6
Radiology Residents as Teachers: Current Status of Teaching Skills Training in United States Residency Programs Andrea Donovan, MD Rationale and Objectives: Radiology residents often teach medical students and other residents. Workshops developed with the goal of improving resident teaching skills are becoming increasingly common in various fields of medicine. The purpose of this study was to deter- mine the prevalence and structure of resident-teacher training opportunities within radiology programs in the United States. Method and Materials: Program directors with membership in the Association of Program Directors in Radiology (APDR) were surveyed to determine views on a panel of topics related to resident-teacher training programs. Results: A total of 114 (56%) of 205 APDR members completed an online survey. Approximately one-third (32%) stated that their program provided instruction to residents on teaching skills. The majority of these programs (72%) were established within the last 5 years. Resi- dents provided teaching to medical students (94%) and radiology residents (90%). The vast majority of program directors agreed that it is important for residents to teach (98%) and that these teaching experiences helped residents become better radiologists (85%). Ninety-four percent of program directors felt that the teaching skills of their residents could be improved, and 85% felt that residents would benefit from instruction on teaching methods. Only one-third of program directors felt their program adequately recognized teaching provided by residents. Conclusion: Program directors identified residents as being active contributors to teaching in most programs. Although teaching was viewed as an important skill to develop, few programs had instituted a resident-teacher curriculum. Program directors felt that residents would benefit from structured training to enhance teaching skills. Future studies are needed to determine how best to provide teaching skills training for radiology trainees. Key Words: Radiology; teaching; curriculum; residency training; faculty development. ªAUR, 2010 R esidents contribute to the teaching of medical students and residents, and spend up to one-quarter of their work hours teaching, evaluating or super- vising trainees (1). Although many residents enjoy teaching and consider it to be an important component of their training (2), many feel inadequately prepared to teach (3). Formal instruction in effective teaching methods is desired by resident trainees (4). Postgraduate accrediting bodies, including the Accredita- tion Council for Graduate Medical Education, consider teaching skills to be among a group of core competencies that residents must achieve during their training (5,6). Subsequently, the last decade has witnessed an increase in resident-focused workshops geared toward helping residents improve their teaching skills (7–9). In 2001, approximately one-half of Accreditation Council for Graduate Medical Education–accredited residency programs in family medicine, internal medicine, pediatrics, psychiatry, general surgery, and obstetrics-gynecology had established programs for residents to improve their teaching skills (8). In radiology, the prevalence and diversityof teacher training activities for radiology residents has not been studied. It is unknown whether such programs are flourishing to the same extent as witnessed in other residency programs. Certainly, resident-teacher training would likely be beneficial in radiology because learner-teacher interactions are common in daily practice (10,11). Instruction on teaching skills may assist radiology residents not only to become more effective teachers, but also to increase their overall satisfaction with teaching and potentially increase their retention in academic teaching centers (8,9,12). Radiology program directors, together with their residency training committee, influence the structure of residency training programs and opportunities for residents to develop their teaching skills. The goals of the present study were to determine the prevalence of resident-teacher training programs in radiology residencies, evaluate factors associated with establishment of resident-teacher training programs, Acad Radiol 2010; 17:928–933 From the Department of Medical Imaging, Sunnybrook Health Sciences Centre, Room AG 278, 2075 Bayview Avenue, University of Toronto, Canada M4N 3M5 (A.D.). Received November 20, 2009; accepted March 9, 2010. This study was supported by the grant from the RSNA/AUR/APDR/SCARD Radiology Education Research Development Grant. Project Title: ‘‘Developing Radiology Residents as Teachers: Program Director Views and Implementation of a National Resident Teacher Development Course’’; applicant’s role: Principal Investigator. Address correspondence to: A.D. e-mail: [email protected] ªAUR, 2010 doi:10.1016/j.acra.2010.03.008 928

Radiology Residents as Teachers

  • Upload
    andrea

  • View
    213

  • Download
    1

Embed Size (px)

Citation preview

Radiology Residents as Teachers:

Current Status of Teaching Skills Training in United States Residency

Programs

Andrea Donovan, MD

Ac

FrCMThRa‘‘DImape-

ªdo

92

Rationale and Objectives: Radiology residents often teach medical students and other residents. Workshops developed with the goal of

improving resident teaching skills are becoming increasingly common in various fields of medicine. The purpose of this study was to deter-mine the prevalence and structure of resident-teacher training opportunities within radiology programs in the United States.

