Objective:To describe a low-cost, reproducible phantom model for training medical practitioners in ultrasound-guided ethanol ablation (EA) of a cystic thyroid nodule.

Methods:The model of cyst contents was created using a mixture of coffee powder, cornstarch and water to mimic colloidal contents. This was injected into the finger of a cut surgical glove secured with transparent tape to serve as an inflatable capsule and placed inside a chicken breast. This setup allows practitioners to perform key ultrasound-guided ethanol ablation techniques including spinal needle insertion, cyst aspiration, saline flushing, re-aspiration and ethanol injection.

Results:The phantom model was assembled for PhP 150.30 per unit and took approximately 5 minutes to construct. This model was demonstrated to be a cost-effective and simple method for enabling specialists to practice and enhance their skills in ultrasound-guided ethanol ablation of a cystic thyroid nodule.

Conclusion:The described phantom model provides an accessible and practical training tool for healthcare providers to gain proficiency in ultrasound-guided ethanol ablation of a cystic thyroid nodule in a safe and controlled setting prior to actual patient handling.

Medical Education ; Otorhinolaryngology ; Radiology ; Ultrasonography

Radiology is a unique medical specialty that focuses on image interpretation and report generation with limited patient contact. Resident read-out sessions with teaching are a quintessential part of reporting workflow practices in teaching institutions. However, most radiologist-educators do not have formal training in teaching and learning experiences vary. The five-step 'microskills' model ('one-minute preceptor' technique) developed by Neher is an easily adopted teaching model that complements the workflow of the typical read-out session, and can be utilised by radiologists of varied teaching experience and seniority. The steps are: (a) get a commitment; (b) probe for supporting evidence; (c) teach general rules; (d) reinforce what was done right; and (e) correct mistakes. Feedback is important to the model and accounts for two out of five microskills. The teaching model emphasises knowledge application and establishing relevance, which is useful in engaging the millennial resident. It is easily assimilated and applied by radiologist-educators.
Curriculum ; Education, Medical ; methods ; Humans ; Internship and Residency ; Learning ; Physicians ; Preceptorship ; Radiographic Image Interpretation, Computer-Assisted ; Radiography ; Radiology ; education ; trends ; Teaching

In response to the demands of an ageing nation, the postgraduate medical education in Singapore is currently in the early stage of transition into the American-styled residency programme. This study assessed the expectations of both radiology trainees and faculty on their ideal clinical learning environment (CLE) which facilitates the programme development. A modified 23-item questionnaire was administered to both trainees and faculty at a local training hospital. All items were scored according to their envisioned level of importance and categorised into 5 main CLE domains-supervision, formal training programme, work-based learning, social atmosphere and workload. 'Supervision' was identified as the most important domain of the CLE by both trainees and faculty, followed by 'formal training programmes', 'work-based learning' and 'social atmosphere'. 'Workload' was rated as the least important domain. For all domains, the reported expectation between both trainees and faculty respondents did not differ significantly. Intragroup comparison also showed no significant difference within each group of respondents. This study has provided valuable insights on both respondents' expectations on their ideal CLE that can best train competency in future radiologists. Various approaches to address these concerns were also discussed. The similarities in findings between ours and previous studies suggest that the 'supervision', 'formal training programmes' and 'work-based learning' domains are crucial for the success of a postgraduate medical training and should be emphasised in future curriculum. 'Workload' remains a challenge in postgraduate medical training, but attempts to address this will have an impact in future radiology training.
Attitude of Health Personnel ; Competency-Based Education ; Curriculum ; Education, Medical, Graduate ; methods ; organization & administration ; Faculty, Medical ; Female ; Humans ; Internship and Residency ; methods ; organization & administration ; Male ; Radiology ; education ; Singapore ; Students, Medical ; psychology ; Surveys and Questionnaires ; Workload

Attitude ; Education, Medical, Undergraduate ; Follow-Up Studies ; Humans ; Longitudinal Studies ; Radiology ; Students, Medical ; Surveys and Questionnaires

