Fast 5 Speakers Promote Change, Adaptability in Radiology

Tuesday, Dec. 01, 2020

Rising to the challenge of the all-virtual format, this year's Fast 5 presenters spoke about the importance of culture and provided perspective on the changes they experienced during the COVID-19 pandemic. Moderated by Richard Heller, III, MD, the fast-paced session reflected the diversity of RSNA and the annual meeting theme, Human Insight/Visionary Medicine.

Promoting Diversity through Intentional Inclusion

International medical graduate students (IMG) are important to inclusion and diversity in the field of radiology in the U.S. Yet, they face more than the usual number of challenges on their journey to residency programs, noted George Vilanilam, MBBS.

After tackling visa sponsorship challenges, they also encounter certification delays through entities like the Educational Commission for Foreign Medical Graduates (ECFMG) before being permitted to participate in the residency match.

"When IMGs are incorporated into the U.S. health care system, they play an exceptional role in meeting the workforce demands of the American population," said Dr. Vilanilam. Mentorship and IMG sponsorship are important to enabling diversity within organizations. Understanding the challenges IMGs face and being prepared to handle them will help facilitate IMG inclusion and retention.

Redesigning Workplace Culture

As the invisible epidemic of burnout was made worse by the invisible pandemic of COVID-19, the radiology workplace was turned upside down, Michael Fishman, MD, said. There were fluctuations in workloads, less control over case volume and a mandated exodus from the reading room. Remote work led to isolation and a loss of social cohesion and community. Social and political unrest exacerbated the problem.

"In a toxic work culture, victims enter a stress response that impacts their reasoning, impulse management, focus and problem solving," Dr. Fishman said.

While many remain isolated in a work-from-home (WFH) scenario, Dr. Fishman recommends promoting a more positive environment by redefining the WFH acronym as wellness, flexibility, helpfulness. "This leads to shared purpose and organizational thriving with respectful behavior triggering emotions of happiness, trust, inclusion and safety driving productivity, engagement, well-being and resilience."

The Importance of Togetherness

For radiology educator Jennifer Weaver, MD, the pandemic provided insight into critical elements of radiology education and highlighted the importance of human interaction and a sense of community among residents and staff.

"Even when we are physically distanced, we must find ways to be socially, emotionally and educationally together," she said.

Faculty can creatively facilitate interaction using technology like video-conferencing platforms that provide a virtual readout experience comparable to in-person readouts. Additionally, reading room web cameras allow resident and faculty engagement by providing a window to non-verbal cues. Dr. Weaver also recommended engaging in social small talk during video conferencing to reduce feelings of isolation.

"As faculty, we must remember what we truly care about and our role in caring for patients and educating the next generation of physicians," Dr. Weaver said.

Unexpected Benefits

Increased access to teaching and customized learning pace are among the unexpected benefits of changes to radiology instruction during the pandemic. Aisling Fagan, MBBCh, noted that although instructional methods have changed, resulting improvements may be beneficial even after the pandemic has passed.

Recorded sessions allowed residents to catch up on teaching they might normally miss while working. In addition, remote learning reduced travel between worksites, allowed sick or isolating residents to continue to learn at a distance and has eliminated workstation crowding.

"By sharing screens using in-house PACs, we can view teaching sessions from our own screens while socially distancing," said Dr. Fagan who emphasized that she hopes the pandemic brings at least one lasting benefit. "Radiology students do not go back to crowding around workstations to catch a glimpse of the key finding that cinches the diagnosis."

The Inevitability of Change

The COVID-19 pandemic has transformed the field of radiology education and forced educators to pivot quickly to continue to deliver quality training.

"This is not the first time that radiology education has been challenged by emergent technologies or highly unusual circumstances," Dyan Floress, MD, said.

From the traditional "hot seat" conference to today's quarantine-driven virtual readouts, innovations and hardships have shaped radiology education over the decades. The invention of the personal computer, creation of PACS, development of digital presentation software, advancements in data collection and rapidly increasing use of social media platforms have all contributed to dramatic changes for educators and students.

Now, eight months after online teaching began, many institutions continue conducting rounds online, and though many are seeking a gradual return to in-person readouts, the future is uncertain. "Fortunately, recent published data show that online platforms have not adversely affected trainee education and are generally accepted by residents," Dr. Floress said.

For More Information:

View the RSNA 2020 session Fast 5 — SPFF31 at