Method and Materials: Program directors with membership in the Association of Program Directors in Radiology (APDR) were surveyed

to determine views on a panel of topics related to resident-teacher training programs.

Results: A total of 114 (56%) of 205 APDR members completed an online survey. Approximately one-third (32%) stated that their program

provided instruction to residents on teaching skills. The majority of these programs (72%) were established within the last 5 years. Resi-

dents provided teaching to medical students (94%) and radiology residents (90%). The vast majority of program directors agreed that it isimportant for residents to teach (98%) and that these teaching experiences helped residents become better radiologists (85%). Ninety-four

percent of program directors felt that the teaching skills of their residents could be improved, and 85% felt that residents would benefit from

instruction on teaching methods. Only one-third of program directors felt their program adequately recognized teaching provided by

residents.

Conclusion: Program directors identified residents as being active contributors to teaching in most programs. Although teaching was

viewed as an important skill to develop, few programs had instituted a resident-teacher curriculum. Program directors felt that residents

would benefit from structured training to enhance teaching skills. Future studies are needed to determine how best to provide teachingskills training for radiology trainees.

Key Words: Radiology; teaching; curriculum; residency training; faculty development.

ªAUR, 2010

Residents contribute to the teaching of medical

students and residents, and spend up to one-quarter

of their work hours teaching, evaluating or super-

vising trainees (1). Although many residents enjoy teaching

and consider it to be an important component of their training

(2), many feel inadequately prepared to teach (3). Formal

instruction in effective teaching methods is desired by resident

trainees (4).

Postgraduate accrediting bodies, including the Accredita-

tion Council for Graduate Medical Education, consider

teaching skills to be among a group of core competencies

that residents must achieve during their training (5,6).

Subsequently, the last decade has witnessed an increase in

ad Radiol 2010; 17:928–933

om the Department of Medical Imaging, Sunnybrook Health Sciencesentre, Room AG 278, 2075 Bayview Avenue, University of Toronto, Canada4N 3M5 (A.D.). Received November 20, 2009; accepted March 9, 2010.is study was supported by the grant from the RSNA/AUR/APDR/SCARDdiology Education Research Development Grant. Project Title:eveloping Radiology Residents as Teachers: Program Director Views andplementation of a National Resident Teacher Development Course’’;plicant’s role: Principal Investigator. Address correspondence to: A.D.mail: [email protected]

AUR, 2010i:10.1016/j.acra.2010.03.008

8

resident-focused workshops geared toward helping residents

improve their teaching skills (7–9). In 2001, approximately

one-half of Accreditation Council for Graduate Medical

Education–accredited residency programs in family medicine,

internal medicine, pediatrics, psychiatry, general surgery, and

obstetrics-gynecology had established programs for residents

to improve their teaching skills (8).

In radiology, the prevalence and diversity of teacher training

activities for radiology residents has not been studied. It is

unknown whether such programs are flourishing to the

same extent as witnessed in other residency programs.

Certainly, resident-teacher training would likely be beneficial

in radiology because learner-teacher interactions are common

in daily practice (10,11). Instruction on teaching skills may

assist radiology residents not only to become more effective

teachers, but also to increase their overall satisfaction with

teaching and potentially increase their retention in academic

teaching centers (8,9,12).

Radiology program directors, together with their residency

training committee, influence the structure of residency

training programs and opportunities for residents to develop

their teaching skills. The goals of the present study were to

determine the prevalence of resident-teacher training

programs in radiology residencies, evaluate factors associated

with establishment of resident-teacher training programs,

TABLE 1. Radiology Program Director and ResidencyProgram Demographics

Academic Radiology, Vol 17, No 7, July 2010 RESIDENT-TEACHER TRAINING IN RADIOLOGY

and assess radiology program directors’ attitudes toward

resident-led teaching activities.

