Surprising Learning Opportunities Enrich Residency Training
by Sam Marie Engle, MS, MHS
The COVID-19 pandemic is changing everything about life in the US. That include not only how training happens for our residents but also what lessons are learned.
In March, Emory University announced all students would transition to remote learning and Emory Healthcare made the difficult decision to postpone most surgical and procedural cases and suspend normal clinical operations. While the changes were essential both to protect learners and prepare for the surge in COVID-19 patients, they nevertheless upended resident training.
“This really challenged us to rethink the way we practice radiology and how we view education,” says Dr. Christopher Ho, associate professor and program director of the Diagnostic Radiology Residency.
Instead of gathering in reading rooms or classrooms, residents now are doing virtual readouts using Microsoft Teams and conferences via Zoom.
Dr. Ryan Peterson, assistant professor and associate program director of the Diagnostic Radiology Residency, is using live cases from PACS from the past five years of his clinical practice as a neuroradiologist during hourlong Zoom conferences. After scrubbing patient identity information, a participating resident takes the case in a “hot-seat” style format, answers questions and recommends next steps. Colleagues like Dr. Brent Weinberg, assistant professor, monitor the chat feature to answer questions, provide pertinent references and add any expert teaching points for the case. Chief Resident Dr. Paty Balthazar promotes these live case sessions on social medial and manages participant access to the sessions to prevent security breaches.
Dr. Peterson has been presenting two or three live case conferences a week. He uses high-yield cases to help first year residents prepare for call and more complex cases to challenge upper level residents.
The COVID-19 pandemic is changing everything about life in the US. That include not only how training happens for our residents but also what lessons are learned.
In March, Emory University announced all students would transition to remote learning and Emory Healthcare made the difficult decision to postpone most surgical and procedural cases and suspend normal clinical operations. While the changes were essential both to protect learners and prepare for the surge in COVID-19 patients, they nevertheless upended resident training.
“This really challenged us to rethink the way we practice radiology and how we view education,” says Dr. Christopher Ho, associate professor and program director of the Diagnostic Radiology Residency.
Instead of gathering in reading rooms or classrooms, residents now are doing virtual readouts using Microsoft Teams and conferences via Zoom.
Dr. Ryan Peterson, assistant professor and associate program director of the Diagnostic Radiology Residency, is using live cases from PACS from the past five years of his clinical practice as a neuroradiologist during hourlong Zoom conferences. After scrubbing patient identity information, a participating resident takes the case in a “hot-seat” style format, answers questions and recommends next steps. Colleagues like Dr. Brent Weinberg, assistant professor, monitor the chat feature to answer questions, provide pertinent references and add any expert teaching points for the case. Chief Resident Dr. Paty Balthazar promotes these live case sessions on social medial and manages participant access to the sessions to prevent security breaches.
Dr. Peterson has been presenting two or three live case conferences a week. He uses high-yield cases to help first year residents prepare for call and more complex cases to challenge upper level residents.
“This format places the resident in real life scenarios and diagnostic dilemmas, many of which forced me to learn and grow” says Dr. Peterson.
“Placing them in the “hot-seat” in front of their peers better engages each participant and improves learning.”
The sessions are so popular, residents from other Emory departments like Neurology and even other radiology residency programs across the country are tuning in. Dr. Peterson welcomes faculty and trainees from Indiana University, the University of Florida Gainesville, Georgetown University, Medical College of Wisconsin, the University of South Florida, and AdventHealth in Orlando to learn along with Emory’s radiology residents. A conference can draw 50 to 120 learners. Faculty from the other schools often step in to co-teach with Dr. Peterson, creating a rich environment for collaborative learning.
While didactics have moved online, residents do miss working with patients in real-time. “They want to be out there, helping during these unprecedented times, but they understand the need for safety,” says Dr. Ho.
They also understand the need to safeguard essential medical supplies like personal protective equipment (PPE) in the face of global shortages, an unexpected but important lesson.
