Hands-on radiology lessons for first-year med students: feasible, affordable—and rewarding

The medical school at Howard University in Washington, D.C., isn’t the first to add a dedicated radiology component for first-year students learning basic anatomy. But it has set the bar for others looking to offer clinical novices a meaningfully deep radiological dive in the face of limited resources—human as well as fiscal—and within an already-packed curriculum.

Six years into the program, its leaders report that students’ impressive interpretive test scores as well their post-program survey responses on clinical confidence and overall satisfaction show it to be a success. The profs have published a detailed report telling how they did it in Anatomical Sciences Education, the journal of the American Association of Anatomists. (If this sounds familiar, you may have seen our news coverage at HealthImaging.com).

Anatomist James Wilson, PhD, radiology chair Andre Duerinckx, MD, PhD, and radiologists Jackie Alvarez, MD, and Bonnie Davis, MD, emphasize that combining cadaveric with radiographic anatomy goes a long way in fostering an integrated, holistic appreciation of the patient. Plus, they say, it helps ward off the then-and-now “disconnect” that can make preclinical lessons seem irrelevant to later clinical training.

The authors describe a number of steps they took, including establishing the interdepartmental collaboration and gaining support from the curriculum committee and the dean’s office. At that point, the team had to get resourceful.

“[I]t was … very discouraging initially to realize that Howard University Medical College did not have the resources to increase the commitment of faculty to teach more radiology using a traditional or didactic instructional model,” they write. “With teaching loads already very high, there is no incentive for a basic science faculty to master new teaching methods or the principles of radiographic reasoning in an environment where research productivity, not teaching, determines faculty rank, salary and status.”

So they asked themselves: What approach would work?

The answer came after someone casually pointed out that today’s students are highly proficient when it comes to doing new things with their smartphones and apps. From there the team went on to procure user-friendly—and free—DICOM-viewing software. They used this to launch the students into a syllabus of self-learning, group testing and small-group study of clinical cases.

Further, to ease the burden on instructors as well as budgets, they used such “simple, effective and inexpensive methods of pedagogy” as YouTube-style video tutorials and group radiographic quizzes. The latter can be taken repeatedly, the authors note, which pretty much guarantees the eventual attainment of a perfect test score—surely the best of all student motivators.

Wilson et al. close with the observation that, beyond building early clinical competencies, adding radiology to anatomy in early medical education serves a much deeper purpose: humanizing the cadaver.

“Habits of mind and respect for the patient are developed when the patient’s external anatomy and internal anatomy are thoroughly inspected before making the first incision,” they write. “From day one, the patient must be central in medical education and practice, requiring the continued exploration of pedagogies that fully integrate clinical practice with dissection. Such an approach reinforces the perspective of the cadaver as the first patient.”

It seems to me the only question now is how quickly other medical schools can follow the trail blazed by Howard University Medical College.