No. %

Program director gender

Male 80 70.2

Female 34 29.8

Years in practice

<5 years 11 9.7

5–10 years 26 22.8

11–20 years 42 36.8

>20 years 35 30.7

Years as program director

<2 years 38 33.3

2–5 years 34 29.8

>5 years 42 36.9

Number of radiology residents

<10 12 10.5

10–20 26 22.8

>20 76 66.7

Residency program setting

Academic 95 83.3

Private practice 19 16.7

MATERIALS AND METHODS

Institutional review board approval was granted for this

retrospective Health Insurance Portability and Accountability

Act–compliant study. After extensive review of the medical

education literature, a questionnaire was designed and then

piloted to ensure clarity. The survey was used to determine

program directors’ views on the role of residents as teachers

and the prevalence of resident-teacher training programs in

residency programs across the United States. A link to an

anonymous and voluntary survey was e-mailed to 205 radi-

ology program directors with membership in the Association

of Program Directors in Radiology (APDR). The survey was

completed using online survey software (www.surveymonkey.

com). Program directors were e-mailed a reminder to

complete the survey 1 month after the initial e-mail.

In this study, a ‘‘resident-teacher training program’’ was

defined as a workshop or course within the radiology

residency program that provided opportunities for residents to

enhance their teaching skills. The survey collected basic demo-

graphic information of program directors, including gender,

age, years of practice, years as program director, and practice

setting (academic or private practice). Specific information

pertaining to the residency program was also collected,

including number of residents in the program, resident teaching

responsibilities, and the presence, duration, and format of any

resident-teacher training program in existence at the program

director’s institution. In addition, the survey evaluated potential

barriers to implementing a resident-teacher skills curriculum.

In the final part of the survey, program directors ranked 13

statements pertaining to resident-led teaching using a 5-point

Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4

= agree, 5 = strongly agree). These statements helped to assess

program directors’ opinions on the importance of resident-led

teaching, the need for more structured resident-teacher

training programs, and whether the teaching efforts of both

faculty and residents were adequately recognized at their insti-

tutions. The scores from all program directors were averaged

to produce a mean score for each of the 13 statements. Specific

details of the survey questions are provided in the tables in the

results section.

Statistical analysis was performed using SAS software,

version 8.2 (SAS Institute, Cary, NC). Chi-square and Fisher

exact tests were used for analysis of categorical data. P < .05

was considered statistically significant for all analyses.

RESULTS

Program Director and Residency ProgramDemographics

One hundred fourteen of 205 radiology program directors

with membership in the APDR completed the online

survey for a response rate of 55.6%. Respondent demo-

graphics are presented in Table 1. Eighty of 114 (70.2%)

program directors were male and 34 (29.8%) were female.

Respondents had practiced radiology for varying lengths

of time, with the largest proportion (42 of 114, 36.8%) prac-

ticing for 11–20 years. Most respondents (72 of 114, 63.2%)

served as program director for 5 years or less. Residency

programs varied in size, with most programs (76 of 114,

66.7%) having more than 20 residents per program

(Table 1). Academic, rather than private practice, was the

most common residency training setting (95 of 114,

83.3%) (Table 1).

Radiology Resident Teaching Responsibilities

The vast majority of respondents indicated that their residents

taught medical students (107 of 114, 93.9%), other radiology

residents (102 of 114, 89.5%), as well as non-radiology trainees

(76 of 114, 66.7%) (Table 2). One hundred three of 114

(90.4%) respondents indicated that their residents delivered

case conferences, and 31 of 114 (27.2%) stated that their

residents were required to present at grand rounds (Table 2).

Teaching Skills Training for Residents

A minority of surveyed programs provided teaching skills

training for faculty and residents. Thirty-six of 114 (31.5%)

stated that residents received instruction on teaching skills

(Table 3). The majority (26 of 36, 72.2%) of resident-

teacher training programs were established within the past 5

years. Nearly two-thirds (23 of 36, 63.9%) of these teacher-

training programs had mandatory attendance requirements

929

TABLE 2. Radiology Resident Teaching Responsibilities*

Resident Teaching Activity No. %

Teach medical students 107 93.9

Teach other radiology residents in the program 102 89.5

Deliver case conferences 103 90.4

Present at multidisciplinary conferences 76 66.7

Present at grand rounds 31 27.2

*More than one response was possible making the total number of

responses greater than the number of respondents (n = 114).

