Tag: textbooks

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Let’s Go Back To The Fundamentals Of Radiology

fundamentals

Yes. I lived in a different world from residents today. We didn’t have all the electronic resources such as virtual flashcards, digital ebooks for almost everything, Radexams, Case stacks, Radprimer, question banks, and other online electronic resources. In addition, there were fewer texts for every topic than what we see today. And, we had only one general review text for the boards (Dahnert). But, as I remember, almost all radiology residents back in my day would read these topic-based physical textbooks to understand the fundamentals of radiology. We needed to read this material to grasp the essence of what we needed to know. Many of today’s residents no longer ascribe to this philosophy and jump right into other ancillary electronic material. 

Moreover, without reading the textbooks that I did when I started, I would never have had the fundamentals I have today to synthesize findings and differentials quickly. By skipping out on reading the fundamental texts, residents build knowledge layered upon a flimsy thin base. They can’t answer the why and how of what we do. And they are much less likely to pass the written board examination. This result is precisely what we ultimately find. So, let’s talk about why returning to reading primary physical textbooks is critical before jumping into all the electronic resources.

Active Learning With A Physical Textbook Is Better For The Fundamentals

Reading with a physical textbook rather than electronic reading material is more efficient. If you are not convinced, take a look at my former article, eBooks vs. Printed Radiology Books- A Death Match Part II. In this article, you will find evidence that using physical texts is better than electronic material for learning material. Holding a book in your hand, highlighting, and taking active notes on flashcards, is more efficient for remembering the material. So, although more portable, electronic resources may not give you the same bang for your buck.

Putting Your Money Where Your Mouth Is!

I know. Many of you have tons of debt from medical school. However, when you pay for something, you establish an unwritten commitment to it. So, when you buy your textbook, you are much more likely to feel like you have to use it, read it, and mark it up. Sharing ebooks with your colleagues is just not the same. Therefore, you should consider going back to the old-fashioned concept of owning your textbooks to increase your retention and maximize the possibility of passing the written boards.

Much Better To Have Conceptual Learning Than Learning Lists!

To this day, I can still remember where and when I learned certain concepts, such as features of extra-axial vs. intra-axial brain tumors (check out Osborn!) or patterns of arthritis (Arthritis In Black And White). When you go directly to the electronic references without reading these source textbooks, you are much more likely to see random lists without knowing the why behind the finding. And, you are much less likely to remember the key concepts that will help you make diagnoses later on. You know what they say – give a man a fish, and he will eat for a day. Teach a man to fish, and they will be able to eat for a lifetime! It’s true! So, make sure to learn the concepts from the text first!

More Difficulties With Complexities And Artifacts

It is much easier to figure out complex problems that don’t follow the rules if you know the basics. And, in radiology, very few cases are precisely what the literature describes. When you know the concepts behind the images, you can adjust your ideas to suit the case and allow you to make the appropriate differential diagnosis because you understand why it can fit what you are seeing. When you are reading electronic material distilled down to the bare bones, you lose out on this ability to make the diagnosis when it doesn’t necessarily follow the rules!

Getting Back To Fundamentals!

I am a purveyor of electronics. It is fun to play around with cell phones, computers, and gadgets. But, based on real-world experience with resident success, I implore residents from the first through third years to opt into reading primary textbooks to establish foundations in their knowledge base. Electronic media does play a role in learning. But, residents should consider delegating that role to the reinforcement of knowledge and not as a place to start. In the end, it is your choice. But, residents that read the introductory texts do better on the boards and make themselves better radiologists!

 

 

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eBooks vs. Printed Radiology Books- A Death Match Part II

books

The days of radiology residents lugging ten-pound textbooks around the department are over. I, too, prefer having a list of books to access at any time on my Ipad for convenience. I even reviewed and studied my Mettler textbook for nuclear medicine on my Ipad just before my recertification ABR examination a while back, and it worked out just fine. But based on recent literature, maybe we should not be giving up on carrying around that 10-pound book. Today I will review the arguments for and against buying and reading electronic radiology books versus carrying around and reading those unseemly heavy old-fashioned radiology textbooks.

