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Radiology Education
ARTICLE IN PRESS
Guest Editorial
Radiology Education: It Takes a Village! Aine Marie Kelly, MD, MS, MA, Priscilla J. Slanetz, MD, MPH, FACR
Welcome to the fifth educational issue of Academic Radiology, a joint effort of the Alliance of Medical Student Educators in Radiology (AMSER) and the Alliance for Clinician Educators in Radiology (ACER) that is dedicated to radiology educational topics. Radiology education is a multidisciplinary and multifaceted effort involving many personnel as part of the team. Many of their roles are carried out behind the scenes and are often not apparent, particularly if done well. In this issue, we focus on some of these practical aspects, including the perspectives of the residency program coordinator, roles of the residency program director, efforts to support resident well-being, methods to provide effective resident feedback, leadership development for clinician educators, and assorted hot topics including global health and empowering radiology residents to add healthcare value. This years’ edition continues with the new format introduced in 2016 with invited perspectives from leaders in the Association of University Radiologists (AUR), an invited education review from experts on radiology thinking, practical how-I-do-it advice from those at the leading edge of radiologic education, a teaching and learning moment from a radiology global initiative in the developing world, and an answer to the Question of the year posed in 2016, which was “What do you see as the greatest challenge facing radiological education today?” This issue also contains the Whitley award winning paper by Spalluto et al. on an innovative leadership program for women in radiology, and the Memorial award winning paper by Pfeifer et al. on privacy, training rights, and accountability in radiology education (1,2). Congratulations to the authors on your submissions! As part of the new accreditation process, the Accreditation Council for Graduate Medical Education (ACGME) introduced self-study in 2014, a new comprehensive evaluation of the training program (residency or fellowship) designed Acad Radiol 2017; ■:■■–■■ From the Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Medical Center, B1 132K Taubman Center/5302, 1500 East Medical Center Drive, Ann Arbor, MI 48109 (A.M.K.); Department of Radiology, Division of Breast Imaging, Beth Israel Deaconess Medical Center (P.J.S.); Harvard Medical School, Boston, Massachusetts (P.J.S.). Received March 27, 2017; accepted March 28, 2017. Address correspondence to: A.M.K. e-mail: [email protected] © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.acra.2017.03.007
to foster overall improvements. Program administrators and directors are encouraged to carry out structured regular program assessment to identify program strengths and areas for improvement. The self-study process is designed to provide coordinated longitudinal feedback about a program and its learning environment in preparation for the ACGME site visit that now occurs every 10 years (3). Robbins and Sarkany share their experience and provide practical tips for surviving, and even excelling, in the residency program self-study process (4). Many of the practical aspects of running a residency program would not take place without the help of the program coordinator. With advents in technology, the residency program coordinator’s role has evolved and changed. Stuckelman and colleagues provide an update on this critical role and share the top five skills in the program coordinator’s “toolbox” (5). The residency program coordinator is often the first to become aware of the resident who is struggling or in distress, given the amount of contact they have with trainees. There are many different precipitating factors and causes for residents in distress, which include a lack of work–life balance and feeling underappreciated (6). A multifaceted or holistic approach may be needed to help trainees get back on track. Residents who are struggling may also suffer academically with poor performance of clinical duties. The sooner the resident is recognized and helped, the better the outcome for all concerned will be, and Rumack et al. provide some useful advice for resident academic remediation (7). Many clinician educators will assume leadership roles throughout their careers and may not feel prepared for these positions. In addition, given the ongoing changes in the healthcare system and specifically within the practice of radiology, radiologists may find themselves having to lead during these times of change. Many academic centers are starting to develop educational fellowship programs that help clinician educators attain leadership skills (8). In this issue, Norbash offers useful and practical advice for successfully leading others during transitional times (9). Health care continues to transition and change, and radiologists need to keep abreast of the changes so as not to be left behind (10). For the radiologists of the future, our current trainees, and in response to the 2016 question of the year—“the greatest challenge facing education today”, Alvin et al. share their insights in training radiology residents to be stewards in healthcare value (11). We live in a world characterized by increasing globalization, which is already impacting medical and radiological practice with many 1
KELLY ET AL