TABLE 3. Teaching Skills Training Opportunities

No. %

Residents provided with regular feedback on

teaching skills

57 50.0

Residents assigned a mentor for guidance with

teaching preparation

60 52.6

Department offers instruction to faculty on

teaching skills

32 28.1

Department offers instruction to residents on

teaching skills

36 31.6

A) Years resident teaching skills program has

been offered

<1 year 7 19.4

1–2 years 9 25.0

3–5 years 10 27.8

>5 years 10 27.8

B) Teaching skills program is mandatory for all

residents

23 63.9

C) Format of the resident teaching skills training

program

One time-workshop 26 72.2

Longitudinal lectures 9 25.0

Educational electives 1 2.8

TABLE 4. Barriers to Offering Teaching Skills Instruction*

Survey Statement No. %

Time constraints imposed by faculty clinical

and research duties

69 60.5

Lack of faculty trained in medical education 65 57.0

Teaching is viewed as faculty role rather than

resident role

23 20.2

Resident teaching skills are viewed as being

currently adequate

17 14.9

Program directors not familiar with concept of

teaching skills workshops

15 13.6

*More than one response was possible making the total number of

responses greater than the number of respondents (n = 114).

DONOVAN Academic Radiology, Vol 17, No 7, July 2010

for residents. The most common format was a one-time

workshop on teaching skills (26 of 36, 72.2%), followed by

a longitudinal course on teaching skills (9 of 36, 25.0%),

and educational electives (1 of 36, 2.7%) (Table 3). Thirty-

two of 114 respondents (28.0%) stated that their department

offered instruction to radiology faculty on teaching skills.

Fifty-seven of 114 (50.0%) respondents indicated that feed-

back on teaching skills was routinely provided to radiology

residents (Table 3). Sixty of 114 (52.6%) respondents indicated

that there was a method in place at their institution to assign

residents to a mentor who could provide guidance with

teaching activities, including preparation for grand rounds

(Table 3).

Barriers to Development of a Resident-teacher TrainingProgram

Program directors identified barriers that hindered develop-

ment of resident-teacher training programs (Table 4). The

majority (69 of 114, 60.5%) felt that the clinical and research

duties of faculty imposed time constraints that hindered

participation in resident-teacher workshops. Approximately

half of respondents (65 of 114, 57.0%) indicated that their

program did not have radiology faculty trained in medical

education who were able to provide instruction on teaching

skills. In addition, 23 of 114 (19.3%) respondents regarded

teaching as being a role of faculty rather than residents, and

15 of 114 (12.6%) respondents stated that they had not previ-

ously thought of the idea of implementing a program on

teaching skills to residents. Seventeen of 114 (14.3%) program

directors felt the teaching skills of their residents were

presently adequate (Table 4).

Program Director Views on Resident-led Teaching

A 5-point Likert scale was used to evaluate program directors’

opinions on resident-led teaching activities (Table 5). One

hundred thirteen respondents completed this portion of the

survey. The vast majority agreed or strongly agreed (111 of

113, 98.2%) that it was important for residents to participate

in a teaching role and that teaching experiences helped resi-

dents to become better radiologists (107 of 113, 94.7%).

Approximately three-quarters (88 of 113, 77.9%) felt that

teaching experiences increased residents’ satisfaction with

training.

930

Many program directors felt that teaching contributions of

residents were not adequately recognized. Only 39 of 113

(34.5%) felt that their program valued teaching provided by

residents and adequately recognized resident teaching efforts.

In contrast, more than two-thirds of respondents (76 of 113,

67.3%) felt that their program valued teaching provided by

faculty and adequately recognized faculty teaching efforts

(Table 5). Ninety-six of 113 (85.0%) felt that their department

should emphasize the importance of residents as teachers and

that teaching provided by residents complemented the

teaching provided by faculty (101 of 113, 89.4%) (Table 5).

