Deploying senior radiology trainees as at-home “teleresidents” is a feasible solution to maintain productivity and social distancing amid the pandemic, according to new research published Friday.
With diagnostic radiology work largely handled electronically, the University of Virginia Medical Center has experimented with administering its residency program remotely. All told, 28 workstations were divvied out to senior residents and fellows, leaders detailed in Academic Radiology.
Two months into the pilot, the institution started seeing signs of success, with residents perceiving their productivity as “unchanged or better” than working at the hospital, based on follow-up surveys.
“For institutions with the financial resources, offering a remote option for senior radiology residents and fellows represents a feasible solution for implementing social distancing and personal safety measures during the pandemic, while maintaining operational productivity,” corresponding author and associate professor Michael Hanley, MD, and colleagues wrote Dec. 3. “These benefits can be applied to other scenarios where residents and fellows are unable to work in-house, including inclement weather,” they added.
UVA Health decided to roll out its remote residency program in late 2020. They purchased workstations consisting of a PC tower, three monitors for viewing images and handling administration work, a keyboard, mouse PowerMic, webcam and other accessories for a total of $2,126 each. The organization’s IT department preinstalled stations with access to the electronic health record, PACS, reporting systems and virtual private network software.
The hospital distributed stations to post-graduate trainees in years 4-6, with all 10 third-year residents participating in the pilot. Thoracic and abdominal CT/MRI, noninvasive cardiovascular imaging, neuroradiology and musculoskeletal imaging work were all eligible for remote interpretation. Other procedural services such as ultrasound, fluoroscopy, breast imaging and nuclear medicine necessitated in-person attendance. Residents handled their duties during normal working hours, same as in-house residency.
Hanely et al. conducted an online survey of 32 staff member and 25 residents two months in, hoping to gauge satisfaction, ease of use and perceived productivity. About 92% of residents and fellows said installation and setup were easy, while 72% reported no noticeable difference in exam loading time. Faculty, however, perceived teaching and education to be worse (63%) or unchanged (38%), and zero staff members saw remote residency as an improvement over the in-person program. Residents, meanwhile, found teaching to be worse (40%) or unchanged (56%).
Gauging productivity, 92% of residents felt they read the same or more studies at home, while 43% of faculty felt trainees handled slightly less, and 31% “much less.” (The study authors found that remote participants read about the same number of studies as their in-person counterparts.) Trainees experienced no noticeable difficulties reporting critical findings or reaching referring providers. In free-text responses, “time saved on commuting” was the most common benefit cited by subjects, showing up in 63% of comments.
“Given concern over new variants, we believe that the home workstation program may continue to have a place in radiology training,” Hanley and colleagues advised. “It contributes to improved quality of life and provides scheduling flexibility among residents and fellows needing to adjust for unexpected life events. This may come at an arguable cost of quality of education; however, further objective studies are needed to confirm,” they added later.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.