61% of residents, faculty believe procedural training in radiology should be standardized

Both resident and faculty respondents to a survey in the Current Problems in Diagnostic Radiology agreed that procedural training should be standardized during radiology residency and competence should be ensured at completion.

The Diagnostic Radiology Milestones Project, conceived as a joint effort by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Radiology, provides a framework for measuring resident competence in radiologic procedures in six areas—patient care and technical skills, medical knowledge system-based practice, practice-based learning and improvement, professionalism and interpersonal, and communication skills.

“We believe that there are limited published data available to guide the choice of procedures a resident should be competent at, or to guide criteria for the evaluation of procedural competence,” wrote lead author Christopher P. Ho, MD, of the Emory School of Medicine in Atlanta, and colleagues.

Ho and colleagues sought to investigate the opinions of both residents and faculty within the radiology department of the Emory University School of Medicine regarding resident competency in image-guided procedures and determine a consensus among residents and faculty.

The researchers issued a survey to 185 students and faculty members, receiving 60 replies. They were surveyed about whether or not there should be standardization of procedural training, in which procedures residents should achieve competency. Ho et al. found:

  • 65 percent of respondents thought that procedural training should be standardized.
  • 88 percent of residents and 61 percent of faculty thought that the number of procedures and direct observation are equally important in the evaluation of procedural competence.
  • 32 percent of faculty noted direct observation is more important than the number of overall procedures performed.
  • Procedures that both residents and faculty agreed are important in which to achieve competency are CT-guided abdominal, thoracic and musculoskeletal procedures; central line/port procedures; minor fluoroscopic procedures; general fluoroscopy; peripheral line placements; and ultrasound-guided abdominal procedures.
  • Faculty noted the aforementioned procedures should be performed 11 to 20 times to achieve competency, and residents recommended they be performed six to 10 times for competency.
  • Procedure only residents agreed were important were: CT-guided neck and neck biopsies, I-131 thyroid ablation therapy for hyperthyroidism, I-131 thyroid cancer therapy, and ultrasound-guided head and neck biopsies.
  • Procedures that neither a majority of residents nor faculty thought should be required for resident training included angioplasty/stent placements, CT-guided spinal procedures, embolization, fluoroscopic-guided drain/tube placements and radiofrequency ablations.

The researchers noted a key limitation to their research was the small cohort. Therefore, they noted, the results are not necessarily generalizable to all radiology residencies.

“This survey can serve as a pilot study which we plan to introduce to a larger and more diverse survey population,” the authors wrote. “Additionally, the list of procedures provided to the respondents is not entirely comprehensive.”

Still, the researchers concluded, their data provide a framework for starting to establish future guidelines for standardizing image-guided procedure training.

“Future studies could be expanded to create a national consensus regarding the implementation of the Diagnostic Radiology Milestones Project,” they concluded.

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As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.

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