Abdominal computed tomography (CT) is widely used as a diagnostic tool in emergency medicine (EM) to accurately diagnose abdominal pain. EM residents must be able to offer preliminary interpretations of CT imaging. In this study, we evaluated the preliminary interpretation ability of a sample of emergency residents presented with adult abdominal CT images, and compared their results with those of radiology residents. We conducted a prospective observational study from November 16, 2008 to June 30, 2009. During this time, we gathered preliminary interpretations of consecutive abdominal CT made by emergency and radiology residents. We assessed the discrepancy rates of both samples by comparing their findings to the final reports from attending radiologists. A total of 884 cases were enrolled in the present study. The discrepancy rates of emergency and radiology residents were 16.7% and 12.2%, respectively. When female genital organs, peritoneum, adrenal glands, or the musculoskeletal system were abnormal, we found that emergency residents' preliminary interpretations of CT images were insufficient compared to those of radiology residents. Therefore more formal education is needed to emergency residents. If possible, the preliminary interpretations of radiology attending physicians are ideal until improving the ability of interpretations of emergency residents in abdomen CT.
Abdominal Pain/*radiography ; Adult ; Aged ; Diagnostic Errors/prevention & control ; Emergency Medicine/*education ; Female ; Humans ; Internship and Residency ; Logistic Models ; Male ; Medical Staff, Hospital ; Middle Aged ; Prospective Studies ; Radiology/education ; Tomography, X-Ray Computed

OBJECTIVE: Imaging methods that use ionizing radiation have been more frequent in various medical fields with advances in imaging technology. The aim of our study was to make residents be aware of the radiation dose they are subjected to when they conduct radiological imaging methods, and of cancer risk. MATERIALS AND METHODS: A total of 364 residents participated in this descriptive study which was conducted during the period between October, 2008 and January, 2009. The questionnaires were completed under strict control on a one-to-one basis from each department. A chi2-test was used for the evaluation of data obtained. RESULTS: Only 7% of residents correctly answered to the question about the ionizing radiation dose of a posteroanterior (PA) chest X-ray. The question asking about the equivalent number of PA chest X-rays to the ionizing dose of a brain CT was answered correctly by 24% of residents; the same question regarding abdominal CT was answered correctly by 16% of residents, thorax CT by 16%, thyroid scintigraphy by 15%, intravenous pyelography by 9%, and lumbar spine radiography by 2%. The risk of developing a cancer throughout lifetime by a brain and abdominal CT were 33% and 28%, respectively. CONCLUSION: Radiologic residents should have updated knowledge about radiation dose content and attendant cancer risks of various radiological imaging methods during both basic medical training period and following practice period.
Adult ; *Awareness ; Chi-Square Distribution ; Female ; Humans ; *Internship and Residency ; Male ; Neoplasms, Radiation-Induced/*etiology ; Questionnaires ; *Radiation Dosage ; Radiation, Ionizing ; Radiology/*education ; Radionuclide Imaging ; Tomography, X-Ray Computed

American Diagnostic Radiology Residency and Fellowship programmes are Graduate Medical Education programmes in the United States (US) equivalent to the Postgraduate Medical Education programmes in Singapore. Accreditation Council for Graduate Medical Education (ACGME) accredited diagnostic radiology residency programmes require 5 years total with Post Graduate Year (PGY) 1 year internship in a clinical specialty, e.g. Internal Medicine following medical school. PGY Years 2 to 5 are the core years which must include Radiology Physics, Radiation Biology and rotations in 9 required subspecialty rotations: Abdominal, Breast, Cardiothoracic, Musculoskeletal, Neuroradiology, Nuclear and Paediatric Radiology, Obstetric & Vascular Ultrasound and Vascular Interventional Radiology. A core curriculum of lectures must be organised by the required 9 core subspecialty faculty. All residents (PGY 2 to 4) take a yearly American College of Radiology Diagnostic In-Training Examination based on national benchmarks of medical knowledge in each subspecialty. Because the American Board of Radiology (ABR) examinations are changing, until 2012, residents have to take 3 ABR examinations: (i) ABR physics examination in the PGY 2 to 3 years, (ii) a written examination at the start of the PGY 5 year and (iii) an oral exam at the end of the PGY 5 year. Beginning in 2013, there will be only 2 examinations: (i) the physics and written examinations after PGY 4 will become a combined core radiology examination. Beginning in 2015, the final certifying examination will be given 15 months after the completion of residency. After residency, ACGME fellowships in PGY 6 are all one-year optional programmes which focus on only one subspecialty discipline. There are 4 ACGME accredited fellowships which have a Board Certifi cation Examination: Neuroradiology, Nuclear, Paediatric and Vascular Interventional Radiology. Some ACGME fellowships do not have a certifying examination: Abdominal, Endovascular Surgical Neuroradiology and Musculoskeletal Radiology. One year unaccredited fellowships can also be taken in Breast, Cardiothoracic or Women's Imaging.
Accreditation ; Clinical Competence ; statistics & numerical data ; Communication ; Curriculum ; Education, Medical, Graduate ; statistics & numerical data ; Educational Measurement ; Educational Status ; Fellowships and Scholarships ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Humans ; Internship and Residency ; statistics & numerical data ; Radiology ; education ; standards ; Singapore ; United States

