An Assessment of Radiology Residency Program Websites

An Assessment of Radiology Residency Program Websites

ORIGINAL ARTICLE An Assessment of Radiology Residency Program Websites David R. Hansberry, MD, PhD a , Jonathan Bornstein, BA, MD a, Nitin Agarwal, M...

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ORIGINAL ARTICLE

An Assessment of Radiology Residency Program Websites David R. Hansberry, MD, PhD a , Jonathan Bornstein, BA, MD a, Nitin Agarwal, MD b, Kristen E. McClure, MD a, Sandeep P. Deshmukh, MD a, Suzanne Long, MD a Abstract Purpose: When prospective radiology residents decide where to apply to residency, many will use the Internet as a resource to garner information. Therefore, it is important for residency programs to produce and maintain an informative and comprehensive website. Here, we review 179 radiology residency program websites for 19 criteria including various aspects related to the residency application process, benefits, didactics, research, clinical training, and faculty leadership. Methods: We evaluated 179 radiology residency program websites for the inclusion of 19 different criteria. Criteria for information not available directly on the website and links with no information were considered not present. Results: Only 12 of the 179 (6.7%) program websites had at least 80% of the 19 criteria. In addition, 41 programs (23%) had less than 50% of the criteria listed on their websites. Websites ranged from having 16% of the criteria to as much as 95%. Conclusion: Although previous studies have shown that prospective radiology resident applicants are influenced by intangibles like current resident satisfaction and academic reputation, they have also shown that applicants are influenced by the educational curriculum, clinical training, program resources, research opportunities, and quality of faculty. Therefore, it is imperative to provide online resources for prospective candidates in an attempt for residency programs to remain competitive in recruiting high-quality US medical student graduates. These findings suggest there is room for improving the comprehensiveness of information provided on radiology residency program websites. Key Words: Radiology residency, website, applicant, ERAS, NRMP, medical student J Am Coll Radiol 2017;-:---. Copyright  2017 American College of Radiology

INTRODUCTION Medical students interested in obtaining a residency position in radiology register on the Electronic Residency Application Service (ERAS) and submit their application to a list of designated programs, potentially undergo interviews, and then list their preferred order of residency programs to the National Residency Matching Program. Although medical students rely on advice from colleagues and mentors when deciding which programs to apply to,

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Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. b Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. Corresponding author and reprints: David R. Hansberry, MD, PhD, Thomas Jefferson University Hospitals, Department of Radiology, 132 South 10th Street, Philadelphia, PA 19107; e-mail: david.hansberry@ jefferson.edu. The authors have no conflicts of interest related to the material discussed in this article.

ª 2017 American College of Radiology 1546-1440/17/$36.00 n https://doi.org/10.1016/j.jacr.2017.11.010

many students will review information offered on the individual radiology program’s website. In fact, a study of anesthesia residency applicants found that 98% of applicants referenced residency program websites during the application process [1]. Given the widespread availability of the Internet, it is not surprising that prospective radiology applicants frequently use the program’s website to garner more information in an effort to better educate themselves about program details like curriculum and research opportunities. Previous studies in other medical specialties have demonstrated deficiencies in online content available on residency program websites [2-7]. An overview of general surgery residency websites in 2004 established a basic set of 10 design criteria and 16 content items [2], followed by a study in which the authors sent out anonymous surveys to establish information needs and thoughts on current websites [1]. This research has demonstrated that residency program websites are often not

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comprehensive and that the missing information can be crucial for applicants in finding the right fit among the programs offered [3,4]. A study evaluating emergency medicine residency websites found that residency applicants valued the content of the website more than the design aspects [5]. Because program websites are often the most convenient or only resource prospective residents have in deciding whether or not to apply to the program, and because the content of a website has been demonstrated to be important to applicants [8], the completeness of the website is critical for programs to remain competitive for applicants, particularly with a decline since 2009 in applications to radiology resident programs [6,7,9]. Previously, it was shown that radiology applicants find great value in the information available online in assisting them through the match process [10]. To date, there has been no study evaluating the completeness of radiology residency websites. We reviewed the websites of 179 radiology residency programs and evaluated each website on information offered, including the application process, didactics, benefits, research, clinical training, and faculty leadership. Thorough evaluation of the criteria described here will allow radiology residency programs to reevaluate their websites and ensure that they are providing comprehensive information to applicants.