Arguments For Reading Physical Radiology Books

Comprehension Retention Issues

When it comes explicitly to reading and retaining knowledge from radiology-specific books, I could not find much information on the web. However, significant studies discuss comparing the retention of general information from print materials vs. e-readers. Some of these studies are generally applicable to the radiology resident audience. In addition, some other issues can support the use of printed texts over e-readers.

Back in 2013, in the International Journal of Educational Research, lead author Anne Mangen in an article, studied 72 tenth graders and compared reading retention in PDF format on a computer screen and in print. She found that students reading the texts in print had significantly better retention of the material than those reading the material electronically. However, there are some differences in applicability to the radiologist. We tend to read images and look at the captions and text. So, perhaps there is some difference regarding the radiology resident.

Subjectively, there are also several surveys of readers touting the comprehension advantages of printed books. In an article in Scientific American, one survey reported a conclusion that “when it comes to reading a book, even they prefer good, old-fashioned print,” and another stated that readers “prefer to read text on paper as opposed to on a screen to ‘understand it with clarity.'” So, maybe there is something to the perception of increased retention with old-fashioned printed texts.

Miscellaneous Other Issues

In addition, you may have difficulty getting to sleep after reading with an electronic device. A study called “Sleep and use of electronic devices in adolescence: results from a large population-based study” concluded a negative relationship between the use of technology and sleep. Now, radiology residents are a bit past adolescence for the most part, but I still think you can generalize this information to the insomniac radiology resident, knowing how I feel after reading the news on my iPhone just prior to bedtime.

Also, there is the issue of eyestrain and reading eBooks. The information here is a bit more mixed as to the amount of eyestrain using eReaders vs. printed text. But, there was an interesting article presenting some of the issues regarding eye strain called “eReader Vs. Printed Book: Which Is Better For Your Eyesight?” They reported that Computer Vision Syndrome (CVS) is an actual entity that can affect readers using electronic readers. However, the claim that backlit devices and softer e-readers like the Nook and Kindle may help some readers counterbalance this argument.

And finally, there is the issue of diversion. When you read a printed textbook, you certainly do not have to worry about essential emails popping up, your spouse calling you, a silly text from your friend, or the thought that you need to click on the most recent exciting blog from radsresident.com! Instead, you can concentrate on the information with much less interruption.

Arguments For Reading Electronic Radiology Texts

Here I think the first and foremost issue supporting using the eReader is sheer convenience and instant availability. Carrying 1000 books in your pocket or your hand is a remarkable technological achievement. Furthermore, at any given moment, you can easily click on a link from your text and go directly to a source document you can confirm on your iPhone. You can’t do these sorts of things in a printed textbook.

Multiple new e-readers use different proprietary technologies to reduce eyestrain. In fact, one article reports eInk from the Kindle and the Nook is a significant improvement over other e-readers. Also, according to the same article, people with poor eyesight tended to read better with a backlit screen than on paper. In addition, for those with poor vision, one can easily adjust the text size with an e-reader, allowing the reader to enjoy an electronic text that they may not be able to read in the printed version.

Once you write on a printed text, you alter the text forever. On the other hand, you can highlight or write electronically in an ebook’s margins without worrying about destroying the book. Furthermore, you cannot write in someone else’s printed book without vandalizing someone else’s property. Another win for the electronic device!!!

This borrowing of books brings me to the next significant advantage of eReaders- sharing. Sharing a chapter, phrase, or critical point with a fellow reader is easy. All it takes is clicking a button with a message or email; many people have the same information. Printed text is just not the same when it comes to sharing.

And finally, there is the issue of bookmarks. Most eReaders automatically bookmark the last page that you look at. If you lose your page on a standard text, there is a good chance that if you return to it without a bookmark, you will not remember the last page you read. At least, this is a significant advantage for me!

So Who Wins This Death Match?

