Clinical study
Renewing Focus on Resident Education: Increased Responsibility and Ownership in Interventional Radiology Rotations Improves the Educational Experience

https://doi.org/10.1016/j.jvir.2010.07.009Get rights and content

Purpose

To enhance the educational experience among residents rotating through interventional radiology (IR) by encouraging ownership and responsibility.

Materials and Methods

In May 2006, the authors implemented changes in resident education in IR that included increased clinical responsibilities, structured didactics, and greater hands-on experience, including call. Residents were assigned as first assistants, ownership of cases was encouraged, and assignment to a week on the consult service was instituted to help residents better understand all aspects of IR practice. Additional faculty recruitment and program expansion ensured the same high level of training for the fellowship program.

Evaluations were reviewed every year (July 1, 2007–June 30, 2009) for hands-on training, daily teaching, didactic conferences, and overall effectiveness of the clinical service. A graduated scale of 1–5 was used.

Results

In 2009, 3 years after the curricular changes were made, the quality of hands-on training, daily case reviews and consults, didactics, and overall education had markedly improved with 89%, 71%, 65%, and 82% of the residents rating these respective aspects of the training as “above expectations” (4 on a scale of 5) or “superior” (5 on a scale of 5) compared with 77%, 23%, 20%, and 60% in 2005–2006. Three years after the changes, the impact of these changes on recruitment patterns also showed improvement, with 28.6% of the class of 2010 pursuing a fellowship in IR.

Conclusions

Increasing resident ownership, responsibility, and hands-on experience improves resident education in IR, which, in turn, promotes interest in the field.

Section snippets

Training Program

The diagnostic radiology residency training program at our institution is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) and has an average of 8 trainees per postgraduate year (PGY II-V, a total of 32 residents). This institution also has an ACGME-accredited fellowship in IR, which trains up to three fellows per year.

Before May 2006, the IR program was geared primarily toward training fellows. At the university hospital, fellows were responsible for

Results

From July 1, 2006 to June 30, 2009, a total of 40 residents rotated through IR for a total of 65 rotations. Of these 65 rotations, a completed evaluation was submitted for 56 rotations (response rate, 86.2%). A total of 15 evaluations (total 21 rotations; response rate, 71.4%) were available from the academic year 2005–2006.

The percentage of responses that evaluated each of the above four criteria were tallied and detailed below.

Discussion

As IR increasingly becomes mainstream and more patients are treated with image-guided minimally invasive procedures, concerns have been raised repeatedly among practitioners with regard to bolstering recruitment and preventing ”turf loss” (4, 5, 6, 7, 8, 9, 10, 11, 12). The rate of growth in number of cases per year continues to outstrip the growth in number of practitioners (4, 5, 7) . Meanwhile, each year not all fellowship positions are filled. In the most recent application cycle (2009),

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The abstract was presented at the 34th annual meeting (2009) for the Society of Interventional Radiology.

None of the authors have identified a conflict of interest.

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