Radiologist Self-training: a Study of Cancer Detection when Reading Mammograms at Work Clinics or Workshops.

Provision of online and remote specialist education and general continued professional education in medicine is a growing field. For radiology specifically, the ability to access web-based platforms that house high resolution medical images, and the high fidelity of simulated activities is increasingly growing due to positive changes in technology. This study investigates the differences in providing a self-directed specialist radiology education system in two modes: at clinics and in-person workshops. 335 Australian radiologists completed 562 readings of mammogram test sets through the web-based interactive BREAST platform with 325 at conference workshops and 237 at their workplaces. They engaged with test sets with each comprising of 60 mammogram cases (20 cancer and 40 normal). Radiologists marked the location of any cancers and had their performance measured via 5 metrics of diagnostic accuracy. Results show that the location of engagement with BREAST did not yield any significant difference in the performances of all radiologists and the same radiologists between two reading modes (P > 0.05). Radiologists who read screening mammograms for BreastScreen Australia performed better when they completed the test sets at designated workshops (P < 0.05), as was also the case for radiologists who read > 100 cases per week (P < 0.05). In contrast, radiologists who read less mammograms frequently recorded better performances in specificity and JAFROC at clinics (P < 0.05). Findings show that remotely accessed online education for specialised training and core skills building in radiology can provide a similar learning opportunity for breast radiologists when compared to on-site dedicated workshops at scientific meetings. For readers with high volumes of mammograms, a workshop setting may provide a superior experience while clinic setting is more helpful to less experienced readers.

Infection prevention and control in medical imaging surveys: The need to map to guidelines to address systemic issues?

BACKGROUND: Infection prevention and control (IPC) in the medical imaging (MI) setting is recognised as an important factor in providing high-quality patient care and safe working conditions. Surveys are commonly used and have advantages for IPC research. The aim of this study was to identify the core concepts in surveys published in the literature that examined IPC in MI environments. METHODS: A literature review was conducted to identify studies that employed a survey relating to IPC in the MI setting. For each included study, descriptive study information and survey information were extracted. For IPC-specific survey items, directed content analysis was undertaken, using eleven pre-determined codes based on the 'Australian Guidelines for the Prevention and Control of Infection in Healthcare'. Content that related to 'Knowledge', 'Attitudes' and 'Practice' were also identified. RESULTS: A total of 23 studies and 21 unique surveys were included in this review. IPC-specific survey items assessed diverse dimensions of IPC, most commonly relating to 'transmission-based precautions' and 'applying standard and transmission-based precautions during procedures'. 'Practice' and 'Knowledge' related survey items were most frequent, compared to 'Attitudes'. CONCLUSION: MI research using survey methods have focused on the 'entry' points of IPC, rather than systemic IPC matters around policy, education, and stewardship. The concepts of 'Knowledge', 'Attitudes' and 'Practice' are integrated in IPC surveys in the MI context, with a greater focus evident on staff knowledge and practice. Existing topics within IPC surveys in MI are tailored to individual studies and locales, with lack of consistency to national frameworks.

Was the risk of death among the population of teachers and other school workers in England and Wales due to COVID-19 and all causes higher than other occupations during the pandemic in 2020? An ecological study using routinely collected data on deaths from the Office for National Statistics.

OBJECTIVES: To estimate occupation risk from COVID-19 among teachers and others working in schools using publicly available data on mortality in England and Wales. DESIGN: Analysis of national death registration data from the Office for National Statistics. SETTING: England and Wales, 8 March-28 December 2020, during the COVID-19 pandemic. PARTICIPANTS: The total working age population in England and Wales plus those still working aged over 65 years. PRIMARY AND SECONDARY OUTCOMES: Death with COVID-19 as a primary outcome and death from all causes as a secondary outcome. RESULTS: Across occupational groups, there was a strong correlation between COVID-19 mortality and both non-COVID-19 and all-cause mortality. The absolute mortality rates for deaths with COVID-19 were low among those working in schools (from 10 per 100 000 in female primary school teachers to 39 per 100 000 male secondary school teachers) relative to many other occupations (range: 9-50 per 100 000 in women; 10-143 per 100 000 in men). There was weak evidence that secondary school teachers had slightly higher risks of dying with COVID-19 compared with the average for all working-aged people, but stronger evidence of a higher risk compared with the average for all professionals; primary school teachers had a lower risk. All-cause mortality was also higher among all teachers compared with all professionals. Teaching and lunchtime assistants were not at higher risk of death from COVID-19 compared with all working-aged people. CONCLUSION: There was weak evidence that COVID-19 mortality risk for secondary school teachers was above expectation, but in general school staff had COVID-19 mortality risks which were proportionate to their non-COVID-19 mortality risk.