initiatives to share the wealth of academic knowledge and clinical practice (12), and Sedora-Romans and Bochnakova share a teaching and learning moment from her recent global health experience in Ghana (13). Most of our learners are now classified as belonging to the “millennial” generation, a generation which has grown up with technology. Millennials are accustomed to gathering information in real time, accessing multiple sources, and using social media to share and acquire information (14,15). For faculty, there is potential for us to better harness social media to enhance our educational efforts and to this end, Shah and Kotsenas provide tips to help us (16). At some stage or another, we all have to provide feedback to our trainees and most of us have no formal training in giving effective and meaningful feedback. Effective feedback should be delivered in the appropriate setting, focus on performance rather than the individual, be specific, be based on direct observation or objective evidence, be delivered using neutral and nonjudgmental language, and identify actions or plans for improvement. Negative or badly delivered feedback can create an emotional response in the recipient, which may interfere with its effectiveness because of dissonance between self-evaluation and external appraisal (17). Therefore, the practical advice and tips by Sarkany and Deitte will be very useful to provide strategies for giving feedback (18). Nonmillennial faculty (and indeed all faculty) need to keep up to date on how people learn and process information, and Naeger and colleagues offer tips on slow and fast thought processing that can be used to improve our teaching efforts (19). Finally, we look forward to receiving responses from the AUR membership to the “2017 Question of the Year.” As special education issue coeditors, we invite the AUR membership to respond to the following question: “What are the greatest achievements in radiology education in recent years?” Submissions for the Question of the Year should be uploaded through the journal editorial manager. The submission should not exceed 500 words, may have up to 5 references, and 1 table/figure. The deadline for submission is on September 30, 2017. We intend to publish some of the responses we receive in the 2018 dedicated Education issue of Academic Radiology. Thanks again to Academic Radiology’s Editor-in-Chief, Dr. Stanley Baum, and to the leadership of the Executive Committees of AMSER and ACER for their support and continued
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Academic Radiology, Vol ■, No ■■, ■■ 2017
encouragement of the annual education issue! Thanks to our dedicated reviewers, who work tirelessly behind the scenes, many of whom are AMSER and ACER members! You, the reviewers, are essential to maintaining the highest-quality articles for the annual education issue! Finally, our sincerest gratitude to Flora Cauley, Editorial Coordinator for Academic Radiology, for her constant support, patience, calmness, and efficiency in this endeavor! REFERENCES 1. Spalluto L. A leadership intervention to further the training of female faculty (LIFT-OFF) in radiology. Acad Radiol 2017; 24:000-0. 2. Pfeifer C. Privacy, trainee rights, and accountability in radiology education. Acad Radiol 2017; 24:000-0. 3. ACGME self-study. Available at: http://www.acgme.org/What-We -Do/Accreditation/Self-Study. Accessed January 23, 2017. 4. Robbins J, Sarkany D. Self-study: practical tips for a successful and rewarding experience. Acad Radiol 2017; 24:000-0. 5. Stuckelman J, Zavatchen SE, Jones SA. The evolving role of the residency coordinator: five essential skills for the coordinator toolbox. Acad Radiol 2017; 24:000-0. 6. Holmes EG, Connolly A, Putnam KT, et al. Taking care of our own: a multispecialty study of resident and program director perspectives on contributors to burnout and potential interventions. Acad Psychiatry. 2017; 41:159–166. 7. Rumack C, Guerrasio J, Christensen A, Aagaard EM. Academic remediation: why early identification and intervention matters. Acad Radiol 2017; 24:000-0. 8. Gruppen LD, Simpson D, Searle NS, et al. Educational fellowship programs: common themes and overarching issues. Acad Med 2006; 81:990– 994. 9. Norbash A. Transitional leadership: leadership during times of transition, key principles and considerations for success. Acad Radiol 2017; 24:000-0. 10. Thomson NB, 3rd, Rawson JV, Slade CP, et al. Transformation and transformational leadership: a review of the current and relevant literature for academic radiologists. Acad Radiol 2016; 23:592–599. 11. Alvin MD, Horton KM, Johnson PT. Training radiology residents to be stewards in healthcare value. Acad Radiol 2017; 24:000-0. 12. RAD-AID International. RAD-AID.org. A Nonprofit Public Service. Radiology Serving the World. Available at: https://www.rad-aid.org/. Accessed January 24, 2017. 13. Sedora-Roman NI, Bochnakova T. Radiology abroad: a global health initiative in Guyana. Acad Radiol 2017; 24:000-0. 14. Kasprzak T. Technology and radiology education-meeting the needs of millennial learners. Acad Radiol 2016; 23:844–847. 15. Slanetz PJ, Kung J, Eisenberg RL. Teaching radiology in the millennial era. Acad Radiol 2013; 20:387–389. 16. Shah V, Kotsenas AL. Social media tips to enhance medical education. Acad Radiol 2017; 24:000-0. 17. Schartel SA. Giving feedback—an integral part of education. Best Pract Res Clin Anaesthesiol 2012; 26:77–87. 18. Sarkany D, Deitte L. Providing feedback: practical skills and strategies. Acad Radiol 2017; 24:000-0. 19. Naeger D. How radiologists think: understanding fast and slow thought processing and how it can improve our teaching. Acad Radiol 2017; 24:000-0.