“What I have learned from this experience so far is that while some institutions like Emory are prepared for the pandemic, the US healthcare system as a whole is not, and we are only as strong as our weakest link,” says Dr. Christopher Hesh, a third-year resident. “My hope is that we as a society learn from this experience and change our healthcare priorities moving forward to align more with those of patients.”
Staffing challenges also are teaching the residents about the need for flexibility. Some residents may temporarily put their radiology residency obligations on hold so they can work in direct patient care areas should other departments become short-handed. “We’re really proud that our residents with training in general medicine, general surgery, and the like have volunteered to be redeployed when necessary,” Dr. Ho says.
When asked why a resident would interrupt their radiology residency to go work in another area, the answer is simple, yet powerful: “Because it’s the right thing to do.”
Like their faculty mentors and clinical staff, residents also have families to worry about. Always challenging, the need to balance safety with responsibility has become even more acute. Second-year resident Dr. Danny Comer notes, “My wife is also pregnant and so little is known about the virus in pregnancy,” he says as he continues to be on call at Grady Hospital. “I will do my best to continue delivering the best care that I can while also remaining vigilant regarding my own and my family's safety.”
As Emory Radiology residents watch the way department leaders prepare for and pivot to meet the challenges of dealing with a global pandemic, they are learning what they’ll need to do as leaders in tomorrow’s medical centers. Dr. Ho is optimistic about their bright futures.
“I’m really proud of the resilience and grit the residents have shown in adapting to these challenging times. They have seen this as an opportunity for growth while we re-examine how we approach residency education."
“Placing them in the “hot-seat” in front of their peers better engages each participant and improves learning.”
The sessions are so popular, residents from other Emory departments like Neurology and even other radiology residency programs across the country are tuning in. Dr. Peterson welcomes faculty and trainees from Indiana University, the University of Florida Gainesville, Georgetown University, Medical College of Wisconsin, the University of South Florida, and AdventHealth in Orlando to learn along with Emory’s radiology residents. A conference can draw 50 to 120 learners. Faculty from the other schools often step in to co-teach with Dr. Peterson, creating a rich environment for collaborative learning.
While didactics have moved online, residents do miss working with patients in real-time. “They want to be out there, helping during these unprecedented times, but they understand the need for safety,” says Dr. Ho.
They also understand the need to safeguard essential medical supplies like personal protective equipment (PPE) in the face of global shortages, an unexpected but important lesson.
“What I have learned from this experience so far is that while some institutions like Emory are prepared for the pandemic, the US healthcare system as a whole is not, and we are only as strong as our weakest link,” says Dr. Christopher Hesh, a third-year resident. “My hope is that we as a society learn from this experience and change our healthcare priorities moving forward to align more with those of patients.”
Staffing challenges also are teaching the residents about the need for flexibility. Some residents may temporarily put their radiology residency obligations on hold so they can work in direct patient care areas should other departments become short-handed. “We’re really proud that our residents with training in general medicine, general surgery, and the like have volunteered to be redeployed when necessary,” Dr. Ho says.
When asked why a resident would interrupt their radiology residency to go work in another area, the answer is simple, yet powerful: “Because it’s the right thing to do.”
Like their faculty mentors and clinical staff, residents also have families to worry about. Always challenging, the need to balance safety with responsibility has become even more acute. Second-year resident Dr. Danny Comer notes, “My wife is also pregnant and so little is known about the virus in pregnancy,” he says as he continues to be on call at Grady Hospital. “I will do my best to continue delivering the best care that I can while also remaining vigilant regarding my own and my family's safety.”
As Emory Radiology residents watch the way department leaders prepare for and pivot to meet the challenges of dealing with a global pandemic, they are learning what they’ll need to do as leaders in tomorrow’s medical centers. Dr. Ho is optimistic about their bright futures.
“I’m really proud of the resilience and grit the residents have shown in adapting to these challenging times. They have seen this as an opportunity for growth while we re-examine how we approach residency education."