Tag: remote

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Why Residents Should Start Returning To On Site Lectures!

on site lectures

Since Covid-19 began, most radiology residencies throughout the country have moved to a model of all remote lectures. At first, it was a knee-jerk reaction, which was entirely logical at the time. Now that we have a better idea of the disease and how it spreads, programs can return to a system with some live lectures. Programs can safely organize conferences with smaller groups in larger spaces to reduce transmission chances. Like public schools, many radiology residencies are returning to some form of a hybrid system with remote and on site lectures.

However, not all programs are going in that direction. So, what have residents lost over the past half-year by having remote lectures only? And, do they stand to gain anything by returning to some form of in-house live classes? Let’s go through why most programs should, in-part, try to get back to some on site lectures.

Keep Residents Awake And Focused

I’ve been in this situation many times. Zoom starts up, and instead of having the camera focused on your face, you decide to put a picture up with a likeness of you and start completing other work. Or, you tend to another conversation at the same time. The bottom line is that it is much easier to lose focus when you are in a remote environment because there is less buy-in. Many other options are available to capture your attention than the lecture itself.

More Invested In Studying For The On Site Lectures

If you know that you will attend a lecture in person, you are much more likely to read up on a topic. Why? Because you don’t want to look like a total dullard. That motivation is vital for some residents to stay on top of their reading. Going remote without that feeling of obligation decreases the resident’s responsibility to learn some of that material beforehand. Anonymity breeds less involvement in the subject matter.

The Personal Touch

Once you go online to listen to your conferences, you lose some of the nuances of the conversation. The lecturer may not see those beads of sweat welling onto your forehead when you are unsure of an answer. Likewise, the listener may lose the tone of the lecturer, perhaps frustration or satisfaction. By missing these cues, you also lose the opportunity to figure out what you might be missing in the conversation and help that student or redirect the speaker.

Training on Software

I don’t know about your program. We have lots of different programs in our nuclear medicine department to help us interpret images. We have one system for DATscan quantification, another method for Neuroquant, a general PACS, GE software for processing cardiac studies, TeraRecon for looking at PET-CT scans, and Intellispace for remote nuclear medicine access. I’m probably even missing a few more. However, my point is that it is challenging to train residents on software without that hands-on touch in person. In my experience, Zoom like encounters for this sort of training does not do the trick. It can be harder to point out how to use different kinds of programs and software.

Esprit-De-Corps

Finally, joint meetings lead to shared experiences both from students/residents and lecturers as well. When you are all in the same environment, you build trust, social interactions, and the feeling of a team environment. It’s just not the same taking your conferences online where you can’t discuss issues after the lecture or crack a few jokes together. It tends to be all business, not the sort of environment that helps to form bonds.

Returning To On Site Lectures Once Again!

As much as it may be more convenient to give and receive lectures by Zoom, there is a role for returning to some form of on-site classes. Of course, remaining healthy is a top priority in almost any residency program. But, it is possible to keep your lecturers and residents at reasonably low risk if you take the proper precautions. So, based on the net positives of keeping residents focused, improving resident studying, personalizing the learning experiences, better technical training, and maintaining a team environment, hopefully, your program is considering on site training in some form once again. It’s not just for show. These are tangible benefits to the on site experience!

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How To Decrease Radiologist Hospital Presence Without Jeopardizing Care

jeopardizing care

For years, the mantra of quality radiology groups was to provide excellent service. And that would involve establishing a presence at all times. But, like many other former tenets of radiology practices, Covid has been turning over many assumptions about our work. Now that we have a situation where physical presence in the hospital can jeopardize radiologist safety, radiology groups have been decreasing their in-hospital staffing. However, potentially reducing staffing can increase patient barriers to quality care. So this begs the question, how are radiologists replacing physical presence in the radiology department without jeopardizing care? I am going to talk about how many groups are going about this process. Then, let’s discuss the reasons why some radiologists will always still need to remain on-site. Finally, we will use a crystal ball and decide where this is all heading.

Ways Radiologists Are Decreasing Physical Presence Without Jeopardizing Care

Less Physical Patient Facetime And More Apple Facetime!

Interventionalists and mammographers, if they haven’t already, will followup patients without an on-site visit. We see even more utilization of online communications via Zoom, Google Meet, Facetime, and whatever other technology rears its head. It also enables radiologists to maintain efficiency and have office hours between reading films at home.

Increased Ordering Of Hands-off Testing

We are noticing an increase in those tests that do not involve a radiologist presence. For instance, if a mammographer cannot be on the site to see patients, instead of a hands-on ultrasound for a positive mammographic finding, he may recommend a breast MRI. Or, radiologists will be more apt to followup findings when they may have suggested a physical procedure such as a biopsy in the past. All these changes are presently occurring below the surface, but they are happening.

Replacing In-Person Interaction With Referring Clinicians

Since the advent of PACS, most radiologists have already noticed a steady decline in direct physical interactions with their clinicians. Surgeons and internal medicine physicians come down much less frequently to review films than ever. And, today’s pandemic is further catalyzing this change. We are seeing even fewer of our colleagues and having more phone interactions than ever before. Even extracurricular activities with our fellow physicians are decreasing. Hospital meetings are becoming online.

More Tech Issues Resolved Remotely

Many radiologists are increasing the physical barriers between the technologist and the radiologist. In the past, radiologists would often ask a question from their technologist, and she would stop by. No longer. Radiologists are tackling these same issues with a phone call or a text. It has become less feasible to have that direct physical technologist interaction.

More Remote Teaching For Residents

And, finally, training is not immune to the Covid world. Already, online seminars have replaced in-house lectures at most training programs throughout the country.  And, I would not expect that to go back to the traditional in-person norm entirely. It becomes more accessible than ever before to teach from a remote site.

So, What’s Left For The Radiologist To Do At The Hospital?

Alright, even with all these factors allowing radiologists to practice off-site, some radiologists must remain as a physical presence in the hospital. Of course, some procedures will always involve a human being. Administration of radioactive treatments, interventional procedures, and emergency coverage for contrast injections will continue to require a radiologist on-site. But, compared to all the roles a radiologist can perform off-site, it is indeed limited. Don’t expect to see as many radiologists sticking around the treatment facilities as they did before. Many practices have reduced their on-site staffing by as much as 30-70% during this crisis.

How Will Radiologist’s Presence At The Hospital Ultimately Evolve?

Many changes are currently in motion, making it even easier to perform more activities outside the confines of a typical hospital or imaging center without jeopardizing care. And, facetime, ordering preference changes, and other remote capabilities are some ways that radiologists have been decreasing physical presence at primary sites. In time, we may begin to see some return of radiologists back to the hospital as the risks to radiologists dwindle. Nevertheless, don’t expect radiologists to return to the same complement on-site after the dust settles as the tools for remote patient care have developed. When culture changes, even temporarily, some of it always sticks. Radiologists are by no means immune!