The vast majority of respondents agreed or strongly agreed

(104 of 113, 93.8%) that the teaching skills of radiology resi-

dents could be improved. Furthermore, the majority (97 of

113, 85.8%) felt that residents would benefit from a teacher

development course, believed that there was a need for

TABLE 5. Program Directors’ Views on Resident-led Teaching*

Survey Statement

Strongly

Disagree

No. (%)

Disagree

No. (%)

Neutral

No. (%)

Agree

No. (%)

Strongly

Agree

No. (%)

Mean

Scorey

Views on resident role as teacher

It is important for residents to participate in a teaching role 0

(0)

0

(0)

2

(1.8)

45

(39.8)

66

(58.4)

4.6

Teaching experiences help residents become better

radiologists

0

(0)

2

(1.8)

4

(3.5)

43

(38.1)

64

(56.6)

4.5

Teaching done by residents complements teaching done by

faculty

0

(0)

4

(3.5)

8

(7.1)

52

(46.0)

49

(43.4)

4.3

My department should emphasize the importance of residents

as teachers

0

(0)

3

(2.7)

14

(12.4)

50

(44.2)

46

(40.7)

4.2

Teaching experiences increase resident satisfaction with

training

0

(0)

5

(4.4)

20

(17.7)

52

(46.0)

36

(31.9)

4.1

Teaching during residency was an important part of my own

training

18

(15.9)

26

(23.0)

22

(19.5)

28

(24.8)

19

(16.8)

3.0

Views on resident teaching skills

The teaching skills of my residents can be improved 0

(0)

0

(0)

7

(6.2)

62

(54.9)

44

(38.9)

4.3

Many residents could benefit from a program which provides

teacher skills training (i.e. teacher development course)

1

(0.9)

4

(3.5)

11

(9.7)

57

(50.4)

40

(35.4)

4.2

I believe teacher skills training should be started early in

residency training

2

(1.8)

8

(7.1)

19

(16.8)

59

(52.2)

25

(22.1)

3.9

I believe there is a need for more teacher skills training during

residency

0

(0)

10

(8.9)

18

(15.9)

58

(51.3)

27

(23.9)

3.9

I have been asked by my residents to include teacher skills

training in the residency curriculum

23

(20.4)

51

(45.1)

30

(26.6)

4

(3.5)

5

(4.4)

2.3

Views on program recognition for teaching efforts

Our program values teaching provided by faculty and

adequately recognizes faculty teaching efforts

3

(2.7)

20

(17.7)

14

(12.4)

54

(47.8)

22

(19.4)

3.6

Our program values teaching provided by residents and

adequately recognizes resident teaching efforts

6

(5.3)

35

(31.0)

33

(29.2)

31

(27.4)

8

(7.1)

3.0

*Reported numbers are based on 113 respondents.yResponses were made using a 5-point Likert scale: 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree.

Academic Radiology, Vol 17, No 7, July 2010 RESIDENT-TEACHER TRAINING IN RADIOLOGY

more formal resident-teacher skills training during residency

(85 of 113, 75.2%), and felt that a resident-teacher training

program should be started early in residency training (84 of

113, 74.3%) (Table 5). Only a minority of program directors

(9 of 113, 8.0%) had been directly asked by residents to include

teacher skills training in the residency curriculum (Table 5).

A sub-analysis of survey responses showed that respondents

from academic and private practice–based setting did not

differ in their responses to survey questions (data not shown).

Factors Associated with Establishment of Resident-teacher Training Programs

Several factors were associated with establishment of a resi-

dent-teacher training program. First, programs having

a teaching skills course for faculty were approximately twice

as likely to also have a resident teaching skills course (P =

.027). Second, the longer the program director had served

as program director, the more likely the residency program

was to have a resident-teacher training program (P = .038).

Furthermore, a trend was identified for larger radiology

programs to have a resident-teacher training program (P =

.073). The number of years the program director had prac-

ticed and the practice setting (academic versus private) were

not associated with establishment of a resident-teacher

training program.

