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Teaching communication skills to radiology trainees: breaking bad news
S190
Scientific e-Posters
significantly longer time to complete the eyeballing game (mean, 324.7 s vs 201.5 s; p ¼ 0.03) and made fewer errors; however, their lower number of errors failed to achieve statistical significance at the 5% level (p ¼ 0.07). The performances on Marble Mania using dominant and nondominant hands and their performance on Archery failed to demonstrate any significant differences (p values ¼ 0.44, 0.35, and 0.67, respectively). Conclusions: The study suggests that certain video games could help us to understand the special visual perception skills that interventional radiologists possess. However, performance on an aptitude test and dexterity as assessed with certain video games were not significantly different between IR experts and nonexperts.
Abstract No. 442 Teaching communication skills to radiology trainees: breaking bad news
Scientific e-Posters
J. Meek1, K. Carlson1, L. Deloney1, M. Meek1; 1University of Arkansas for Medical Sciences, Little Rock, AR Purpose: Radiology trainees are expected to effectively communicate with patients, families, and the public on a variety of issues. Although communication is the most commonly used medical skill, most radiologists have minimal formal training. Proven techniques, including steps to effectively deliver bad news and pitfalls that should be avoided, can be taught and learned. Role playing and standardized patients (SPs) are effective at enhancing communication skills, and tools such as the SPIKES (Setting, Perception, Invitation, Knowledge, Emotions, Strategy, and Summary) method have structured the delivery of bad news. Materials: We developed a highly consolidated simulationbased training course to prepare trainees for these types of situations. Learners had a pre-reading assignment and attended a one-hour didactic conference to learn the SPIKES 6-step protocol and view a video demonstration of communication techniques. Then residents worked in pairs and had 3 ten-minute encounters with standardized patients: (1) breast cancer diagnosis, (2) trauma patient death, (3) anencephaly on ultrasound. The fellows had trauma patient death and HHT embolization. Results: A total of 29 diagnostic radiology residents and 2 fellows participated in the training. SPs scored the encounters over 10 domains of physician-patient communication using a 5-point Likert scale (1 ¼ poor to 5 ¼ excellent). The average communication score for the group was 91.2% with 8 participants scoring 100%. The average time to complete the encounters was Anencephaly (5 minutes), Breast Cancer (7 minutes), HHT Embolization (12 minutes), and Trauma Patient Death (10 minutes). Learners were asked for feedback about the course. Qualitative responses confirmed the realistic feel of the encounters. Most agreed that they learned important communication techniques and would be better able to handle difficult situations. Conclusions: Before this curriculum, trainees had minimal education in delivering bad news. The didactic and experiential learning based curriculum used for the radiology trainees improved their confidence in delivering bad news, and it demonstrated a need for more communication training in residency.
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JVIR
Abstract No. 443 Effects of fellowship training on radiation exposure to patients and staff in interventional radiology E. Rinker1, S. Joshi1, A. Sever1, M. Vanderhoek1, S. Schwartz1; 1Henry Ford Hospital, Detroit, MI Purpose: It is well established that with experience comes increased efficiency and decreased procedure time. Cardiology studies have shown that first year fellows can receive as much as 60% more radiation than their more senior counterparts [1]. We aim to evaluate and quantify differences in radiation exposure to patients and staff due to the presence of a fellow during interventional radiology cases. Materials: Dose data for interventional radiology cases, both with and without a fellow, were compared at a teaching hospital from July 2015 to February 2016. For each case, kerma area product (KAP in Gy-cm2) was used as a surrogate of total fluoroscopic radiation output and to represent patient dose. Individual staff doses were measured using the RaySafe i2 system, with dosimeter badges worn outside their lead vests. Only cases with a KAP greater than 20 Gy-cm2 were considered, in order to minimize error introduced from badge accuracy. Staff positions include the attending, fellow, and scrub technologist. 101 cases were evaluated; 60 with a fellow, and 41 without. Results: 1. Average KAP for cases with a fellow was 54% greater than without (170.7 vs. 97.8 Gy*cm2; p ¼ 0.01). 2. Average exposure to the fellow was 31% greater than to the attending working alone (20.7 vs. 15.1 uSv; p ¼ 0.38). 3. Average exposure to the attending was 47% greater when a fellow was present (24.4 vs. 15.1 uSv; p ¼ 0.27). 4. Average exposure to the scrub technologist was 44% greater when the fellow was present (8.6 vs. 5.5 uSv; p ¼ 0.10). Conclusions: Cases involving a fellow resulted in statistically significant increases in radiation exposure to the patient, as well as a trend towards statistically significant increases in exposure to the scrub technologist. Fellows and attendings experienced, on average, a higher dose when working together, though not statistically significant. This is perhaps best explained by the variability of interventional radiology cases, and by variable fellow involvement as principal operator. By being aware of these increases in radiation exposure during the training process, steps can be undertaken to minimize them; including appropriate training on fluoroscopic techniques and optimization of shielding.
