998 the author has taken his S o n y M a v i c a ® midrange digital c a m e r a to daily f i l m reading and teaching sessions. T y p i c a l l y 1 to 3 c a s e s are p h o t o g r a p h e d and p r o c e s s e d the s a m e day by the author. R e s u l t s : T h e "digital-shootont" s h o w e d no difference in subjective evaluation of quality b e t w e e n the 3 5 - m m and the digital proj e c t e d i m a g e s . P r e s u m e d l y a h i g h resolution c a m e r a w o u l d do no better; ie, the " w e a k link" is the f u z z i n e s s in the original radiological image. Further the author f o u n d preparation o f cases the s a m e day very desirable as e v e n interesting c a s e s b e c o m e "cold" after a few days. C o n c l u s i o n s : A h a n d - h e l d digital c a m e r a can take high-quality i m a g e s on-line during routine f i l m review s e s s i o n s that are readily p r o c e s s e d into teaching c a s e s allowing for easier preparation o f quality lectures. Disclosure S t a t e m e n t : The author has no proprietary or financial interest in any technique or product mentioned in this abstract.
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04-25 How Well Does A p p l i c a n t Rank Order Predict Radiology Resident Performance? Saroja A d u s u m i l l i , MD, University of Michigan Medical Center, Ann Arbor, MI, Richard H. C o h a n , M D , Kelley W. Marshall, M D , Barry H. Gross, M D , J a m e s T. Fitzgerald, PhD, M a r y Oh, BS, et al P u r p o s e : To d e t e r m i n e w h e t h e r there is a relationship b e t w e e n rank order of applicants selected for a residency training p r o g r a m and s u b s e q u e n t radiology r e s i d e n c y performance. M a t e r i a l s a n d M e t h o d s : R e c o r d s o f radiology residents c o m pleting their r e s i d e n c y b e t w e e n 1991 and 1998 were reviewed. R a n k order as an applicant w a s c o m p a r e d with several subsequently obtained variables a s s e s s i n g resident performance: m e a n of f o u r t h - y e a r radiology resident rotation evaluation scores, m e a n score o f retrospective evaluation of resident p e r f o r m a n c e as ass e s s e d by four senior faculty, and scores on the written portion of the A m e r i c a n B o a r d o f R a d i o l o g y ( A B R ) examination. Correlation coefficients were calculated for each c o m p a r i s o n . R e s u l t s : Resident rank order w a s not significantly correlated with f o u r t h - y e a r resident rotation e v a l u a t i o n s (r = - . 15, P = .45, n = 26) or with A B R written e x a m i n a t i o n scores (r = .21, P = .32, n = 26). In c o m p a r i s o n , there w a s a w e a k but statistically significant correlation b e t w e e n rank order and overall retrospective evaluation of resident p e r f o r m a n c e by the four faculty (r = .29, P = .04, n = 50). C o n c l u s i o n : Factors that lead to a r e s i d e n t ' s being ranked h i g h e r or lower by the r e s i d e n c y selection c o m m i t t e e still play a part in the retrospective r a n k i n g o f the resident after the residency h a s been completed; however, applicant rank order does not predict s u b s e q u e n t radiology resident p e r f o r m a n c e , either as a s s e s s e d subjectively on rotation evaluation f o r m s or objectively on the A B R written examination.
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04-22 Developing an Ethics C u r r i c u l u m S p e c i f i c a l l y Designed for Radiology Brad H. T h o m p s o n , MD, University of Iowa Hospitals & Clinics, Iowa City, IA, Heather J. Ohrt, M D , S a m u e l K. Payne, M D P u r p o s e : There are ethical d i l e m m a s that are unique to radiology. Issues such as the allocation of scarce resources (nonionic contrast material) and reporting of i m a g i n g results to patients are classic examples. These ethical d i l e m m a s are further complicated by the radiologist's primary role as a consultant. Resident participation in a radiology-based ethics course would provide the intellectual foundation required to formulate rational ethical positions and arguments. Materials/1Vlethods: A survey presenting 19 ethical issues was given to radiology residents (n = 27) at T h e University o f Iowa before and after incorporating formal ethics instruction into the residency program. R e s u l t s : Resident r e s p o n s e s tended to vary significantly (from gold standard) regarding issues about a d v a n c e d directives, resource allocation, patient a u t o n o m y / D M C , and informed consent. Following formal instruction, resident responses indicate that the ethics curriculum greatly assisted in establishing rational ethical positions and arguments to a variety o f clinical situations. C o n c l u s i o n : W e believe the incorporation o f formal ethics curr i c u l u m specific to radiology should be included in radiology resident training programs. This paper will specifically discuss the composition and format o f our ethics curriculum.