To evaluate whether specific program director opinions

influenced the establishment of a resident-teacher training

program, a forward stepwise logistic regression was performed

based on the series of 13 possible statements included in

Table 5. This analysis showed that agreement with the state-

ment ‘‘My department should emphasize the importance of

residents as teachers’’ was the only significant independent

predictor (P = .05) of having a resident-teacher training

program among 13 statements.

DISCUSSION

Resident trainees frequently teach medical students and other

residents (1). In some institutions, resident-teachers provide

931

DONOVAN Academic Radiology, Vol 17, No 7, July 2010

up to 70% of the clinical teaching received by medical students

(7). Respondents to the present survey indicated that most

United States radiology residents teach medical students as

well as other radiology residents. Many studies suggest that

teaching performed by residents has a positive impact on

learners. For example, residents are frequently identified by

medical students and junior residents as being among their

most memorable teachers (13). Compared to attending faculty

members, residents may be able to better relate to their peers

and provide teaching in a safe, nonthreatening environment

(14). Residents may themselves benefit from teaching. For

example, residents’ medical knowledge and clinical compe-

tence were shown to increase by teaching others (15). In the

present study, the vast majority of radiology program directors

agreed that it is important for residents to participate in

a teaching role, and moreover that these teaching experiences

help residents to become better radiologists.

Although residents frequently provide teaching, many

trainees consider their repertoire of teaching skills to be inade-

quate (16). Observational studies of teaching skills among

internal medicine residents suggested that many residents teach

ineffectively (17). For example, it is uncommon for residents to

ask questions or to give feedback to learners (18). Furthermore,

residents do not teach problem-solving skills or address psycho-

social topics as often as attending physicians (19). A fundamental

goal of residency training is to achieve the key competencies

needed to practice medicine. In addition to clinical competence

and skills to conduct research (20), many accrediting bodies

now mandate that trainees achieve key competencies to teach

(5,6,21,22). These competencies include the demonstration

of effective teaching skills when teaching medical students,

peers, other health professionals and patients, as well as the

ability to self-evaluate teaching effectiveness.

Although residents have expressed a need to improve their

teaching skills (4), they are unlikely to be aware of available

methods to improve these skills. Indeed, only 8% of surveyed

program directors had been directly asked by residents to

incorporate a resident-teacher training program into the resi-

dency curriculum. Three-quarters of respondents agreed or

strongly agreed that there is a need for resident-teacher

training during residency and believed that this training

should be started early in residency. It may be helpful to

develop and disseminate a sample teaching curriculum to

radiology program directors, because not all may be familiar

with the opportunities that exist for resident-teacher training.

This curriculum would be designed with the primary goal to

help residents achieve key competencies as teachers, but could

also serve a secondary goal to increase awareness of a radiology

clinician-educator track, inform residents of opportunities to

obtain funding for medical education research, and promote

educational scholarship (23). It is possible that residents who

are exposed to teaching opportunities and mentoring early

in their training, and who enjoy it, may be more likely to

consider a career in an academic teaching center (13,24,25).

Other authors concur, and have cited teaching as being one

of the top reasons that radiologists choose an academic

932

career (Collins J, presented at the 2009 annual meeting of

the Association of University Radiologists).

To the best of the author’s knowledge, this is the first study

to evaluate the prevalence of resident-teacher training

programs in radiology. In this study, approximately one-

third of program directors indicated that their program

provided instruction to residents on teaching skills. The

most common method of delivery was a 1-day workshop.

Although longer educational electives may offer more oppor-

tunities for feedback, it is often difficult to free residents from

clinical service for extended period. Previous studies sug-

gested that both short courses and longer electives improve

resident teaching skills and satisfaction with teaching

(8,9,26). In one study, residents who completed a teaching

skills training course expressed greater enthusiasm for

teaching, demonstrated more learner-centered and empathic

teaching approaches, and had a richer understanding of

teaching principles and skills (13). Perhaps most importantly,

residents who participated in the teaching skills course wanted

to continue teaching during and after residency training (13).

