ABSTRACT
The first year of radiology residency presents many unique challenges, from transitioning into a completely new, specialized field to preparing for call. Implementation of a longitudinal lecture series dedicated towards the clinical demands of being a first-year radiology resident may improve their knowledge and comfort level, as well as benefit the entire program. In this article, we outline our experience with the development of a resident-led dedicated first-year radiology resident lecture series providing targeted, high-yield instruction on rotation logistics, basic physics and artifacts, examination protocolling, and common and "don't miss" pathology.
Subject(s)
Internship and Residency , Radiology , Curriculum , Educational Measurement , Humans , Radiography , Radiology/educationABSTRACT
BACKGROUND: Plasmacytomas are monoclonal proliferations of plasma cells that typically affect the intramedullary axial skeleton. Imaging findings of an extramedullary plasmacytoma on radiograph and computed tomography can be nonspecific and can resemble other entities such as lymphoma, metastases, chondrosarcomas, or giant cell tumors. CASE REPORT: A 60-year-old female with a medical history of partial complex seizures, hypertension, diabetes, glaucoma, and hyperlipidemia presented with complaints of superficial abdominal pain associated with erythema and swelling for 3 weeks. Computed tomography of her abdomen at time of presentation revealed a 5.8 × 2.7-cm irregularly marginated soft-tissue density just below the umbilicus with an adjacent defect in the midline rectus abdominis. The final pathologic diagnosis was extramedullary plasmacytoma. Treatment during the next year included local radiation, systemic chemotherapy, and an autologous peripheral blood stem cell transplant. Three years after initial diagnosis, the patient presented to the emergency department, and testing revealed new plasmacytomas. The decision was made to proceed with palliative care. CONCLUSION: This case is a unique example of a patient with an extramedullary plasmacytoma with no diagnostic signs of multiple myeloma.
ABSTRACT
PURPOSE: The aim of this study was to assess the effect of overnight shifts (ONS) on radiologist fatigue, visual search pattern, and diagnostic performance. METHODS: This experimental study was approved by the institutional review board. Twelve radiologists (five faculty members and seven residents) each completed two sessions: one during a normal workday ("not fatigued") and another in the morning after an ONS ("fatigued"). Each radiologist completed the Swedish Occupational Fatigue Inventory. During each session, radiologists viewed 20 bone radiographs consisting of normal and abnormal findings. Viewing time, diagnostic confidence, and eye-tracking data were recorded. RESULTS: Swedish Occupational Fatigue Inventory results demonstrated worsening in all five variables (lack of energy, physical exertion, physical discomfort, lack of motivation, and sleepiness) after ONS (P < .01). Overall, participants demonstrated worse diagnostic performance in the fatigued versus not fatigued state (P < .05). Total viewing time per case was longer when fatigued (35.9 ± 25.8 seconds) than not fatigued (24.8 ± 16.3 seconds) (P < .0001). Total viewing time per case was longer for residents (P < .05). Mean total fixations generated during the search increased by 60% during fatigued sessions (P < .0001). Mean time to first fixate on the fracture increased by 34% during fatigued sessions (P < .0001) and was longer for residents (P < .01). Dwell times associated with true- and false-positive decisions increased, whereas those with false negatives decreased. CONCLUSIONS: After ONS, radiologists were more fatigued with worse diagnostic performance, a 45% increase in view time per case, a 60% increase in total gaze fixations, and a 34% increase in time to fixate on the fracture. The effects of fatigue were more pronounced in residents.