How Do We Teach High-Value Radiology?
- 28 Downloads
Purpose of Review
The healthcare environment is under tremendous flux and the rate of change is continuously increasing. Calls have been made and efforts are underway to transform medical education. In this article, trends, key drivers, and resources for both global medical education and some specific to radiology are discussed.
Great strides have been made to begin shifting focus towards high-value healthcare delivery through both non-traditional methods and innovation. We are not alone in this journey; resources are readily offered by instrumental key drivers of medical education with collaboration and sharing as valuable tools at our disposal.
Despite initial progress, barriers persist to achieving meaningful and sustainable changes in medical education. We must commit our resources and empower our current and future medical providers to lead the way in providing high-value healthcare for our patients. An awareness of trends and driving forces in healthcare and medical education is necessary for radiologists to be relevant and vital contributors to the healthcare team.
KeywordsValue Patient outcomes Cost Medical education Health systems science Healthcare delivery
Compliance with Ethical Guidelines
Conflict of interest
Viet T. Le declares no potential conflicts of interest. Marc H. Willis reports personal fees from Radiology Support, Communication and Alignment Network (R-SCAN) through a Transforming Clinical Practice Initiative (TCPi) grant to the American College of Radiology.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Recently published references of particular interest have been highlighted as: • Of importance •• Of major importance
- 2.U.S. Centers for Medicare and Medicaid Services. National health expenditures 2016 highlights. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html. Accessed 7 Dec 2017.
- 3.Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington, DC: National Academy Press; 2000.Google Scholar
- 4.Committee on Quality of Health Care in America, Institute of Medicine Staff, and Institute of Medicine (U.S.). Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.Google Scholar
- 6.Ahrq.gov. Agency for Healthcare Research and Quality. https://www.ahrq.gov (2018). Accessed 3 Feb. 2018.
- 7.Flexner A. Medical education in the United States and Canada: a report to the Carnegie foundation for the advancement of teaching. New York: Carnegie Foundation for the Advancement of Teaching; 1910.Google Scholar
- 10.Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs: Prentice-Hall; 1984.Google Scholar
- 11.Bloom BS. Taxonomy of educational objectives: the classification of educational goals. New York: Longmans, Green; 1956.Google Scholar
- 12.Anderson LW, Krathwohl DR. A taxonomy for learning, teaching, and assessing: a revision of bloom’s taxonomy of educational objectives. New York: Longman; 2001.Google Scholar
- 16.Ziv A, et al. Simulation-based medical education: an ethical imperative. Acad Med. 2003;78: 783–8. https://www.ncbi.nlm.nih.gov/pubmed/12915366.
- 18.Havyer RD, et al. Addressing the interprofessional collaboration competencies of the association of American Medical Colleges: a systematic review of assessment instruments in undergraduate medical education. Acad Med. 2016;91(6):865–88. https://doi.org/10.1097/ACM.0000000000001053.CrossRefPubMedGoogle Scholar
- 20.Higginson J, Lake DM. Chapter 7. Principles of teamwork and team science. In: Skochelak SE, Hawkins RE, Lawson LE, Starr SR, Borkan JM, Gonzalo JD, editors. Health systems science. New York: Elsevier; 2017.Google Scholar
- 21.Ahrq.gov. TeamStepps. Agency for Healthcare Research and Quality. https://www.ahrq.gov/teamstepps/index.html (2018). Accessed 3 Feb 2018.
- 24.•• American Medical Association. Creating a community of innovation: the work of the AMA accelerating change in medical education consortium. Chicago; 2017. A current report that highlights the consortium’s achievements, including emerging innovations in physician education and evidence-based impact on best practices. The report continues to inspire the future direction of collaborative efforts to change medical education. Google Scholar
- 25.•• Gonzalo JD, Skochelak SE, Wolpaw DR: Chapter 1. Health systems science in medical education. In: Skochelak SE, Hawkins RE, Lawson LE, Starr SR, Borkan JM, Gonzalo JD, editors. Health systems science. Elsevier; 2017. The first chapter in the Health Systems Science textbook introduces the new, 3rd pillar of science in medical education, which is a cornerstone of value in health care. Google Scholar
- 26.Gonzalo JD, Starr SR, Borkan JM. Chapter 2. What is Health systems science? Building an integrated vision. In: Skochelak SE, Hawkins RE, Lawson LE, Starr SR, Borkan JM, Gonzalo JD, editors. Health systems science. New York: Elsevier; 2017.Google Scholar
- 27.Regenstrief Institute. Homepage—Regenstrief Institute. https://www.regenstrief.org (2016). Accessed 3 Feb 2018.
- 28.Aamc.org. Teaching for quality—continuing education and improvement—initiatives—AAMC. https://www.aamc.org/initiatives/cei/te4q/ (2018). Accessed 3 Feb 2018.
- 31.Abms.org. Steps toward initial certification and MOC| ABMS. http://www.abms.org/board-certification/steps-toward-initial-certification-and-moc/ (2018). Accessed 3 Feb 2018.
- 32.Ihi.org. Overview. http://www.ihi.org/education/ihiopenschool/overview/Pages/default.aspx (2018). Accessed 3 Feb 2018.
- 33.Costsofcare.org. This is our story—costs of care. http://costsofcare.org/home/ (2016). Accessed 3 Feb 2018.
- 34.Choosingwisely.org. Choosing wisely promoting conversations between providers and patients. http://www.choosingwisely.org (2018). Accessed 3 Feb 2018.
- 35.ABIM Foundation. (2018). ABIM Foundation | Advancing Medical Professionalism. http://abimfoundation.org [Accessed 3 Feb. 2018].
- 36.National Resident Matching Program. Results and data: 2017 main residency match®. National Resident Matching Program, Washington, DC; 2017Google Scholar
- 37.• Straus CM, et al. Medical student radiology education: summary and recommendations from a national survey of medical school and radiology department leadership. J Am Coll Radiol 2014;11(6): 606–610. https://doi.org/10.1016/j.jacr.2014.01.012. A national survey that demonstrates the critical need for a bolder presence of radiologists in medical education with recommendations to address these gaps.
- 42.Squire-statement.org. SQUIRE. About SQUIRE. http://www.squire-statement.org/index.cfm?fuseaction=Page.ViewPage&pageId=488 (2017). Accessed 3 Feb 2018.
- 43.Goodman D, et al. Explanation and elaboration of the SQUIRE (standards for quality improvement reporting excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature. BMJ Qual Saf Published Online First: 13 April 2016. https://doi.org/10.1136/bmjqs-2015-004480.
- 44.Ash JS, et al. Some unintended consequences of clinical decision support systems. AMIA Annu Symp Proc 2007: 26–30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813668/.
- 46.American College of Radiology. Clinical decision support. https://www.acr.org/Clinical-Resources/Clinical-Decision-Support (2018). Accessed 3 Feb 2018.
- 47.Jones J. Teaching imaging appropriateness. https://www.acr.org/Practice-Management-Quality-Informatics/Imaging-3/Case-Studies/Quality-and-Safety/Teaching-Imaging-Appropriateness (2017). Accessed 3 Feb 2018.
- 48.American College of Radiology. R-SCAN: radiology support communication and alignment network. https://rscan.org (2017). Accessed 3 Feb 2018.