Improvement in resident teaching skills may also lead to better

doctor-patient communication (27), enhanced patient

satisfaction, and possibly improved clinical outcomes (23,28).

This study highlighted several barriers to developing work-

shops or courses on teaching skills for residents. The majority

of respondents felt that time constraints imposed by the clin-

ical and research duties of faculty, and lack of trained medical

educators in radiology hindered implementation of resident

focused instruction on teaching skills. Inadequate recognition

of faculty who might ultimately lead such a course is another

barrier that needs to be overcome (29). Potential solutions

include collaboration between radiologists and medical

educators at one’s institution (30) or establishment of teaching

skills workshops led by experienced medical educators from

other institutions (23).

Many residents and faculty consider teaching to be under-

valued (2). Only one-third of program directors in the present

study felt that teaching performed by residents was adequately

recognized. Most respondents felt that their department

should emphasize the importance of residents as teachers.

How best to increase recognition of the teaching efforts of

radiology residents and faculty remains to be determined.

Recognition of outstanding resident and faculty teachers,

with local and national awards for teaching excellence, may

offer an immediate strategy. However, fostering an environ-

ment that supports and promotes teachers continues to be

a fundamentally important goal for the specialty of radiology.

It is interesting that institutions that had a faculty teaching

skills course were more likely to have a resident-teacher

training course. It is possible that academic institutions that

value the contributions of their teachers are interested to

develop teaching skills of all members of the department.

Institutions seeking to develop a resident teaching skills course

might consider initially implementing a faculty teacher

development course. Thereafter, radiology faculty could be

identified to lead a resident-teacher training course.

Academic Radiology, Vol 17, No 7, July 2010 RESIDENT-TEACHER TRAINING IN RADIOLOGY

There are several limitations to this study. First, a potential

response bias from program directors interested in resident-led

teaching may have overestimated the importance placed on

the role of resident teaching during radiology residency

training and the prevalence of resident-teacher training

programs in radiology. The response rate of 56% in the current

study is similar to a response rate of a prior survey of program

directors in the APDR (31). The proportion of respondents in

this survey who identified themselves as practicing radiology

in an academic setting (83%) parallels the current proportion

of academic programs in the entire APDR (84%). Second, this

study evaluated the prevalence of resident-teacher training

programs at individual institutions, but did not seek to assess

resident-teacher training opportunities available through

national radiology societies. Select radiology residents have

the opportunity to participate in teacher training at the Asso-

ciation of University Radiologists (AUR) annual meeting

through the Siemens AUR Radiology Resident Academic

Development Program and the American Association of

Academic Chief Residents in Radiology program.

In conclusion, program directors valued the role that radi-

ology residents play in medical education and felt that

teaching experiences helped residents become better radiol-

ogists. Most believed that residents would benefit from

structured training to enhance teaching skills. A minority

of residency programs had established a teaching skills

program for their residents. There is an expressed need for

additional strategies to develop the teaching skills of

radiology residents.

ACKNOWLEDGMENTS

The author is indebted to Marko Katic, biostatistician with

the Institute for Clinical Evaluative Sciences, Toronto, for

assistance with data analysis.

REFERENCES

1. Seely A. The teaching contributions of residents. Can Med Assoc J 1999;

161:1239–1241.

2. Bing-You RG, Harvey BJ. Factors related to residents desire and ability to

teach in the clinical setting. Teach Learn Med 1991; 3:95–100.

3. Makoul G. Essential elements of communication in medical encounters:

the Kalamazoo consensus statement. Acad Med 2001; 76:390–393.

4. Morrison EH, Hollingshead J, Hubbell FA, et al. Reach out and teach

someone: generalist residents’ needs for teaching skills development.

Fam Med 2002; 34:445–450.

5. Accreditation Council for Graduate Medical Education. ACGME Compe-

tencies Introduction. http://www.acgme.org/acWebsite/navPages/nav_

commonpr.asp. Accessed November 17, 2009.

6. Royal College of Physicians and Surgeons of Canada. 2005. The Can-

MEDS 2005 physician competency framework. http://rcpsc.medical.org/

canmeds/index.php. Accessed November 17, 2008.

