教育研究:加拿大成人神经病学住院医师计划中的神经放射学课程和能力

Diana Benea, Rose Di Ioia, Julien Bejjani, Anne Xuan-Lan Nguyen, Isabelle Hardy, Isabelle Trop, Nicolas Jodoin
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引用次数: 1

摘要

背景和目的在受益于神经放射学家的报告的同时,神经学家也使用他们自己的图像解释来指导临床决策,特别是在急性护理环境中。根据目前的教育差距和实践,这需要在神经内科住院医师中进行强有力的神经放射学培训。本研究旨在(1)探讨加拿大神经内科住院医师项目中正规神经放射学课程的特点;(2)评估神经内科住院医师的神经影像学解释能力;(3)定义神经内科住院医师和项目主任(pd)对当前课程和未来方向的态度。方法对加拿大神经科住院医师和pd进行匿名调查,询问他们的神经放射学学习活动、涵盖的成像模式、评估模式、住院医师对不同模式的理解能力以及对神经放射学培训的态度。住院医师被要求解读15例神经影像学病例。进行描述性和推断性分析。使用双尾Welch检验(95% CI)和Holm-Bonferroni比较调整来检验住院医师解释成功率因资历、自我感知熟练程度和课程充分性感知而存在的潜在差异。统计数据用Excel计算。结果78名居民(32.6%)和11名pd(68.8%)参与了调查。11个pd中有10个报告包括强制性的神经放射学轮转,9/11提供了正式的神经放射学课程,包括头部CT、头颈部CT血管造影(CTA)、脊柱MRI和头部MRI。项目主要提供额外的教学讲座(9/11)、教学案例(8/11)和影像网站(8/11)。大多数住院医师同意至少1个月的轮转,并希望定期接受神经放射学家的指导。居民对头部MRI(88.5%)、头颈部CTA(76.9%)和脊柱MRI(69.2%)的了解程度较高。老年住院医师的自我感知能力在头部CT、头部MRI和头颈部CTA方面最高,但低于初级医师的感知能力。老年人的口译评分高于青少年(84.5%±13.2% vs 69.1%±19.9%);p & lt;0.0001)。大多数博士(7/11,63.6%)对目前的课程表示满意,而居民的满意度为32.1%。pd认为时间和教育人员短缺是增加培训的主要障碍。神经放射学培训因项目而异。住院医生对常用的教学模式表现出强烈的兴趣,他们也表现出很高的自我认知能力。然而,pd对目前培训的满意度高于住院医师。利用与神经放射学家的互动和基于案例的在线学习,同时强调受训者的兴趣,可以加强研究生神经放射学对这一有用技能的培训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Education Research: Neuroradiology Curriculum and Competencies Among Canadian Adult Neurology Residency Programs
Background and Objectives While benefitting from neuroradiologists' reports, neurologists use their own image interpretation to guide clinical decisions, especially in acute care settings. This calls for robust neuroradiology training in neurology residency, informed by current educational gaps and practices. This study aims to (1) characterize the formal neuroradiology curriculum among Canadian neurology residency programs; (2) assess neurology residents' neuroimaging interpretation competencies; and (3) define neurology residents' and program directors' (PDs) attitudes toward the current curriculum and future directions. Methods Anonymous surveys were sent to Canadian neurology residents and PDs, querying neuroradiology learning activities, imaging modalities covered, assessment modalities, perceived residents' competencies to interpret different modalities, and attitudes regarding neuroradiology training. Residents were asked to interpret 15 neuroimaging cases. Descriptive and inferential analyses were performed. Potential differences in residents' interpretation success rates by seniority, self-perceived proficiency, and perception of curriculum sufficiency were examined using 2-tailed Welch tests with a 95% CI and Holm-Bonferroni comparison adjustment. Statistics were computed using Excel. Results Seventy-eight (32.6%) residents and 11 (68.8%) PDs participated. Ten of 11 PDs reported including a mandatory neuroradiology rotation, and 9/11 offered a formal neuroradiology curriculum covering head CT, head and neck CT angiography (CTA), spine MRI, and head MRI. Programs predominantly offered additional didactic lectures (9/11), teaching cases (8/11), and imaging websites (8/11). Most of the residents agreed with a minimum 1-month long rotation and desired regular didactics from neuroradiologists. Residents favored learning about head MRI (88.5%), head and neck CTA (76.9%), and spine MRI (69.2%). Senior residents' self-perceived competencies were highest for head CT, head MRI, and head and neck CTA, but lower than PDs' perception. Senior residents had greater interpretation scores than juniors (84.5% ± 13.2% vs 69.1% ± 19.9%; p < 0.0001). Most PDs (7/11, 63.6%) expressed satisfaction with current curricula vs 32.1% of residents. PDs identified time and educator shortages as main barriers to increased training. Discussion Neuroradiology training varies among programs. Residents expressed strong interest in commonly taught modalities, for which they also expressed high self-perceived competencies. However, PDs expressed greater satisfaction than residents with the current training. Leveraging interactions with neuroradiologists and online case-based learning while emphasizing trainees' interests can enhance postgraduate neuroradiology training for this useful skill.
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