How To Prepare For Interdisciplinary Conferences As A Radiology Resident
You get the email… There is a urology conference on Tuesday morning at 7 AM and you are responsible for showing 4 cases with multiple radiological studies. You’ve never done this before! How do you know which images to show? Is there a logical order to the images? Will I be able to answer the questions posed by the clinicians in the room? Your heart beats a bit faster as you contemplate the issues.
This situation is common for the beginning radiology resident. Often times, first year radiology residents are thrust into their first interdisciplinary conference without much preparation. However, even though initially nerve racking as an experience, these conferences are a great opportunity to get to know your nonradiological colleagues as well as a way for them to find out about how knowledgeable you are!
Presenting for the intradisciplinary crowd is a bit different than preparing for the typical conference that you have been accustomed to over the years. Your audience is going to be a bit more sensitive to mistakes that are made by the presenter because decisions can often directly affect patient care. Therefore, today I am going to discuss some of the common questions that arise when you encounter your first interdisciplinary conference to make you feel a bit more comfortable . These topics include how to sort through what is important, what to discuss, and when to ask for additional help in order to prepare for your first solo interdisciplinary conference as a radiology resident. So let’s get started…
When going through a case, clinicians like to have the relevant initial diagnostic images and the subsequent follow up images. So, it is imperative to get the correct history for the main diagnosis. When you check the computerized records, make sure to find all studies that support the main diagnosis. Then, you will need to look for the earliest studies of this sort. So, if the diagnosis is breast cancer, find the first mammogram and breast MRI that is present on record. If the topic is metastatic colon cancer, look for the first CT scan showing the metastatic disease.
Next, you need to find the first post treatment studies. So, find the next series of relevant studies. If the topic is a retroperitoneal bleed, find the first series post intervention cases such as the post embolization ct scan. These will usually be the second from the beginning.
And, then finally, look for the most recent relevant studies. If this was that case of metastatic colon cancer, find the most recent CT scan of the abdomen and pelvis to show the final consequences of treatment or lack of treatment.
Seclecting Individual Images
There are two ways to show images during a presentation. First of all, you can go to the source images in the PACs system and flip through the images directly. Or, you can select individual images and display them on a PowerPoint presentation. I would recommend to do the latter. Why? Simply, you leave less to interpretation by the audience. You will get a lot less questions regarding things that you are not sure about during the presentation and the clinician will less likely ask about information and findings that are irrelevant. For instance, you are less likely to get a question about that borderline enlarged node on the corner of the film that was not mentioned but is present on the pacs display. By choosing the PowerPoint format, you have much more control over what is displayed. This keeps the discussion centered on the important topics.
Also, there is less chance for technical issues. Pacs systems have a tendency to go down when you most need it since it relies on an internet connection. A PowerPoint presentation is much more reliable since do you do not have to rely upon the internet.
In addition, when choosing individual images make sure to look for the relevant information without the fluff. For instance, If it is that metastatic colon cancer patient, take those pictures only of the liver metastasis without the volume averaging artifact. If it is the retroperitoneal bleed, show only those images containing the bleed without other distracting findings on the film. And so on…
When it is your turn to discuss a case, keep the discussion targeted. You want to only start discussing those issues that are relevant to the clinician’s question. If they want to know if the metastatic colon cancer lesion is better, worse, or unchanged, provide the clinician the relevant information such as the measurements. If they want a differential diagnosis, provide it. But, do not go off on a tangential vector! If you go off topic, clinicians tend to get angry because of the limited time that you will have during the morning to discuss patient care and other cases. So, don’t do it!
Also, try to look up relevant information on the topic during your preparations prior to participating in the conference. If you want to look like a star, gain additional knowledge on the relevant topics so that you can answer those questions intelligently and with authority. Then, you will establish an excellent reputation for yourself during the conference. Imagine how you will sound being able to describe the features of colon cancer metastasis if asked rather than muddling through and stuttering.
When To Ask For Help?
So, you’ve gathered your studies and selected your images. When is appropriate to ask your attending for some assistance? Here are some specific circumstances: You have never rotated through a specific modality and you are presenting those images during that case. You are not sure that the report description is the same as the information on the images. You do not understand some of the disease entity issues that are going to be discussed.
Personally, I always like to know about any questions the resident may have prior to completing preparations for a conference. Better to be safe than sorry!!!
Preparing your first interdisciplinary conference can be a very stressful situation, especially if you do not have much basic guidance. Hopefully, this short summary will allow you to make more sense of the necessary preparations involved. Good luck with your next conference!