METHODS A list of 180 diagnostic radiology residency programs and websites was obtained from the ERAS in March 2016. Of the 180 programs, 179 were evaluated (one program’s website was inaccessible). All websites were freely available to the public including any potential applicant. The website for each program was then accessed at the link provided by ERAS or through a Google search. The websites were then searched for the presence of 19 unique criteria (Table 1). Inclusion of information required its presence directly on the radiology residency or department website. However, information on salary, benefits, parking, meals, and faculty listing was considered present if it was accessible by a direct link from the radiology website. This information was collected by one of the authors (J.B.) and verified by a second author (D.R.H.). Analysis of programs based on geographic location and size were also performed. Programs were divided into institutions based in the Northeast (Maryland, Pennsylvania, Delaware, New Jersey, New York, Connecticut, Massachusetts, Vermont, Rhode Island, New Hampshire, Maine, and the District of Columbia), South (Virginia, 2

Table 1. List of 19 features and the percentage of total programs that included the feature on their website Features Facility description Contact e-mail Academic courses (such as AIRP or physics) Current residents Benefits Information on surrounding area Past research projects Comprehensive faculty listing Rotation schedule Call schedule Research description Link to ERAS Fellowship placement Salary Message from program director Message from chairperson Meal allowance Selection criteria Parking

% of Programs That Included Feature 89 88 83 78 69 66 65 63 62 61 59 57 55 51 46 42 40 37 36

AIRP¼American Institute for Radiologic Pathology; ERAS¼Electronic Residency Application Service.

Kentucky, Arkansas, Oklahoma, Texas, North Carolina, South Carolina, Georgia, Florida, Louisiana, Mississippi, Alabama, Tennessee, Puerto Rico), West (New Mexico, Colorado, Washington, Oregon, Nevada, Utah, Arizona, California, Hawaii), and Midwest (Nebraska, Kansas, Minnesota, Iowa, Missouri, Wisconsin, Illinois, Michigan, Indiana, Ohio, West Virginia). States without programs included Alaska, Wyoming, Montana, Idaho, North Dakota, and South Dakota. The Northeast contained 70 programs, the South contained 43 programs, the West contained 25 programs, and the Midwest contained 41 programs. For analysis based on program size, the median number of residents (not including interns) was 24, so programs with 24 residents or more were considered a large program, and programs with fewer than 24 were considered small programs. By these criteria, there were 90 large programs and 86 small programs. Three programs did not have information on the number of residents in the program.

RESULTS Of the 179 radiology residency program websites evaluated, only 12 (6.7%) addressed at least 80% of the 19 Journal of the American College of Radiology Volume - n Number - n Month 2017

different criteria. The average number of criteria that each website included on their website was 11.5 (60.8%) of the possible 19 with an SD of 3.0. Programs had as few as 3 of the 19 (15.8%) criteria included on their website, and others had as many as 18 of the 19 (94.7%) criteria. In fact, 41 of the 179 programs (22.9%) had fewer than 50% of the criteria included. Criteria included on at least 75% of the websites included description of the facility (89.4%), a contact e-mail (88.3%), a listing of the current residents (86.3%), a description of extra courses available such as American Institute for Radiologic Pathology (AIRP) (82.1%), and a listing of current faculty (78.2%; Table 1). Criteria included on fewer than 50% of the websites included parking information for residents (35.8%), specific information on selection criteria that the program uses to evaluate applicants (36.9%), meal allowance for residents (40.2%), a message from the chair of the department (42.1%), and a message from the program director (45.5%). Analysis based on geographic region (Table 2) showed that programs based in the Midwest had the highest rate of inclusion of the 19 criteria evaluated with an average of 12.1 (SD 2.7), followed by programs from the Northeast with an average of 11.8 (SD 2.8), then the South with an average of 11.3 (SD 3.1), and last, the West with an average of 10.6 (SD 3.2). Larger programs included an average of 12.0 of the criteria (SD 2.6), and smaller programs included an average of 11.0 (SD of 3.2; Table 2). There is no statistical difference between the number of criteria included on a website based on the location of the program or size of the program.

