The Practice of Radiology Education: Challenges and Trends

“Teaching is not a lost art, but the regard for it has become a lost tradition.” This quote in The Practice of Radiology Education: Challenges and Trends expresses the book's underlying concern: that the reciprocal partnership between radiology teaching and education is vital and yet often neglected in academic radiology.

The Practice of Radiology Education —second in a series on radiology education—serves as a reference guide for readers interested in improving radiology teaching programs and resident education. Based primarily on the experiences of educators in the Department of Medical Imaging at the University of Western Ontario, Canada, the book presents an international perspective on how to best implement postgraduate training programs and improve radiology education. Although radiologists are the target audience, the book contains universal themes and recommendations for postgraduate physician education in any medical specialty. The authors' main goal is to emphasize the symbiotic relationship between teaching and education and to demonstrate its effective incorporation into residency training programs, both in theory and in practice.

The book is divided into 3 main sections. The first section, “Curriculum,” outlines the journey many radiologists take as educators, describing the important partnership between radiology teaching and resident education. Radiology learning is an active, ongoing, integrative process that combines “three basic skills: perception, interpretation and diagnosis.” The book provides effective ways to develop these skills and design a core curriculum for residents and fellows. The main examples provided are the CanMeds and Accreditation Council for Graduate Medical Education radiology residency programs in Canada and the United States, respectively. The “three basic core approaches” to resident training—rotations, case-based learning, and academic time—are discussed in depth. The authors stress the need for a participatory and dynamic learning environment with an “integrated curriculum” in medical imaging (self-directed study, online learning, and teaching modules) to better suit the needs of a rapidly changing specialty, especially with the implementation of new technology including digital imaging.

The second section, “Programs and Trainees,” offers an international perspective on how to redesign and effectively implement radiology education programs. The national training programs in Australia/New Zealand and Thailand are showcased as examples of a more effective way to train and deploy radiologists. Daily resident case review is the most important component of a radiology training program, its effectiveness depending on the quantity and variety of teaching interactions and available cases. However, some of the chapters in this section, including the training of musculoskeletal ultrasound specialists and medical physics in radiology imaging, seem misplaced and not specifically related to radiology education and the ethos of the book.

The third section, “Leadership and Resources,” effectively details how radiologists can overcome the inherent obstacles involved in restructuring an academic program and how to use their available resources to improve both clinical and academic productivity. It offers a firsthand account of how a new department chairman rejuvenated a program and serves as a primer for those interested in leadership positions in radiology. The importance of fostering translational research is likewise discussed, emphasizing “residents who transition from practitioners to researchers are more likely to become successful academic leaders.” It additionally stresses the importance of research mentors, transdisciplinary learning, and annual research forums.

The importance of having a standardized structure and documentation process in a teaching program—from resident selection to staff evaluations to research projects—is heavily emphasized. Differentiated instruction is championed, recognizing that new medical school graduates often present to residencies with different “funds of knowledge.” The chapter covering this topic offers an interesting perspective, explaining that difference should not be equated with deficiency and shows how residents can use differentiated instruction to create a more individualized learning program. The book also questions, but does not effectively answer, how more universal terminology might be created to organize and communicate radiological information more efficiently and effectively.

The Practice of Radiology Education: Challenges and Trends is a valuable reference to help design, develop, and implement more effective training programs. Radiologists are not only clinicians but valued consultants, helping referring physicians as well as patients. The book is most compelling when emphasizing the important relationship between teaching and education—vital in all medical specialties—which ultimately leads to improved patient care.