The Challenge with Clinical Radiology Electives: Student and Faculty Perspectives Identify Areas for Improvement

Abstract

Purpose To determine medical students' and radiologists’ attitude toward radiology electives at a distributed medical school and identify specific areas for improvement. Methods During a single academic year, both students and faculty preceptors were surveyed anonymously following a senior radiology elective. The survey was based on an established theoretical framework for studying the educational environment which takes into account domains: (1) goal orientation, (2) organization/regulation, and (3) relationships. Mann-Whitney tests were performed to determine if there was any difference between the overall satisfaction of students and preceptors, responses from the different elective sites and students’ ratings of the domains. Statistical significance was set at P < .05. Thematic analysis was performed on the narrative comments to identify specific challenges. Results The response rate was 82.0% for students (95/116) and 19.5% (31/159) for radiologists. There was no difference in responses based on elective site. Overall, the elective was viewed positively by both groups however students rated their experience as significantly better than their preceptors ( P = .0012). Students viewed the relationships domain more positively than both the other two (goal orientation, P = .0001; organization/regulation, P = .0038). Thematic analysis identified that the student challenges were lack of autonomy, structured teaching, and preceptor continuity and the preceptor challenges were ambiguous learning objectives/expectations and insufficient resources. Conclusions The radiology elective challenges identified in this study provide educators with specific areas to target when updating radiology electives. A better elective experience may improve students' radiology knowledge and attitude towards the specialty as well as radiologists’ interest in teaching.

Undergraduate Radiology Education During the COVID-19 Pandemic: A Review of Teaching and Learning Strategies

“…Before the pandemic, medical students indicated they desired a more active role in patient care during radiology electives, including interpreting and dictating imaging studies. 35,36 Although some institutions allow students to dictate patient reports, this is often impossible due to issues with obtaining hospital privileges and workstation availability. 35 This becomes even more challenging during the pandemic with some departments limiting reading room occupancy and workstation use.…”

“…35,36 Although some institutions allow students to dictate patient reports, this is often impossible due to issues with obtaining hospital privileges and workstation availability. 35 This becomes even more challenging during the pandemic with some departments limiting reading room occupancy and workstation use. This issue can be mitigated by developing a blended-learning environment with simulated cases that students can review virtually with a preceptor.…”

“…This creates an opportunity for departments to improve their elective experience, as students indicated in a recent study that they would like more formally organized student-specific activities during their elective. 35 Participation in direct patient care is voluntary Non-direct patient care opportunities should be offered Students must always be appropriately supervised Sufficient personal protective equipment (PPE) supplies are available for students where PPE use is indicated The learning environment supports physical distancing as recommended by regional, provincial, or federal public health units Learners are encouraged to stay home when sick, without penalty Transparent and equitable consideration for accommodations is provided for learners with medical conditions that place them at risk in certain clinical environments Abbreviations: AAMC, Association of American Medical Colleges; AFMC, Association of Faculties of Medicine of Canada. a Adapted from the AFMC and AAMC Guidelines.…”

“…Over 80% of students report working primarily with residents while on elective in a recent study. 35 Teaching delivered by residents has been shown to be equivalent to teaching delivered by faculty and superior to teaching delivered by fellows. 42 Webb et al proposed a ''Teaching Resident'' leadership position to promote residents' interests in an academic career and improve medical students' learning experience.…”

“…In the clinical environment, students learn radiology from radiology-specific electives and from interaction with radiologists on other rotations. 35,36 During radiology electives, students shadow radiologists, technologists, and trainees performing their daily work including in-person scans and procedures. The pandemic presents logistical challenges, including safety concerns, with having students in the reading room and observing procedures and the reporting of imaging studies.…”