Elsevier

Academic Radiology

Volume 14, Issue 2, February 2007, Pages 239-245
Academic Radiology

Radiology resident education
A Quality Assurance Elective for Radiology Residents1

https://doi.org/10.1016/j.acra.2006.10.018Get rights and content

Rationale and Objectives

As a component of the practice-based core competency of the Accreditation Council for Graduate Medical Education, all radiology residents must receive training to be able to evaluate and improve their patient care practices. To achieve this goal, our quality management section has implemented a comprehensive elective rotation in quality assurance.

Materials and Methods

We have designed a month-long structured resident elective in radiology quality assurance at the Beth Israel Deaconess Medical Center, Harvard Medical School. This elective provides a combination of didactic teaching, self-learning, and practical experience in the methodology, workings, and clinical applications of quality assurance as these relate to improving technical and clinical performance in a large academic radiology department.

Results

During this rotation, residents are exposed to the spectrum of commonly used tools and techniques used for performance improvement related to the practice of radiology. By actively participating in department and hospital quality assurance (QA) committee meetings, and through initiation of a mentored project coupled with didactic instruction, residents are exposed first hand to the practice and role of continuous quality monitoring and to the implementation and monitoring of action items.

Conclusion

Participation in our QA elective provides our residents with a comprehensive exposure to the spectrum of quality-related problems, and equips them with the necessary tools to resolve many of the clinical or technical problems they are likely to encounter in their future careers. It is thus an appropriate tool to instruct residents in the competency of “practice-based learning and improvement.”

Section snippets

Goals of elective

After approval by our radiology education committee, we have introduced a structured QA elective for our radiology residents. The broad goals of this elective are to familiarize residents with the principles and practice of QA. In addition, this training will meet the core competency requirement guidelines as established by the ACGME. We firmly believe that this exposure will enable our residents to initiate their own continuous performance improvement programs in their future careers.

The

Structure of the elective

To maximize exposure and mentoring, we allow one resident to participate in this elective at a time. For a resident to be eligible, he or she should have completed the first year of radiology training and must have the approval of the Director of the radiology residency program and our director of radiology quality assurance. We do allow residents from other training programs and other fields to participate in our elective program, and more commonly will allow nonradiology residents to

Discussion

Although the goals of this elective are ambitious, each rotation is structured according to the varying interests of each resident. During the final week of this elective, residents meet with the radiology QI director to review the overall elective experience, at which time the resident receives feedback from program staff and the resident provides feedback about the elective. Because QA is not a universally popular topic among trainees, particularly as it is not a subject tested on American

References (27)

  • L.W. Bassett et al.

    Quality assurance in mammography: status of residency education

    AJR Am J Roentgenol

    (1993)
  • L.B. Talner et al.

    The department of radiology quality assessment meetingAn unexpected teaching bonus

    Invest Radiol

    (1994)
  • S.N. Weingart et al.

    Creating a quality improvement elective for medical house officers

    J Gen Intern Med

    (2004)
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    Supported by the Beth Israel Hospital Radiology Foundation.

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