Simulated daily readout program mimics pre-COVID workflow, earning praise from radiology residents and faculty

The COVID-19 pandemic has hit hospital imaging volumes hard, causing major disruptions to a key piece of radiology residents’ education: daily readouts. Imaging experts from one large institution have successfully combated this effect, however, utilizing a simulated daily readout program.

Doctors with New York University Grossman School of Medicine worked with informatics colleagues to replicate the traditional side-by-side reading collaboration, selecting a mixture of imaging cases for daily work lists that are accessible either in person or via their remote picture archiving and communication system.

Typically these images would come from outpatient and inpatient imaging exams, but the new approach has received high marks from both residents and faculty. And first author Michael P. Recht, MD, with NYU’s Department of Radiology and colleagues, acknowledges that while losing experience from daily readouts over the near-term may not be too harmful, who is to say imaging will return to normal any time soon?

“Learning to independently interpret exams, not knowing if the exams are normal or abnormal (as opposed to reviewing teaching files), and having to clearly and concisely report findings are essential parts of radiology training,” Recht et al. added June 8 in Academic Radiology. “Although losing this experience for one to two months might not have a significant adverse effect on training, there is no guarantee that the world of radiology will return to ‘normal’ in such a short time period.”

For their simulated approach, the group manually picked a combination of normal and abnormal cases that were performed during the final four months of 2019, using an “appropriate” mix of imaging modalities. Each subspecialty was responsible for creating daily worklists for their rotations, which required about 20-30 hours of preparation.

A total of 32 residents participated in the project, 25 of whom completed a simulated read program pre-implementation survey. Twenty-four ultimately responded to the survey, handed out within the first month after implementation. Another 45 teaching faculty also shared their opinions.

All respondents “strongly agreed” that COVID-19-related workflow changes negatively impacted the radiology residents’ training experience, and residents were “neutral to optimistic” about a simulated program’s ability to change that.

Two weeks after the initiative both residents and teachers liked the experience, with both saying they “felt strongly” that the program “mitigated” the pandemic’s negative impact. And both groups indicated the simulated reads accurately mimicked typical daily work.

There was also little difference in the positive marks attributed to the initiative between those using the platform remotely or in person.

Many hospitals and radiology departments have experimented with different approaches to preserve residents’ daily readouts. One such study, also published in Academic Radiology, found that Brigham and Women’s Hospital Department of Radiology trainees and attendings found a ‘remote readouts’ program highly beneficial.

While Recht and colleagues noted that the effectiveness and enthusiasm for their simulated readouts could wane over time, they view the project as having a long-term impact.

“Although initially intended as an educational tool during the COVID-19 pandemic, SDR can serve as an enduring teaching tool for rotation preparation, supplementation, and even assessment,” the authors concluded.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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