Development and implementation of a systems-based practice project requirement for radiology residents.

RATIONALE AND OBJECTIVES: Radiology residents must now participate in a learning activity that involves identification and analysis of system errors and implementation of potential solutions. Evidence of participation must be documented in the resident's learning portfolio. MATERIALS AND METHODS: An activity based on adult learning principles was designed for residents to increase their knowledge of health care systems and problems; gain experience in writing a proposal, conducting an investigation, and reporting results; organize and present information in a supportive environment; and document participation in their portfolio. Postgraduate year 2 residents identify a systems problem. A written proposal is required and must include a "plan" that includes a hypothesis, a methods section that explains what they will "do" as an intervention, a "study" that involves collection and analysis of relevant data, and a systems change or "act." Proposals approved by the program director are presented to the radiology department. Residents complete projects, evaluate their effectiveness, and present their results by spring of postgraduate year 3. RESULTS: Goals, objectives, and guidelines were written. Assessment tools were identified. From 2006 to 2008, nine projects were proposed and conducted by 12 residents. Local and national systems issues were selected, and interventions involved residents, faculty, and medical students. A timeline was imposed to promote sustained effort. CONCLUSION: Opportunities of daily work can be used to teach and learn systems-based practice concepts. Residents can use the scientific method to test effects of change on health care systems. Relevant and practical projects enable residents to learn while improving their clinical and learning environments.

RadioGraphics: a Web-based model for radiology resident self-education.

RATIONALE AND OBJECTIVES: The residency review committee (RRC) for diagnostic radiology of the Accreditation Council for Graduate Medical Education mandates core competencies including computer-aided applications in medicine. The purpose of this review was to evaluate the use of RadioGraphics' on-line CME to satisfy the RRC requirements. MATERIALS AND METHODS: Twenty radiology residents at a university training program read the same four articles in the on-line version of RadioGraphics. Before reading each article, the residents took the associated CME pre-test and, after completing the article, the CME post-test. Each resident completed a survey to evaluate the quality of the resident experience using RadioGraphics' CME on-line program after completing the four articles and tests. RESULTS: The combined mean scores of all four articles pre-test and post-test scores were 5.6 and 9.3. Significant improvement in the test scores was determined by a student t-test (P < .001). Fourteen residents agreed and one resident disagreed with the statement that the modules were time effective. Nineteen of 20 residents agreed with the statement that valuable information for future practice was gained and that they would continue to use RadioGraphics for CME in the future. All of the residents agreed with the statement that the experience satisfied the residency's requirement to teach computer skills appropriate for ongoing learning. CONCLUSION: RadioGraphics' on-line CME an effective method to teach residents skills required by the RRC.