On-call training: PACS-integrated curriculum improves student comprehension, relieves anxiety

Training radiology residents for on-call duties using a blended-curriculum model—known as a flipped classroom—has been gaining traction in graduate medical education. A recent study found integrating a cloud-based PACS viewer further improved trainee comprehension and comfort. 

In the research, published July 29 in Current Problems in Diagnostic Radiology, authors selected 50 neuroradiology emergency cases and imported them into their cloud-based PACS platform.

During the second half of the academic year at a large ACGME accredited academic medical center, authors administered the flipped classroom curriculum to 12 first-year radiology residents. The assessment took place over the course of a month.

Participants completed a five- to eight-question pre-quiz after finishing the normal examination modules, which focused on commonly encountered emergency department pathology.

Subsequently, a post-quiz, in-person session involved 25 new cases based on images presented in the prior quiz. Students then completed a rating scale to evaluate their personal anxiety in anticipation of neuroradiology on-call cases. A 10 indicated high anxiety, while a 1 was least nervous.

First author Payam Sajedi, with UCLA’s department of radiology, and colleagues found a “substantial” improvement in average scores from the pre-quiz (65 percent) to after the quiz (83 percent). The greatest improvement was in pediatric cases, followed by the head and neck.

“With the aid of this imaging platform to facilitate a flipped classroom session, our study shows overall improved comprehension amongst PGY2 radiology residents with common on-call neuroradiology cases after completion of this web-based teaching session,” the authors wrote.

Participants rated the overall pre-call experience a 9 out of 10, which Sajedi et al. wrote was as important as their other findings. All involved recommended the session for the upcoming year’s PGY2 class.

“Ultimately, we foresee this platform translating into an enduring curriculum to train radiology residents and fellows with a unique approach emphasizing self-learning, simulation, and repetition,” they concluded.

Jason Hostetter, MD, and investigator on this study disclosed he is the creator and owner of the cloud-based PACS viewer used in the research.