1. Web-based Education in Emergency Medicine: Development of an Electronic Radiology Database, Teaching Module and Digital Image Database Ivy Cheng David Lendrum Nazanin Meshkat SWCHSC and UHN

2. Part I: Radiology Database and Teaching Module

3. Part II: Photographic Image Database

4. Part I: Radiology Image Database

5. Questions (to ask yourself): What percentage of the emergency physician’s time is spent independently reading radiology images? How important is accurate interpretation with respect to patient care? What tools are available in teaching this skill? Is there a deficit of resources?

6. Objectives: 1. Determine the need for a radiology teaching file 2. Development of comprehensive database 3. Dissemination for teaching and evaluation of students, nurses, paramedics, or residents 4. Evaluation of tool

7. Objective 1: Needs Survey: 1. How did you acquire your radiological interpretation skills? 2. (Faculty) Do you feel you acquired adequate radiology interpretation skills by the end of your residency? 3. (Residents) Do you have adequate educational resources for acquisition of interpretative skills of radiological images?

8. Needs Survey (con’t) 4. (Faculty) Do you have adequate resources for teaching the interpretation of radiological images? 5. To what degree would you use a radiology image database correlated with the RCPS core curriculum for the purpose of learning or teaching radiology image interpretation?

9. Needs Assessment: Results E-mail questionnaire sent out to emergency services list-serv Dillman method: 3 separate send-outs 82 response out of 161 potential responses Response rate: 50.9%

10. Q1: Radiology Skills Acquisition Residents (21)Faculty (61) Radiology Elective 19.0% 54.1% Book61.9%73.8% Website33.3%27.9% Before Residency90.5%62.3% During Residency95.2%82.0% After Residency19.0% (?)78.2% Other14.3%6.6%

11. Q2. (Faculty) Adequacy of Knowledge Acquisition? Yes=49.2% No=44.3% No answer=6.6%

12. Q3. (Residents) Adequacy of radiology educational resources? Yes=33.3% No=66.7%

13. Q4. (Faculty) Adequate radiology teaching resources? Yes=31.1% No=68.9%

14. Q5. Potential radiology image database: frequency of use? ResidentsFacultyCombined All of the time38.1%19.7%24.4% Some of the time 61.9%63.9%63.4% Rarely0%11.5%8.5% Never0%3.3%2.4%

15. Conclusion Acquisition of radiology interpretation skills is inconsistent across residents and staff Only 50% of faculty felt they acquired adequate interpretation skills by the end of their residency 67% of resident respondents voted that there are inadequate radiology educational resources 69% of faculty respondents voted that there are inadequate radiology teaching resources. 88% of all respondents would use a radiology digital database some, or all of the time for learning, or teaching

16. Therefore: Development of a comprehensive radiology image database

17. Objective 2: Comprehensive Database Paralleled to the Canadian Core Content Listing for Emergency Medicine Core Content is cross-referenced to chapters in Tintinalli, and Rosen Web-based User friendly

18. Organization (handout): Acute disorders by Body System Geriatrics Paediatrics Trauma Geriatrics Paediatrics Toxicology Environmental

19. Ethical Considerations: Patient Privacy: All images must be cleaned of all identification Hospital must be made aware of database’s existence

20. Acquisition/Retrieval of Images Via: all Toronto emergency medicine faculty who are interested in contributing to the database Radiologists willing to share their databases Recognition of contribution User-friendly, web-based system to allow retrieval of images for teaching/examination purposes Password protected

21. Resident Teaching File Images used for exam purposes are to be transferred to resident teaching file with answers Password protected PGY5 access to full library for study purposes

22. Objectives 3 and 4: Database as an Evaluation Tool: Bellringer: September 2005 10 images Short-answer questions

23. Question 4 3.2.10 C2frac.xr

26. Database as an Evaluation Tool: Bellringer to be done quarterly Assessment of residents against PGY level Assessment of resident during PGY progression Tool to demonstrate deficits Determination of appropriate images for exam purposes Development of resident teaching file

27. Current Status: Acquisition of more images (incentive) Website in development: Teaching module: www.howtoreadxrays.com by Dr. Nazanin Meshkat www.howtoreadxrays.com

28. Future Possibilities: Computer-generated quizzes Expansion of teaching file for other specialties Photographic digital images….

29. Part II: Photographic Image Database

30. Special Thanks: Dr. Glen Bandiera Dr. