ABSTRACT
PURPOSE: The aim of this report is to provide a detailed description of a program employing medical students to assist with triaging off-hour diagnostic imaging studies at a major academic medical center. METHODS: Current and former participants of the Medical student Emergency Department (ED) Radiology Triage Program were interviewed regarding the inception, development, and impact of this program. Student participation and triage activities were compiled and tabulated from scheduling records and triage assistant call logs. RESULTS: Opportunities for medical students to obtain an intensive, well-organized experience in radiology are often absent or occur relatively late during medical school, which can be problematic for developing basic imaging literacy and for making timely, well-informed decisions regarding radiology as a career path. The authors describe a program that provides students with a rigorous, hands-on experience in radiology relatively early in their training by employing medical students to assist the emergency department radiology staff with managing off-hour radiology workflow. Students work with the off-hour emergency department radiologists and staff members answering phone calls and help to facilitate the ordering and protocoling of studies and the dissemination of results to clinicians. CONCLUSIONS: The employment of medical student triage assistants provides in-depth exposure to clinical radiology relatively early in medical school, while providing an effective system to help streamline the off-hour workflow for attending radiologists, residents, technicians, and support staff members.
Subject(s)
After-Hours Care/organization & administration , Education, Medical, Undergraduate/organization & administration , Emergency Service, Hospital/organization & administration , Radiology/education , Salaries and Fringe Benefits/economics , Students, Medical/statistics & numerical data , Academic Medical Centers , Female , Humans , Male , Personnel Staffing and Scheduling , Program Development , Program Evaluation , Triage/organization & administration , United States , WorkforceABSTRACT
This article discusses the basic principles of dynamic contrast-enhanced MR imaging (DCE-MR imaging) of the breast, including technical parameters, image acquisition, and image interpretation. Clinical DCE-MR imaging of the breast has undergone considerable growth from a once investigational technique to an important clinical tool in widespread use. Progress in MR technology and refinement of MR imaging parameters now allow for concurrent acquisition of high-spatial-resolution and adequate-temporal-resolution images, which are necessary for accurate assessment of breast lesion morphology and qualitative kinetic analysis. More advanced DCE-MR imaging techniques involving higher-temporal-resolution images and rigorous quantitative analysis of the time signal enhancement curves are currently an area of research.
Subject(s)
Breast Neoplasms/diagnosis , Magnetic Resonance Imaging/methods , Breast/pathology , Breast Neoplasms/pathology , Contrast Media , Female , Gadolinium , Humans , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Imaging, Three-Dimensional , Sensitivity and SpecificityABSTRACT
OBJECTIVES: Although human immunodeficiency virus (HIV)-infected patients are now living longer, there are no published data on colorectal cancer (CRC) screening in this population. We hypothesized that HIV-infected patients were less likely to be screened for CRC compared to patients without HIV. METHODS: Consecutive HIV-infected patients > or =50 yr old seen in our outpatient clinic from 1/1/01 to 6/30/02 were identified. For each HIV-infected patient, we selected one age- and gender-matched control subject without HIV infection who was seen during the same time period. The electronic medical records were reviewed to determine the proportion of patients that had a fecal occult blood test (FOBT), flexible sigmoidoscopy, air-contrast barium enema (ACBE), or colonoscopy. RESULTS: During the 18-month study period, 538 HIV-infected outpatients were seen and 302 (56.1%) were > or =50 yr old. Despite significantly more visits with their primary care provider, HIV-infected patients were less likely to have ever had at least one CRC screening test (55.6%vs 77.8%, p < 0.001). The proportion of HIV-infected patients who ever had a FOBT (43.0%vs 66.6%, p < 0.001), flexible sigmoidoscopy (5.3%vs 17.5%, p < 0.001), ACBE (2.6%vs 7.9%, p= 0.004), or colonoscopy (17.2%vs 27.5%, p= 0.002) was significantly lower than in control subjects. In addition, HIV-infected patients were significantly less likely to be up-to-date with at least one CRC screening test according to current guidelines (49.3%vs 65.6%, p < 0.001). CONCLUSIONS: A substantial number of HIV-infected patients are > or =50 yr of age and CRC screening is underutilized in this population. Public health strategies to improve CRC screening in HIV-infected patients are needed.
