Early exposure improves medical student perceptions on female and minority physician inclusion in interventional radiology

Abstract

Purpose: To examine the relationship between resident experience and fluoroscopy time for peripherally inserted central venous catheter (PICC) placement in a single program over a fouryear period. Materials: We conducted a retrospective analysis of the fluoroscopy times for PICC insertions by radiology residents and IR fellows from a single program, dual institution, over a four-year period. The date of procedure, resident operator and fluoroscopy time (in minutes) were compiled from technician logs. Resident schedules were cross-referenced to determine the level of operator experience at the time of each procedure, defined as weeks of training. Mixed regression models were then used to test the longitudinal relationship between fluoroscopy time and weeks of training. Results: The modeling dataset included 780 observations, with complete data for 735 observations. This included 40 residents with a maximum of 95 observations per resident. The overall model fit was significant (Null model likelihood ratio test chisquare ¼ 51.64), p o 0.0001. The solution for fixed effects noted a significant negative relationship between weeks of training and fluoroscopy time. This relationship was maintained until resident training level reached 20 weeks. Past 20 weeks, a further increase in weeks of experience was met with a plateau in fluoroscopy time. The average fluoroscopy time regardless of experience was 0.88 minutes, with a standard deviation of 1.06 minutes. Conclusions: Fluoroscopy time decreased as resident experience increased. This highlights the importance of early, frequent and hands-on resident participation in the interventional suite to achieve and maintain procedural competency. While technical skill as a function of experience is likely a significant contributor to this phenomenon, a focused orientation to fluoroscopy equipment and radiation reduction techniques may be useful in protecting patients and staff from unnecessary radiation exposure.Purpose: To evaluate the effects of a 10-week interventional radiology elective on pre-clinical medical student perceptions regarding the field of interventional radiology. Materials: A 10-week interventional radiology elective was created by two full-time IR faculty at the University of California, San Francisco Medical School. The elective was offered to first and second year medical students and conducted during the winter elective. At the conclusion of the elective, a survey was distributed to all first and second year students. Responses were collected anonymously via online survey. Results: A total of 53 responses were collected. This included 30 students who did not attend any portion of the elective (noexposure group), and 23 students who attended between 1 and 10 elective sessions (exposure group). Using Fisher's exact tests, the exposure group demonstrated statistically significant differences in knowledge of upcoming changes to the IR training pathway, as well as perceptions regarding inclusivity of female and minority physicians within the specialty. Non-stati...

The future of interventional and neurointerventional radiology: learning lessons from the past

“…46 More importantly, studies investigating the impact of active participation in IR clinical practice through student electives and dedicated internship rotations have demonstrated an increase in the visibility of IR as a specialty, improved perceptions of changes in training pathways and increased interest in IR as a potential career pathway. 47,48 Specifically, a study assessing a 10 week IR elective demonstrated improved perceptions regarding patient interaction, percentage of procedural work and safety from radiation exposure, although the results were non-significant. 47 A survey of 353 practicing IRs and US medical students regarding a dedicated IR clinical clerkship showed that the majority felt that taking call with the attending IR (60.1%), access to a simulation centre (81%) and a properly structured IR rotation (82% IR, 71% medical students) would be a "critical tool in creating and cultivating medical student interest in IR".…”

“…47,48 Specifically, a study assessing a 10 week IR elective demonstrated improved perceptions regarding patient interaction, percentage of procedural work and safety from radiation exposure, although the results were non-significant. 47 A survey of 353 practicing IRs and US medical students regarding a dedicated IR clinical clerkship showed that the majority felt that taking call with the attending IR (60.1%), access to a simulation centre (81%) and a properly structured IR rotation (82% IR, 71% medical students) would be a "critical tool in creating and cultivating medical student interest in IR". 48 Radiology trainees in early years of training could be increasingly encouraged and educated to perform "core" IR procedures such as biopsies, drainages and vascular access including tunnelled or totally implantable venous access devices.…”