MEDNAX Radiology Education has begun offering radiologists weekly CME sessions that take around 15 minutes to complete and were more than a decade in the making.
The free case reviews, good for one-quarter credit each with the correct answer to a quick question, fall in with a growing library of resources under the umbrella of MEDNAX Radiology Education. Its shelves also house scheduled and/or archived webinars, conferences, articles, case studies and so on.
But the parts needed to assemble the “CME of the Week” sessions—all of which concentrate on emergency radiology—only came together gradually. That’s because the necessary technical tools had to catch up with the educational idea as conceived.
“Before high-end exporting capabilities came in 10 to 15 years ago, you couldn’t make a movie out of a CT scan,” explains Benjamin W. Strong, MD, chief medical officer and principal educator for vRad, a MEDNAX Company. “You had to show and tell with one slice at a time. It was very cumbersome—ridiculous, in fact.”
Even after those capabilities emerged and began to mature, two other major hurdles remained. One was the lack of a way to present a CT movie file in a way that replicated the scrolling, eye-scanning and interactivity of a radiologist on the job.
The other was the notoriously poor resolution and slow speed of screen-capture programs. For years, they just weren’t up to snuff for the quality needed for medical education, Strong recalls.
“And now everything has come together, enabling us to offer weekly emergency CME case reviews,” he told MIR in a recent phone interview. “We still utilize things like color-coded arrows denoting the key findings and screen captures of the interesting single images within these movies. But now we’re presenting those single images, with annotations, right alongside a view that’s scrolling through the full image set, emulating the interpretation process used by diagnostic radiologists.”
No time like downtime
MEDNAX Radiology Education delivers the weekly CME sessions via email to subscribing radiologists and also posts a non-credit version on its YouTube Channel. Since the first lessons became available in early April, 14 courses have been published featuring standout cases of orbital trauma, pulmonary embolism, mediastinal trauma, epidural hemorrhage, neck trauma and more.
The demand is definitely there, as several hundred recipients have already racked up more than 2,000 views, according to the company’s marketing team. And around 75 especially eager recipients regularly complete new releases within an hour of receiving each email.
Strong chalks up the robust response to the decision to go with just a quarter-hour’s worth of CME credits per pop. And that call, he says, had everything to do with ensuring convenience for the learner.
“We’re going with the smallest amount of accreditation a physician can claim because we want to keep these short and sweet,” he says. “CME of the Week is the kind of thing people can do in the downtime between cases or on the train into work. It’s a quick chance to learn from an interesting case and earn CMEs.”
Ingestible and in the moment
The element that finally sparked the launch of CME of the Week was a collective sense of timing among MEDNAX and vRad leadership, whose members noticed that the company’s educational resources were both popular and productive.
To name just one illustrative example, its annual board review “boot camp,” begun in 2015, has drawn hundreds of radiologists preparing to pass the American Board of Radiology’s certifying exam. For this four-hour webinar, Strong selects cases from nearly 20,000 digitized radiology teaching files from historic sources as well as from vRad’s 500 radiologists.
For the weekly series, Strong and colleagues wanted “something that was contemporary, relevant to the emergency work that our own radiologists do and that was available in an ingestible format,” he says. “That last characteristic—recognizing the best format in which to present these cases—is what finally tipped us over into doing this series.”
Expounding on his earlier point about overcoming technical hurdles, Strong says the development process was so arduous that it inspired him to create a presentation on how to present a radiology case.
“It was a really long haul,” he says—but there’s no doubt he feels the present results are worth the past trouble.
“When I’m preparing for an educational session based on an emergency CT examination,” he says, “I can scroll through and save the entire thing such that I can present it in context: ‘Here is the abnormality, and here is everything around it that contributed to this diagnosis.’”
Equally important in creating the weekly program was selecting cases to present. Here the challenge was separating the merely edifying from the truly illuminating.
“I don’t want to have people just looking at bread-and-butter, routine things that neither inspire nor excite them—‘Oh, that’s just another case of appendicitis,’” Strong says. “We’re teaching physicians who do this exact kind of work every day and at a very high functional level. It’s got to be quite a case.”
He’s got a lot to choose from. vRad maintains a teaching-file feature built into its operational platform. This allows any vRad radiologist to flag and permanently save a study if it seems remarkable enough that other radiologists stand to learn from it.
This feature enables Strong to pick and choose the strongest cases to use for teaching aids.
“I generally go looking in those saved cases every month,” he says. “I’ll consider what people have suggested, make the call and then figure out what happened to that particular patient. Did anything else show up in surgery? What additional imaging, if any, was brought out for the final diagnosis? I incorporate all of that into these presentations.”
To keep the flagged cases coming, vRad has started a “Great Call of the Month” competition. The company’s QA committee and medical leadership take a vote, give out a prize and spotlight the case in a newsletter and online.
Up with radiology education
As CME of the Week continues growing at the rate of 52 per year, vRad plans to branch out into other subspecialties as soon as 2020.
“We hope to leverage the expertise and the case content of our affiliate practices that work in aspects of radiology outside of emergency,” Strong says, referring to the handful of practices that have joined vRad under the MEDNAX banner. “We’ll soon have much more access to different types of imaging and more obscure sub-branches of radiology—things that vRad itself, by virtue of its being focused on emergency radiology, hasn’t seen so much of.”
Strong closes with a hopeful word about the future state of continuing radiology education at large.
“If you look at the educational materials that are out there for radiologists, the PowerPoints are static,” he says. “They lack dynamic annotations and they lack interactivity.”
Strong pauses a moment, then adds:
“I think we’re raising the bar enormously for radiology education. I would love to see other people recognize the value of these methods and incorporate them into their own teaching materials. There’s a need out there for more polish, forethought and leveraging of the available technologies to better emulate the whole experience of interpreting a diagnostic imaging examination. That’s what we’re trying to address with our approach to radiology education.”
To access all the free CME webinars and courses, including the new 15-minute video case reviews, visit the MEDNAX Radiology Education course page.