04-23 Effectiveness of Resident-prepared C o n f e r e n c e for T e a c h i n g Radiology Residents Imaging Utilization Guidelines M a r t h a Beretta Mainiero, Rhode Island Hospital, Providence, RI, Jannette Collins, M D , MEd, Steven L. Primack, M D P u r p o s e : To determine if resident-prepared conferences are an effective m e a n s to teach radiology residents i m a g i n g utilization guidelines. M a t e r i a l s a n d M e t h o d s : B r o w n University radiology residents gave 61 presentations on i m a g i n g utilization guidelines. T h e residents were e x a m i n e d on topics presented and were surveyed about their familiarity with the A C R appropriateness criteria, issues o f cost-effectiveness and degree o f confidence in providing i m a g i n g consultation. T h e s a m e e x a m i n a t i o n and survey were administered to Wisconsin and O H S U residents as controls. Scores were c o m pared u s i n g linear regression and W i l c o x o n rank s u m test. Results: Controlling for years in residency, Brown residents scored on average 16.0% (SE = 2.2%) higher than residents at the other universities (P = .000). Controlling for this institution, residents in the third or fourth year scored on average 7.4% (SE - 2.1%) points higher than residents in the first and second year (P = .001). B r o w n residents expressed m o r e familiarity with the A C R appropriateness criteria and more exposure to cost-effectiveness issues in conferences than control residents (P < .005) but no difference in the level o f confidence in providing i m a g i n g consultation. C o n c l u s i o n : R e s i d e n t - p r e p a r e d c o n f e r e n c e s are an effective m e a n s o f t e a c h i n g i m a g i n g utilization guidelines, but confidence in i m a g i n g consultation was not d e p e n d e n t on h a v i n g attended s u c h conferences.
04-24 Routine Online H a n d h e l d Photography of T e a c h i n g Cases R a y A. Blinker, MD, Medical College of Ohio, Toledo, OH P u r p o s e : (1) Can a hand-held midrange digital camera take highquality photographs o f images on the viewbox during routine teaching sessions? (2) H o w complex is processing (PhotoShop®) and incorporation (PowerPoint®) of these p h o t o g r a p , h ~ t o a lecture? (3) Are these images comparable to "c~tu~e~i~ll~' ~'~kles from a dedicated radiology p h o t p . .J.~ 4- -~-l-~- o- ~ l ~ _ _ . . , ~ " " Methods: A J ' was " -hel-d ir M a y 1998 c o m p a r ing, side b y side, d 35 m m slide and a digital projected image. Since June o f 1998 the author has taken his S o n y M a v i c a ® midrange digital c a m e r a to daily f i l m reading and teaching sessions. T y p i c a l l y 1 to 3 c a s e s are p h o t o g r a p h e d and p r o c e s s e d the s a m e day by the author. R e s u l t s : T h e "digital-shootont" s h o w e d no difference in subjective evaluation of quality b e t w e e n the 3 5 - m m and the digital proj e c t e d i m a g e s . P r e s u m e d l y a h i g h resolution c a m e r a w o u l d do no better; ie, the " w e a k link" is the f u z z i n e s s in the original radiological image. Further the author f o u n d preparation o f cases the s a m e day very desirable as e v e n interesting c a s e s b e c o m e "cold" after a few days. C o n c l u s i o n s : A h a n d - h e l d digital c a m e r a can take high-quality i m a g e s on-line during routine f i l m review s e s s i o n s that are readily p r o c e s s e d into teaching c a s e s allowing for easier preparation o f quality lectures. Disclosure S t a t e m e n t : The author has no proprietary or financial interest in any technique or product mentioned in this abstract.
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04-25 How Well Does A p p l i c a n t Rank Order Predict Radiology Resident Performance? Saroja A d u s u m i l l i , MD, University of Michigan Medical Center, Ann Arbor, MI, Richard H. C o h a n , M D , Kelley W. Marshall, M D , Barry H. Gross, M D , J a m e s T. Fitzgerald, PhD, M a r y Oh, BS, et al P u r p o s e : To d e t e r m i n e w h e t h e r there is a relationship b e t w e e n rank order of applicants selected for a residency training p r o g r a m and s u b s e q u e n t radiology r e s i d e n c y performance. M a t e r i a l s a n d M e t h o d s : R e c o r d s o f radiology residents c o m pleting their r e s i d e n c y b e t w e e n 1991 and 1998 were reviewed. R a n k order as an applicant w a s c o m p a r e d with several subsequently obtained variables a s s e s s i n g resident performance: m e a n of f o u r t h - y e a r radiology resident rotation evaluation scores, m e a n score o f retrospective evaluation of resident p e r f o r m a n c e as ass e s s e d by four senior faculty, and scores on the written portion of the A m e r i c a n B o a r d o f R a d i o l o g y ( A B R ) examination. Correlation coefficients were calculated for each c o m p a r i s o n . R e s u l t s : Resident rank order w a s not significantly correlated with f o u r t h - y e a r resident rotation e v a l u a t i o n s (r = - . 15, P = .45, n = 26) or with A B R written e x a m i n a t i o n scores (r = .21, P = .32, n = 26). In c o m p a r i s o n , there w a s a w e a k but statistically significant correlation b e t w e e n rank order and overall retrospective evaluation of resident p e r f o r m a n c e by the four faculty (r = .29, P = .04, n = 50). C o n c l u s i o n : Factors that lead to a r e s i d e n t ' s being ranked h i g h e r or lower by the r e s i d e n c y selection c o m m i t t e e still play a part in the retrospective r a n k i n g o f the resident after the residency h a s been completed; however, applicant rank order does not predict s u b s e q u e n t radiology resident p e r f o r m a n c e , either as a s s e s s e d subjectively on rotation evaluation f o r m s or objectively on the A B R written examination.
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