7. Bing-You RG, Tooker J. Teaching skills improvement programmes in US

internal medicine residencies. Med Educ 1993; 27:259–265.

8. Morrison EH, Friedland JA, Boker J, et al. Residents-as-teachers training

in U.S. residency programs and offices of graduate medical education.

Acad Med 2001; 76:S1–S4.

9. Morrison EH, Rucker L, Boker JR, et al. The effect of a 13-hour curriculum

to improve residents’ teaching skills: a randomized trial. Ann Intern Med

2004; 141:257–263.

10. Collins J, Hyde C, Gray L, et al. Radiology resident evaluation: a form that

addresses the six competencies of the accreditation council for graduate

medical education. Acad Radiol 2002; 9:815–816.

11. Mainiero MB, Collins J, Primack SL. Effectiveness of resident-prepared

conferences in teaching imaging utilization guidelines to radiology

residents. Acad Radiol 1999; 6:748–751.

12. Busari JO, Scherpbier AJ, van der Vleuten CP, et al. The perceptions of

attending doctors of the role of residents as teachers of undergraduate

clinical students. Med Educ 2003; 37:241–247.

13. Morrison EH, Shapiro JF, Harthill M. Resident doctors’ understanding of

their roles as clinical teachers. Med Educ 2005; 39:137–144.

14. Bulte C, Betts A, Garner K, et al. Student teaching: views of student near-

peer teachers and learners. Med Teach 2007;1–8.

15. Busari JO, Scherpbier AJ. Why residents should teach: a literature review.

J Postgrad Med 2004; 50:205–210.

16. Neacy K, Stern SA, Kim HM, et al. Resident perception of academic skills

training and impact on academic career choice. Acad Emerg Med 2000; 7:

1408–1415.

17. Wilkerson L, Lesky L, Medio FJ. The resident as teacher during work

rounds. J Med Educ 1986; 61:823–829.

18. Skeff KM. Enhancing teaching effectiveness and vitality in the ambulatory

setting. J Gen Intern Med 1988; 3:S26–S33.

19. Wray NP, Friedland JA, Ashton CM, et al. Characteristics of house staff

work rounds on two academic general medicine services. J Med Educ

1986; 61:893–900.

20. Hillman BJ, Gay SB. Research residents’ choices of academic radiology

careers. J Am Coll Radiol 2005; 2:1030–1032.

21. Roberts CC, Chew FS. Teaching radiology residents, and radiology

residents as teachers. Acad Radiol 2003; 10(Suppl 1):S97–S101.

22. Halsted MJ, Perry L, Racadio JM, et al. Changing radiology resident

education to meet today’s and tomorrow’s needs. J Am Coll Radiol

2004; 1:671–678.

23. Gunderman RB, Kang YP, Fraley RE, et al. Teaching the teachers.

Radiology 2002; 222:599–603.

24. Donovan A, Donovan J. Mentorship in postgraduate training programmes:

views of Canadian programme directors. Med Educ 2009; 43:155–158.

25. Donovan A, Donovan J. Mentorship in medicine: potential implications

beyond the mentee-mentor relationship. Med Teach 2009; 31:874.

26. Smith KL, Petersen DJ, Soriano R, et al. Training tomorrow’s teachers

today: a national medical student teaching and leadership retreat. Med

Teach 2007; 29:328–334.

27. Kurtz S, Silverman J, Benson J, et al. Marrying content and process in

clinical method teaching: enhancing the Calgary-Cambridge guides.

Acad Med 2003; 78:802–809.

28. Cegala DJ, Lenzmeier Broz S. Physician communication skills training:

a review of theoretical backgrounds, objectives and skills. Med Educ

2002; 36:1004–1016.

29. Wilson FC. Residents as teachers. J Bone Joint Surg Am 2001; 83-A:

1441–1443.

30. Mann KV, Sutton E, Frank B. Twelve tips for preparing residents as

teachers. Med Teach 2007; 29:301–306.

31. Donovan A. Views of radiology program directors on the role of mentorship

in the training of radiology residents. AJR Am J Roentgenol; 194:704–708.

933