Guest Editorial
Radiology Education: It Takes a Village! Aine Marie Kelly, MD, MS, MA, Priscilla J. Slanetz, MD, MPH, FACR
Welcome to the fifth educational issue of Academic Radiology, a joint effort of the Alliance of Medical Student Educators in Radiology (AMSER) and the Alliance for Clinician Educators in Radiology (ACER) that is dedicated to radiology educational topics. Radiology education is a multidisciplinary and multifaceted effort involving many personnel as part of the team. Many of their roles are carried out behind the scenes and are often not apparent, particularly if done well. In this issue, we focus on some of these practical aspects, including the perspectives of the residency program coordinator, roles of the residency program director, efforts to support resident well-being, methods to provide effective resident feedback, leadership development for clinician educators, and assorted hot topics including global health and empowering radiology residents to add healthcare value. This years’ edition continues with the new format introduced in 2016 with invited perspectives from leaders in the Association of University Radiologists (AUR), an invited education review from experts on radiology thinking, practical how-I-do-it advice from those at the leading edge of radiologic education, a teaching and learning moment from a radiology global initiative in the developing world, and an answer to the Question of the year posed in 2016, which was “What do you see as the greatest challenge facing radiological education today?” This issue also contains the Whitley award winning paper by Spalluto et al. on an innovative leadership program for women in radiology, and the Memorial award winning paper by Pfeifer et al. on privacy, training rights, and accountability in radiology education (1,2). Congratulations to the authors on your submissions! As part of the new accreditation process, the Accreditation Council for Graduate Medical Education (ACGME) introduced self-study in 2014, a new comprehensive evaluation of the training program (residency or fellowship) designed Acad Radiol 2017; ■:■■–■■ From the Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Medical Center, B1 132K Taubman Center/5302, 1500 East Medical Center Drive, Ann Arbor, MI 48109 (A.M.K.); Department of Radiology, Division of Breast Imaging, Beth Israel Deaconess Medical Center (P.J.S.); Harvard Medical School, Boston, Massachusetts (P.J.S.). Received March 27, 2017; accepted March 28, 2017. Address correspondence to: A.M.K. e-mail: [email protected] © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.acra.2017.03.007
to foster overall improvements. Program administrators and directors are encouraged to carry out structured regular program assessment to identify program strengths and areas for improvement. The self-study process is designed to provide coordinated longitudinal feedback about a program and its learning environment in preparation for the ACGME site visit that now occurs every 10 years (3). Robbins and Sarkany share their experience and provide practical tips for surviving, and even excelling, in the residency program self-study process (4). Many of the practical aspects of running a residency program would not take place without the help of the program coordinator. With advents in technology, the residency program coordinator’s role has evolved and changed. Stuckelman and colleagues provide an update on this critical role and share the top five skills in the program coordinator’s “toolbox” (5). The residency program coordinator is often the first to become aware of the resident who is struggling or in distress, given the amount of contact they have with trainees. There are many different precipitating factors and causes for residents in distress, which include a lack of work–life balance and feeling underappreciated (6). A multifaceted or holistic approach may be needed to help trainees get back on track. Residents who are struggling may also suffer academically with poor performance of clinical duties. The sooner the resident is recognized and helped, the better the outcome for all concerned will be, and Rumack et al. provide some useful advice for resident academic remediation (7). Many clinician educators will assume leadership roles throughout their careers and may not feel prepared for these positions. In addition, given the ongoing changes in the healthcare system and specifically within the practice of radiology, radiologists may find themselves having to lead during these times of change. Many academic centers are starting to develop educational fellowship programs that help clinician educators attain leadership skills (8). In this issue, Norbash offers useful and practical advice for successfully leading others during transitional times (9). Health care continues to transition and change, and radiologists need to keep abreast of the changes so as not to be left behind (10). For the radiologists of the future, our current trainees, and in response to the 2016 question of the year—“the greatest challenge facing education today”, Alvin et al. share their insights in training radiology residents to be stewards in healthcare value (11). We live in a world characterized by increasing globalization, which is already impacting medical and radiological practice with many 1
KELLY ET AL