Unfortunately, convincing someone about how to read a radiology book is challenging. We all have our set ways and opinions about how to read and what is more effective for us as an individual. And there are real advantages and disadvantages to both. Although not conclusive, the body of evidence points to increased retention for paper, but for many, the convenience of e-texts outweighs the incremental retention. You can easily share an eBook, but you may have more eyestrain reading the same book. So what do you do in today’s world? I think it depends upon you as an individual and the available resources. The bottom line as a radiology resident is to read a lot regardless of the book type. It will serve as a permanent foundation for the rest of your career!

 

Other relevant articles

http://www.huffingtonpost.com/the-national-book-review/drop-that-kindle-10-reaso_b_8234890.html

 

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Radiology Textbooks Vs. Case Review Books- A Death Match

textbooks

One question that often arises is: what material should I study since there is so much information to learn? But I think a more appropriate question may be: how can I get the most bang for my buck when there are so many reading materials out there? In this post, I will address this issue by talking about when you should be reading textbooks and when you should emphasize case reviews since both play a role in getting up to speed during radiology residency or learning about a new area of interest as an attending. (This is our death match!!!)

Why Textbooks?

Sometimes you lack any understanding of a modality when you begin a residency program, are starting a new rotation, or are attempting to learn a new modality such as MRI, perhaps not covered in your residency. For instance, when they begin, most radiology residents have no clue about ultrasound: how it works, and the images the technologist takes. Therefore, starting to read a case series on ultrasound may not be helpful when beginning.

Instead, a general introductory textbook such as Ultrasound: The Requisites makes more sense at this point to understand the basic principles of ultrasound and the key images that need to be taken and interpreted during a renal ultrasound, Ob/Gynecology ultrasound, etc. Another example would be reading CT scans of the chest. Most residents, when they start, do not have a search pattern for reading chest CT scans. Nor do they know their CT chest anatomy well. An introductory textbook on chest CT scans, such as Computed Tomography and Magnetic Resonance of the Thorax by Webb, would be appropriate before reading a case series.

In addition, good textbooks usually better outline the fundamental knowledge needed to interpret images better than a case review series can. Textbooks are better organized by topics, whereas case review series tend to be more haphazard. For example, it may be more direct and efficient to learn the fundamentals of determining whether an intracranial mass is intra-axial or extra-axial once in a textbook than reading 10 case series on the topic and trying to figure the same approach out.

How To Read Textbooks

When you read a textbook, you should emphasize the images, read the captions, and then read the text to get the most out. Reading in this manner reinforces the information that you need to know better than starting from the text first. This process differs vastly from reading a medical school general medicine textbook, where the text is usually more important than the images. You are now a radiology resident, so you have to think differently!

Why Case Review Series?

In our field, we solely exist because we are image interpreters. So, it makes sense to learn those images and what they mean. What better means to reinforce and understand radiology than with a case series? But, this assumes that the reader has some background knowledge on the topic and can understand the basic principles/fundamentals/meanings behind the images in the case review series.

In addition, case review series tend to have more of a “real word bent.” The images we read daily tend not to follow in an orderly manner by topic. Usually, an almost random distribution of cases comes through our departments. Going through a case review series is usually more similar to going through many images in no particular order.

How To Approach Case Review Series

It would help to start the case review series as soon as you have the fundamental knowledge to understand the modality, anatomy, and primary disease processes on imaging. On each initial rotation, you should aim to start reading at least one case review type of book after you have learned the fundamentals from lectures and textbooks. Do not wait too long to get started, however. Going through the case review series will be more helpful and applicable than most textbooks when you read out cases with attendings and when taking cases at noon conferences. But remember- it often does not summarize the fundamentals of a given subject as well as a textbook.

The Moral Of The Death Match

Both textbooks and case review series are at the beginning resident’s learning armamentarium. Be wary of someone that tells you that you can get through residency by just reading textbooks or case reviews by themselves. Each has its place, and you should use the correct one depending on your level and knowledge base. Now become great radiologists: go forth and read!!!