Publication

A new publication from Dr. Jessica L. Dobson!

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Abstract

Introduction

Despite the presence of medical imaging and radiological services in nearly all specialties of medicine, Canadian medical students report they receive limited exposure to Radiology in their curriculum.1 The COVID-19 pandemic has amplified these challenges, as it has forced medical schools to transition to a virtual learning environment. This survey aims to assess radiology teaching methods of Canadian medical schools and provide insight into students’ general radiology knowledge and confidence of image interpretation.

Methods

This is an institutional review board approved multicenter survey that assessed medical student’s exposure to the field of Radiology, radiology teaching methods, and student’s confidence in image interpretation. Distribution was achieved by having recruited student ambassadors from radiology interest groups distribute the link to students at their institution. The survey was conducted in September 2020. Descriptive statistical calculations were used to evaluate the responses. Subgroup analyses were conducted between pre-clerkship and clerkship students.

Results

The survey was sent to 698 students. A total of 545 Canadian medical students from all 17 medical schools completed the survey giving a response rate of 78.1%. The responses demonstrated all years (Table 1). Most respondents (79.1%) had radiology concepts tested during their preclinical exams. Didactic lectures were the most common encountered teaching method (74%), followed by self-guided studying (49%), and problem-based small groups (29%); a few respondents (12%) reported receiving no formal radiology education in school.

Most students received training in normal radiographic anatomy (73%) and in abnormal radiographic anatomy (70%). In assessing common pathologies, 52% reported receiving teaching about fractures, 70% about pneumonia, 63% about pleural effusion, 34% about subdural hemorrhage, and 67% about pneumothorax. When asked about their confidence in evaluating various chest radiograph findings, less than half of all survey respondents were very confident or moderately confident in any single disease process (Figure 1). Subgroup analyses on confidence level in evaluating various items on chest radiographs was conducted between pre-clerks and clerks. Significantly more clerks reported being “very confident” in evaluating all common pathologies. In evaluating radiology importance, over 90% of students responded that it was either “Very Important” or “Moderately Important” for junior residents to interpret image findings. Additionally, 87% of students responded that they did not feel they had adequate exposure to radiology during medical school.

Discussion

Several deficiencies have previously been identified across radiology education, such as a lack of radiologist educators, under-representation in the curriculum, and a misunderstanding of the field.^1,2,3 Our survey responses indicate that radiologists have become increasingly involved in teaching radiology, and that students seem to understand the importance of imaging. However, students continue to feel like radiology is not taught enough and that they do not have adequate education for image interpretation. An argument can be made for continued radiology expansion in the undergraduate curriculum, through both formal lectures as well as innovative teaching methods.

An additional educational concern was the lack of required clerkship radiology experiences, with only one Canadian medical school requiring a radiology rotation to complete its core clinical requirements.⁴ Even with the lack of mandatory clerkship radiology rotations, clerkship students reported more formal radiology education and greater imaging confidence compared to pre-clerkship students. This suggests that radiology teaching occurs at all levels of training in Canadian medical schools despite a lack of mandatory clerkship rotations.

Conclusion

This national survey of Canadian medical students demonstrates that students value radiology in their curriculum and feel like they do not receive adequate exposure. This survey identifies areas that can be addressed to promote further radiology education, such as increased interaction with radiologists during clinics as well as fostering students’ confidence in image interpretation.