Effectiveness of a 12-Month Emergency Radiology Curriculum for Improving Self-Confidence and Competence of Postgraduate Year 1 Radiology Residents-A Canadian Study.

PURPOSE: Limited radiology curriculum during postgraduate year 1 of radiology residency combined with increasing workloads during emergency radiology call have contributed to heightened anxiety and responsibilities for junior residents. This study aimed to evaluate the effectiveness of a 12-month emergency radiology curriculum on self-rated confidence and general competence of Canadian postgraduate year 1 radiology residents. METHODS: A cohort of Canadian postgraduate year 1 Diagnostic Radiology residents voluntarily enrolled in a 12-month self-directed online emergency radiology curriculum (9 modules). Participants completed pretest and posttest surveys and examinations to gauge their self-rated competence on module material and knowledge acquisition, respectively. Average pretest and posttest scores were compared using Student 2-tailed unpaired t test, and Likert data from self-reported confidence were compared using a Mann Whitney U test. Statistical significance was defined as P < .05. RESULTS: Sixty-six trainees completed at least 1 module, and 15 trainees completed all 9 modules. Both self-rated confidence and posttest scores were statistically higher after module completion (P < .001) for all 9 learning modules. The greatest improvement in test scores was seen in the female genitourinary module (28.12 ± 3.018; difference between pretest and posttest means ± SEM). CONCLUSIONS: Our study demonstrates learning benefits for junior radiology trainees who participated in a self-directed online emergency radiology curriculum during postgraduate year 1. In the face of ever-increasing demands for imaging in on-call settings across Canada, inclusion of a self-directed online curriculum may become more important for upcoming competency-based medical education as it encourages a learner-driven and non-time-based method of education.

Evaluation of different metrics as an index for the assessment of arterial stiffness.

Elevated intravascular pressure is a contributing factor to increased arterial stiffness, and is a risk factor for cardiovascular morbidity and mortality. Assessment of arterial stiffness is of importance in evaluating cardiovascular risk. Pulse wave velocity (PWV) has been broadly used in the assessment of arterial stiffness. We compared three different metrics of arterial stiffness to PWV. Hemodynamic recordings were carried out in anesthetized hypertensive and normotensive rats (n = 25; 13-14 weeks old). Four parameters were calculated (PWV, elastic modulus (Einc), stiffness index (ß), and pressure-strain modulus (Ep)) as metrics of arterial stiffness. Hypertensive in comparison to normotensive rats had significantly higher systolic and diastolic blood pressures. Metric for arterial stiffness were significantly (p < 0.002) higher in hypertensive animals: PWV (8.46 ± 2.01 vs. 6.39 ± 1.28 m/s), Ep (0.246 ± 0.019 vs. 0.137 ± 0.010 dyn/cm2 × 10-6), Einc (17.5 ± 1.8 vs. 10.1 ± 0.9 dyn/cm2 × 10-6), and ß (2.43 ± 0.11 vs. 1.98 ± 0.08) (mean±SE). Bland-Altman analysis revealed ß as the only metric aligned with PWV in hypertensive state. We find in state of reduced arterial compliance associated with high systemic pressure, ß but not Einc or Ep is an index of arterial stiffness showing agreement with PWV.

The effect of inflammation on sympathetic nerve mediated contractions in rat isolated caudal artery.

Chronic inflammatory process(es) contributes to changes in vascular function in a variety of diseases. Sympathetic nerve-mediated responses in blood vessels play a pivotal role in regular physiological functions. We tested the hypothesis that sympathetic neuro-effector function will be altered as consequence of inflammatory state. Sympathetic nerve-mediated contractions and alpha adrenergic receptor expressions were evaluated in isolated caudal arteries of rats treated with saline and Complete Freund's adjuvant (CFA). While CFA-treated animals had significantly higher plasma levels of tumor necrosis factor-alpha compared to saline, blood pressure remained unchanged. Immunofluorescence revealed increased expression of ionized calcium adapter binding molecule-1 in the adventitia of blood vessels from CFA-treated animals compared to saline. In isolated arteries, electrical field stimulations between 1.25 and 40Hz resulted in frequency-dependent contractions that wasabolished by tetrodotoxin. Neurogenic contractions from CFA groups were significantly greater than saline. While the presence of alpha1-adrenoceptor antagonist (prazosin) significantly inhibited contractions at lower frequencies of stimulation (1.25-5Hz) in isolated arteries of CFA-treated rats compared to controls, alpha2-adrenoceptor antagonist (rauwolscine) had modest effects. Inhibition of neuronal reuptake by cocaine comparably enhanced field-stimulated responses in vessels of experimental and control animals. Immunofluorescence revealed a difference in expression of alpha1- and alpha2-adrenoceptors in the endothelium of blood vessels of CFA compared to saline controls. Collectively, our observations lend support to enhanced neurogenic contractions in blood vessels of inflamed animals possibly attributing to alterations in responsiveness and/or distribution of post-junctional alpha1-adrenoceptors.