Interactivity and personal touch brings success in the classroom

Teaching came under the microscope during the professional challenges session on Friday, March 5, at which speakers gave practical tips on how to engage radiology trainees and prepare them for the future.

The essential advice was to practice, use a variety of methods, be engaged and enthusiastic, get involved, seek feedback, and make a life-long commitment, said Prof. Robert Greif, director of medical education at Bern University Hospital in Switzerland.

“There is a lot of science behind the art of teaching,” he said. “And you should always remember that teaching is not so well-paid, and usually students don’t say thanks!”

Teachers should avoid conventional lectures of more than 10 to 12 minutes because listeners’ minds wander. They should use interactive discussions, practical exercises, and anything else that forces students to engage their brains, he said. They should also be aware of several myths in medical education: if you know your topic, you can teach; a brilliant researcher is a good teacher; a failing student is either lazy or lacks intelligence; those who can’t do, teach; and good teachers are born, not made.

The time spent with an experienced senior doctor who inspires a trainee is still the greatest and most valuable experience that trainee can have, according to Dr. Christiane Nyhsen, a consultant radiologist at the Sunderland Royal Hospital and immediate past chair of the Radiology Trainees Forum. Whether it’s a one-to-one discussion of a CT case or small group teaching, there is no substitute for such interaction, she said.

To find out their perceptions of radiology, Nyhsen and her colleagues in Sunderland have just conducted a survey of 90 newly qualified doctors who had not yet started their specialist training. The response rate was an impressive 98% because it was conducted by phone. Of the respondents, 59% were women, 85% were between 22 and 27 years old, and 10% were older than 31.

Seven percent of respondents said they received radiology training on a daily basis during the current academic year, while 48% had weekly radiology training, 29% had a monthly radiology session, and 11% had no formal exposure. Two thirds of the sample wanted more radiology teaching, particularly for MRI, CT, and ultrasound.

“Maybe we are losing the reputation for being miserable creatures sitting in a dark room and not being very accessible. Hopefully we are becoming more friendly, and with the advent of PACS, we are more reachable and people know we are doing different things,” Nyhsen said.

She added that these young people’s primary motivation to learn about radiology is to become a good doctor, not just to pass an exam.

Of the newly qualified doctors, 22% said they would be interested in pursuing a career in radiology, whereas 77% said they would not; one person was undecided. Some trainees said they felt lost in the radiology department, and they did not know what to ask and do. They also wanted to learn more about techniques, preparing patients, and choosing the correct investigation.

The respondents also answered questions about teaching methods. Interactive case-based discussions were by far the most popular approach, followed by interactive system-based discussions and then PowerPoint lectures. Dedicated, self-directed e-learning was rated less highly, probably due to the quality of the modules, and the respondents were very unlikely to read textbooks and journal articles. New technology offers new opportunities, but a computer can never replace an inspiring teacher, Nyhsen said.

Dr. Dick Fowler, a consultant radiologist from the Leeds Teaching Hospitals NHS Trust in the U.K., said e-learning represents the future and will become the major source of core radiology knowledge as didactic lectures become obsolete. With e-learning, interactions between teachers and learners should improve, the focus should be more clinical, and training should become more productive and cost-effective, he said.

“E-learning is a web-based learning episode or experience. I prefer the word ‘experience’ because it should be something that they’re involved in.” he said. “It should be part of a wider educational design and it must have structure. To have structure, it must be curriculum-mapped, otherwise it’s like saying, ‘Here’s a lovely, large library, go and enjoy it.’ That’s hopeless.”

Two important questions still need to be addressed, according to session moderator Dr. Joachim Wildberger, a radiologist from Maastricht University Medical Center in the Netherlands. One, because no one practices the entire field, why do we insist that radiologists become at least minimally competent in the entire field? And two, how can we realise that our radiological work is not just technically accurate, but that it is appropriate to the clinical setting?

Note: a version of this article appeared in the 2010

ECR Today

newspaper on Saturday, March 6.