Additional learning opportunities boost on-call residents' confidence, knowledge

Implementing mixed-media teaching tools could boost radiology residents’ comfort levels when dealing with after-hours breast imaging emergencies and expand their knowledge of the topic, according to a study published in Emergency Radiology early this month.

Breast imaging emergencies may be few and far between during off-hours at a hospital, but they do happen, Deborah O. Jeffries, MD, and colleagues at the University of Michigan wrote. And when they do, they’re handled by radiology residents who are often new to the practice with limited experience.

“The task of managing breast emergencies at night can be intimidating for a junior resident who has recently started taking call shifts,” Jeffries et al. wrote. “At our institution, residents may only have rotated through breast imaging for one month prior to taking call, with minimal participation in breast interventional procedures and limited experience performing breast ultrasound.”

At the University of Michigan, the authors wrote, it was clear residents lacked confidence when it came to taking on after-hour shifts alone. Though emergency radiology faculty and breast imaging specialists are on-call if a resident comes across a question they feel they can’t answer or a situation that’s difficult to resolve, for the most part residents are on their own, handling phone calls from patients and completing on-the-spot imaging evaluations in rare cases.

Jeffries and her team designed two teaching interventions—one a mixed-media lecture and the other a reference booklet for on-call residents—and surveyed 36 radiology residents at their hospital. Surveys focused on both subjective questions about residents’ experiences and knowledge questions structured to assess expertise in the field.

The authors said they gave residents two learning options in an effort to embrace the generational differences in learning styles that are becoming increasingly apparent as more millennials enter the workforce.

“It has been shown that millennials learn best when they feel that the material is relevant, the presentation is engaging and audience participation is included,” the authors wrote, noting they included interactive clinical scenarios and pre- and post-lecture question sessions in their educational presentation.

The informational reference document, titled “How to Handle on-Call Issues,” was a simply formatted document that listed different scenarios of breast imaging emergencies and how a resident could best respond in each situation, like in the case of hematoma or post-op breast pain.

Survey results obtained after the learning interventions showed 33 of 36 residents—or 91.7 percent—felt an increase in their comfort and confidence levels after using one or both of the interventions. Resident knowledge also rose, from 40 percent at baseline to 68 percent post-intervention.

“Interestingly, the results demonstrated that using one or both interventions resulted in the same score increase on the pre- and post-intervention surveys, which may be due to the residents having the ability to choose which type of medium suited their learning best,” Jeffries and co-authors said. “This model of education could greatly improve resident education by tailoring the information in a similar manner for different topics of interest.”