DISCUSSION Through a semiquantitative evaluation of radiology residency websites, this study sought to highlight Table 2. Average number of the 19 features included on programs’ websites based on program size and geographic location Feature Size of program Small Large Location of program Northeast Midwest South West

Average Number of Features on Programs’ Websites (SD) 11.0 (3.2) 12.0 (2.6) 11.8 (2.8) 12.1 (2.7) 11.3 (3.1) 10.6 (3.2)

Journal of the American College of Radiology Hansberry et al n Evaluating Radiology Residency Websites

shortcomings on radiology residency websites and facilitate better information sharing between programs and prospective applicants. Similar to a previous study regarding otolaryngology residency program websites [7], information regarding various benefit information such as salary, meal allowance, and parking information for residents was among the most frequently omitted from websites. In addition, many residency websites lack information regarding the structure of the program such as rotation schedule and ongoing and past research projects. Details on the curriculum and quality of training, which previous research has shown to be among the most important factors to prospective residents, are also frequently omitted. Also, the ABR certification process was restructured in 2007 [8], and many programs have made significant changes to the structures of their programs to prepare residents for the new core examination. Even in light of these recent changes, our evaluation shows that a large percentage of programs still fail to provide a comprehensive insight into this new structure, which prospective applicants are likely interested in knowing. Determining which criteria to use in conducting this evaluation was necessarily subjective. However, we selected similar criteria to previous studies [7], as well as criteria established to be important to radiology program applicants [11], because these criteria were comprehensive and addressed a variety of domains including information on benefits for residents, nature of the curriculum, quality of life, and research opportunities, among others. We chose to include 19 unique criteria that encompass a broad range of information of probable interest to medical students applying to a radiology residency. In addition, this study does not attempt to evaluate all aspects of radiology residency websites. Criteria were marked as either present or absent on a website without specific regard for the quality of the content, because doing so would make the evaluation subjective and limit reproducibility. In addition, this study did not attempt to evaluate either the appearance of or ease of navigating the websites; however, previous research has shown that these are factors for applicants [12]. We evaluated strictly for presence or absence of certain criteria and did not validate the accuracy of the online information provided by the residency programs. Unfortunately, the ability to validate this information still relies on the prospective applicant and can be done by directly speaking with the program and asking specific questions, which can ideally be done on an interview day as a prospective applicant. 3

Important information for prospective residents, including basic benefits and specific information on selection criteria, is frequently omitted from websites, which leaves curious applicants with insufficient material to gauge interest in a program. The lack of information may also force applicants to apply more broadly to residency programs and makes it significantly more difficult to determine clear differences between programs in areas that residents value. Findings in this study show that there is room for improvement for radiology residency programs in the delivery of relevant information to prospective applicants. The residency application process is extremely time intensive for both applicants and programs, and implementing changes to streamline websites will improve the recruitment process for programs and facilitate applicants’ decisions on where to apply.

CONCLUSION A residency program’s website may be the most widely utilized and cost-effective communication tool for residency program recruitment. As shown here, there is a wide variety in the comprehensiveness of these websites. Beyond the intangibles that make a program desirable, such as overall resident satisfaction and program reputation, many of the factors evaluated here, such as curriculum, program resources, research opportunities, and quality of faculty, have been demonstrated to greatly influence decision making of applicants [9,13-15]. TAKE-HOME POINTS -

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Only 12 of 179 programs addressed at least 80% of the criteria evaluated for the study on their website. Selection criteria for potential applicants, information on parking and meal allowances for residents, a message from the chair and program director, along with essential information on the structure of the program like curriculum information and ongoing or past research projects were among the most frequently excluded criteria.

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Residency program websites are among the most frequently utilized resources by students and are a very cost-effective tool for programs, but are still incomplete.

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