Abstract No. 444 Endovascular simulation with medical students: survey results from the 2016 Society of Interventional Radiology Annual Meeting B. Marinelli1, J. Buethe2, A. Fischman1; 1Icahn School of Medicine at Mount Sinai, New York, NY; 2Johns Hopkins Hospital, Baltimore, MD Purpose: With the advent of the IR/DR integrated residency, interactive experiences for medical students that improve exposure to IR merit exploration. We sought to assess whether endovascular simulation in a conference setting may
Scientific e-Posters
significantly longer time to complete the eyeballing game (mean, 324.7 s vs 201.5 s; p ¼ 0.03) and made fewer errors; however, their lower number of errors failed to achieve statistical significance at the 5% level (p ¼ 0.07). The performances on Marble Mania using dominant and nondominant hands and their performance on Archery failed to demonstrate any significant differences (p values ¼ 0.44, 0.35, and 0.67, respectively). Conclusions: The study suggests that certain video games could help us to understand the special visual perception skills that interventional radiologists possess. However, performance on an aptitude test and dexterity as assessed with certain video games were not significantly different between IR experts and nonexperts.
Abstract No. 442 Teaching communication skills to radiology trainees: breaking bad news
Scientific e-Posters
J. Meek1, K. Carlson1, L. Deloney1, M. Meek1; 1University of Arkansas for Medical Sciences, Little Rock, AR Purpose: Radiology trainees are expected to effectively communicate with patients, families, and the public on a variety of issues. Although communication is the most commonly used medical skill, most radiologists have minimal formal training. Proven techniques, including steps to effectively deliver bad news and pitfalls that should be avoided, can be taught and learned. Role playing and standardized patients (SPs) are effective at enhancing communication skills, and tools such as the SPIKES (Setting, Perception, Invitation, Knowledge, Emotions, Strategy, and Summary) method have structured the delivery of bad news. Materials: We developed a highly consolidated simulationbased training course to prepare trainees for these types of situations. Learners had a pre-reading assignment and attended a one-hour didactic conference to learn the SPIKES 6-step protocol and view a video demonstration of communication techniques. Then residents worked in pairs and had 3 ten-minute encounters with standardized patients: (1) breast cancer diagnosis, (2) trauma patient death, (3) anencephaly on ultrasound. The fellows had trauma patient death and HHT embolization. Results: A total of 29 diagnostic radiology residents and 2 fellows participated in the training. SPs scored the encounters over 10 domains of physician-patient communication using a 5-point Likert scale (1 ¼ poor to 5 ¼ excellent). The average communication score for the group was 91.2% with 8 participants scoring 100%. The average time to complete the encounters was Anencephaly (5 minutes), Breast Cancer (7 minutes), HHT Embolization (12 minutes), and Trauma Patient Death (10 minutes). Learners were asked for feedback about the course. Qualitative responses confirmed the realistic feel of the encounters. Most agreed that they learned important communication techniques and would be better able to handle difficult situations. Conclusions: Before this curriculum, trainees had minimal education in delivering bad news. The didactic and experiential learning based curriculum used for the radiology trainees improved their confidence in delivering bad news, and it demonstrated a need for more communication training in residency.
’
JVIR
Abstract No. 443 Effects of fellowship training on radiation exposure to patients and staff in interventional radiology E. Rinker1, S. Joshi1, A. Sever1, M. Vanderhoek1, S. Schwartz1; 1Henry Ford Hospital, Detroit, MI Purpose: It is well established that with experience comes increased efficiency and decreased procedure time. Cardiology studies have shown that first year fellows can receive as much as 60% more radiation than their more senior counterparts [1]. We aim to evaluate and quantify differences in radiation exposure to patients and staff due to the presence of a fellow during interventional radiology cases. Materials: Dose data for interventional radiology cases, both with and without a fellow, were compared at a teaching hospital from July 2015 to February 2016. For each case, kerma area product (KAP in Gy-cm2) was used as a surrogate of total fluoroscopic radiation output and to represent patient dose. Individual staff doses were measured using the RaySafe i2 system, with dosimeter badges worn outside their lead vests. Only cases with a KAP greater than 20 Gy-cm2 were considered, in order to minimize error introduced from badge accuracy. Staff positions include the attending, fellow, and scrub technologist. 101 cases were evaluated; 60 with a fellow, and 41 without. Results: 1. Average KAP for cases with a fellow was 54% greater than without (170.7 vs. 97.8 Gy*cm2; p ¼ 0.01). 2. Average exposure to the fellow was 31% greater than to the attending working alone (20.7 vs. 15.1 uSv; p ¼ 0.38). 3. Average exposure to the attending was 47% greater when a fellow was present (24.4 vs. 15.1 uSv; p ¼ 0.27). 4. Average exposure to the scrub technologist was 44% greater when the fellow was present (8.6 vs. 5.5 uSv; p ¼ 0.10). Conclusions: Cases involving a fellow resulted in statistically significant increases in radiation exposure to the patient, as well as a trend towards statistically significant increases in exposure to the scrub technologist. Fellows and attendings experienced, on average, a higher dose when working together, though not statistically significant. This is perhaps best explained by the variability of interventional radiology cases, and by variable fellow involvement as principal operator. By being aware of these increases in radiation exposure during the training process, steps can be undertaken to minimize them; including appropriate training on fluoroscopic techniques and optimization of shielding.
Abstract No. 444 Endovascular simulation with medical students: survey results from the 2016 Society of Interventional Radiology Annual Meeting B. Marinelli1, J. Buethe2, A. Fischman1; 1Icahn School of Medicine at Mount Sinai, New York, NY; 2Johns Hopkins Hospital, Baltimore, MD Purpose: With the advent of the IR/DR integrated residency, interactive experiences for medical students that improve exposure to IR merit exploration. We sought to assess whether endovascular simulation in a conference setting may