OBJECTIVE: To evaluate the interobserver variability and performance in the interpretation of ultrasonographic (US) findings of thyroid nodules. MATERIALS AND METHODS: 72 malignant nodules and 61 benign nodules were enrolled as part of this study. Five faculty radiologists and four residents independently performed a retrospective analysis of the US images. The observers received one training session after the first interpretation and then performed a secondary interpretation. Agreement was analyzed by Cohen's kappa statistic. Degree of performance was analyzed using receiver operating characteristic (ROC) curves. RESULTS: Agreement between the faculties was fair-to-good for all criteria; however, between residents, agreement was poor-to-fair. The area under the ROC curves was 0.72, 0.62, and 0.60 for the faculties, senior residents, and junior residents, respectively. There was a significant difference in performance between the faculties and the residents (p < 0.05). There was a significant increase in the agreement for some criteria in the faculties and the senior residents after the training session, but no significant increase in the junior residents. CONCLUSION: Independent reporting of thyroid US performed by residents is undesirable. A continuous and specialized resident training is essential to enhance the degree of agreement and performance.
Adult ; Aged ; Clinical Competence/*statistics & numerical data ; Diagnosis, Differential ; Faculty, Medical/*statistics & numerical data ; Female ; Humans ; Internship and Residency/*statistics & numerical data ; Male ; Middle Aged ; Observer Variation ; ROC Curve ; Radiology/education ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland/ultrasonography ; Thyroid Neoplasms/*ultrasonography

INTRODUCTIONThis study compares the attitudes between preclinical and clinical medical students towards radiology, following the introduction of a new radiology curriculum for 1st year students.

MATERIALS AND METHODSRevision of the 1st year medical school curriculum for the academic year of 2008/9 with the inclusion of 13 one-hour formal radiology lectures integrated with each body system was done in an undergraduate Southeast Asian medical school. In the old curriculum, 1st and 2nd year medical students are not exposed to radiology. They received limited radiology teaching in their 3rd and 5th years with 2 one-hour lectures as part of their medicine and surgery rotations. In the 4th year, they have a one week non-examinable posting in radiology. A survey was administered to preclinical (new curriculum) and clinical (old curriculum) students. Survey responses were tabulated and attitudes between preclinical and clinical students were compared.

RESULTSMore than half of the preclinical students (155 out of 270 students, 59%) and 90 out of 720 clinical students (12.5%) responded. Students exposed to the new curriculum had attended one or two dedicated radiology lectures and were considering radiology as a clinical elective. Both groups of students did not feel familiar with radiology as with other specialties, were not considering radiology as a career, but felt that radiology was interesting and important to the overall practice of medicine.

CONCLUSIONSExposure of 1st year students to radiology increases their interest in the subject. Further intervention, fi ne-tuning of the curriculum and follow-up surveys will be carried out to see if this interest persists throughout their clinical years.

Attitude of Health Personnel ; Clinical Clerkship ; Clinical Competence ; statistics & numerical data ; Curriculum ; Education, Medical, Undergraduate ; Educational Measurement ; Educational Status ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Humans ; Radiology ; education ; Schools, Medical ; statistics & numerical data ; Singapore ; Students, Medical ; psychology ; statistics & numerical data ; Surveys and Questionnaires

INTRODUCTIONTo compare class attendees versus absentees in their ability to retain knowledge during a diagnostic radiology course.

MATERIALS AND METHODSThis study recruited 146 fourth-year medical students who attended a diagnostic radiology course from February 2004 to June 2004. Eight unit tests were conducted. Questions for each test covered content taught in the prior class. Another examination (which students were not aware of beforehand) was conducted in June, and the questions for this examination included content from all lectures in the course. The class attendance rates were measured separately 6 times during the course. Students who were present on the last of these dates were categorised as attendees (group A students) and those who were absent were categorised as absentees (group B).

RESULTSThe average class attendance was 76.8% and the lowest attendance was 56.8%. For the unit tests, the average score of group A students (80.7 +/- 7.3) was significantly higher than that of the group B students (76.2 +/- 8.8) (P = 0.001). However, in the unanticipated examination, there was no significant difference in the scores between group A (68.1 +/- 10.3; range, 36-92) and group B students (65.5 +/- 13.5; range, 28- 88) (P = 0.19). Self-learning time was related to the unit test scores (P = 0.001) but not to the unanticipated examination scores (P = 0.27).

CONCLUSIONStudents who frequently attend classes or study for longer can retain their knowledge over a short period of time, but there is no difference in knowledge retention between class attendees and absentees at the end of a 4-month course.

Absenteeism ; Education, Medical, Undergraduate ; Educational Measurement ; Knowledge ; Radiology ; education ; Retention (Psychology) ; Students, Medical