initiatives to share the wealth of academic knowledge and clinical practice (12), and Sedora-Romans and Bochnakova share a teaching and learning moment from her recent global health experience in Ghana (13). Most of our learners are now classified as belonging to the “millennial” generation, a generation which has grown up with technology. Millennials are accustomed to gathering information in real time, accessing multiple sources, and using social media to share and acquire information (14,15). For faculty, there is potential for us to better harness social media to enhance our educational efforts and to this end, Shah and Kotsenas provide tips to help us (16). At some stage or another, we all have to provide feedback to our trainees and most of us have no formal training in giving effective and meaningful feedback. Effective feedback should be delivered in the appropriate setting, focus on performance rather than the individual, be specific, be based on direct observation or objective evidence, be delivered using neutral and nonjudgmental language, and identify actions or plans for improvement. Negative or badly delivered feedback can create an emotional response in the recipient, which may interfere with its effectiveness because of dissonance between self-evaluation and external appraisal (17). Therefore, the practical advice and tips by Sarkany and Deitte will be very useful to provide strategies for giving feedback (18). Nonmillennial faculty (and indeed all faculty) need to keep up to date on how people learn and process information, and Naeger and colleagues offer tips on slow and fast thought processing that can be used to improve our teaching efforts (19). Finally, we look forward to receiving responses from the AUR membership to the “2017 Question of the Year.” As special education issue coeditors, we invite the AUR membership to respond to the following question: “What are the greatest achievements in radiology education in recent years?” Submissions for the Question of the Year should be uploaded through the journal editorial manager. The submission should not exceed 500 words, may have up to 5 references, and 1 table/figure. The deadline for submission is on September 30, 2017. We intend to publish some of the responses we receive in the 2018 dedicated Education issue of Academic Radiology. Thanks again to Academic Radiology’s Editor-in-Chief, Dr. Stanley Baum, and to the leadership of the Executive Committees of AMSER and ACER for their support and continued
2
Academic Radiology, Vol ■, No ■■, ■■ 2017
encouragement of the annual education issue! Thanks to our dedicated reviewers, who work tirelessly behind the scenes, many of whom are AMSER and ACER members! You, the reviewers, are essential to maintaining the highest-quality articles for the annual education issue! Finally, our sincerest gratitude to Flora Cauley, Editorial Coordinator for Academic Radiology, for her constant support, patience, calmness, and efficiency in this endeavor! REFERENCES 1. Spalluto L. A leadership intervention to further the training of female faculty (LIFT-OFF) in radiology. Acad Radiol 2017; 24:000-0. 2. Pfeifer C. Privacy, trainee rights, and accountability in radiology education. Acad Radiol 2017; 24:000-0. 3. ACGME self-study. Available at: http://www.acgme.org/What-We -Do/Accreditation/Self-Study. Accessed January 23, 2017. 4. Robbins J, Sarkany D. Self-study: practical tips for a successful and rewarding experience. Acad Radiol 2017; 24:000-0. 5. Stuckelman J, Zavatchen SE, Jones SA. The evolving role of the residency coordinator: five essential skills for the coordinator toolbox. Acad Radiol 2017; 24:000-0. 6. Holmes EG, Connolly A, Putnam KT, et al. Taking care of our own: a multispecialty study of resident and program director perspectives on contributors to burnout and potential interventions. Acad Psychiatry. 2017; 41:159–166. 7. Rumack C, Guerrasio J, Christensen A, Aagaard EM. Academic remediation: why early identification and intervention matters. Acad Radiol 2017; 24:000-0. 8. Gruppen LD, Simpson D, Searle NS, et al. Educational fellowship programs: common themes and overarching issues. Acad Med 2006; 81:990– 994. 9. Norbash A. Transitional leadership: leadership during times of transition, key principles and considerations for success. Acad Radiol 2017; 24:000-0. 10. Thomson NB, 3rd, Rawson JV, Slade CP, et al. Transformation and transformational leadership: a review of the current and relevant literature for academic radiologists. Acad Radiol 2016; 23:592–599. 11. Alvin MD, Horton KM, Johnson PT. Training radiology residents to be stewards in healthcare value. Acad Radiol 2017; 24:000-0. 12. RAD-AID International. RAD-AID.org. A Nonprofit Public Service. Radiology Serving the World. Available at: https://www.rad-aid.org/. Accessed January 24, 2017. 13. Sedora-Roman NI, Bochnakova T. Radiology abroad: a global health initiative in Guyana. Acad Radiol 2017; 24:000-0. 14. Kasprzak T. Technology and radiology education-meeting the needs of millennial learners. Acad Radiol 2016; 23:844–847. 15. Slanetz PJ, Kung J, Eisenberg RL. Teaching radiology in the millennial era. Acad Radiol 2013; 20:387–389. 16. Shah V, Kotsenas AL. Social media tips to enhance medical education. Acad Radiol 2017; 24:000-0. 17. Schartel SA. Giving feedback—an integral part of education. Best Pract Res Clin Anaesthesiol 2012; 26:77–87. 18. Sarkany D, Deitte L. Providing feedback: practical skills and strategies. Acad Radiol 2017; 24:000-0. 19. Naeger D. How radiologists think: understanding fast and slow thought processing and how it can improve our teaching. Acad Radiol 2017; 24:000-0.