Challenges in medical imaging teaching

Abstract

See one, do one, teach one.Are the opportunities to 'see one' becoming fewer and more far for medical students in relation to medical imaging?The rapid evolution of imaging allows human anatomy to be depicted as never before. Yet, the article by Subramaniam et al.suggests that over the past 20 years, despite major advances in radiology, medical student radiology teaching is lagging behind. 1 In response to workforce shortage, medical students are increasing in number. Since 2000, five new medical schools have opened in Australia with a further seven programmes planned by 2008. 2 Reliance on imaging in clinical medicine is increasing, whereas undergraduate anatomy teaching is decreasing. Imaging methods and their interpretation are becoming more complex. Is the current undergraduate medical imaging teaching enough, and is it effective? Traditional radiology teaching is based on lectures and, more recently, also on small group tutorials. Students commonly perceive radiologists as unsociable creatures, sitting in dark rooms in hospital basements devoid of patient interaction. Junior medical staff, in general, from observation, appear to have had limited exposure to radiology in a practical sense. d Many have never seen a CT, MRI or mammogram being carried out. d Many have never seen simple radiological procedures such as imaging-guided biopsies or central venous catheter insertions. This undoubtedly poses difficulties with explaining such procedures to patients.d Second-and third-year graduates are increasingly admitting to never having seen or carried out basic procedures such as pleural/abdominal aspiration and lumbar puncture, let alone imparting these clinical skills to medical students. d Limited understanding of anatomy in light of decreased undergraduate anatomy teaching gives rise to difficulty interpreting routine studies, such as chest radiographs carried out for assessment of central venous catheter position. d Lack of understanding leads to an increase in the volume of inappropriate requests and unnecessary imaging.There is now a greater need for improved integration of medical imaging teaching into the medical curriculum and for increased recognition of radiologists' educational role not only in imaging but also in anatomy and procedural skills. Current difficulties arise from the inevitable clash between service and education commitments, intimately related to resource availability. 3 Staff, time and space are needed. 'Academic time' is still, for some, a notion yet to be realized. Radiology, rather than constituting a core part of the medical curriculum, is too often incorporated merely as a peripheral addition. Students require more opportunities to learn radiology through direct observation. Two issues are particularly important to the future of medical imaging teaching: d Development of dedicated rotations through medical imaging, similar to some existing 2-week rotations for medical and surgical specialties. This would allow students to observe both diagnostic and interventional studies, providing...

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