Radiology education has made substantial progress since its debut in the medical sphere, but students and faculty alike continue to suffer from communication barriers, high burnout risks and a lack of defined roles in the classroom, a group of administrators wrote in a compiled advice column for the Journal of the American College of Radiology (JACR).
“Although a positive learning environment helps minimize burnout and is directly related to more effective learning, work satisfaction and staff morale, creating such an environment can be challenging,” Deborah Reede, MD, and Richard B. Ruchman, MD, said. Both physicians are department chairs, hailing from SUNY Downstate Medical Center in New York and Monmouth Medical Center in New Jersey, respectively.
Reede and Ruchman argued the greatest challenges in a radiology learning environment stem from its faculty, who are expected to practice, innovate and teach the next generation of radiologists simultaneously. With ACGME program requirements piling on the work, they said, staff are forced to juggle ever-increasing clinical workloads while also making time for scholarly activities and faculty development.
The pair of said standardized learning material, developed by nationally recognized organizations, could be time-savers for radiology educators who are already stretched thin. It could eliminate the need for staffers to spend time constructing specific lectures or assessments, they wrote, and the cost of investing in such programs would be easily outweighed by a hike in productivity, quality standards and learning optimization.
However, Daniel Ortiz, MD, radiology chief resident at Eastern Virginia Medical School, questioned that ideology.
“The optimal clinical learning environment achieves a balance between the implementation of training standards to ensure the provision of excellent, safe patient care and the allowance of some flexibility for individual trainee differences to flourish,” he wrote in JACR. “A stringent one-size-fits-all system stifles innovation and is a major contributor to burnout among radiology trainees.”
Ortiz advocates for a more diverse radiology learning environment—one in which residents are able to develop skill sets tailored to their medical interests. He said the expectations that trainees should excel in all aspects of education, including research, image interpretation, teaching and leading, are “unrealistic” and “toxic.”
“We must accept our limitations,” Ortiz wrote. “These differences should be celebrated, not punished.”
He also alluded to “the never-ending checkboxes” required of both faculty and students when it comes to the learning environment. Radiologists have seen an uptick in the utilization of imaging exams in clinical practice, he said, which, while positive, also means imagers are required to dissect more complex cases, more often.
“As the clinical learning environment continues to evolve, requirements modifications and subtractions should be used as much as additions, if not more,” Ortiz wrote.
Program director Tara Catanzano, MD, and associate program director Amy Oliveira, MD, agreed the increase in exam utilization is adding unnecessary weight to a radiologist’s already-full workload. The directors, both from the University of Massachusetts Medical School-Baystate, said physician shortages also contribute to stress.
“The increasing relative value unit pressures can have a negative impact on the learning environment,” Catanzano and Oliveira wrote. “This manifests as a decrease in workstation-based teaching and potentially a higher conference cancellation rate because of faculty unavailability.”
Program directors should be working with associate PDs, program coordinators and department chairs to create a united front and a common vision for their learning program, the women said. Building communication, as well as fostering a more positive environment that recognizes good work and scholarly success, would make for more cohesive programs without impeding quality education.
“Community breaks down silos between department leadership, faculty members, technical staff members and trainees, fostering an inclusive ‘us’ environment,” Catanzano and Oliveira wrote.
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.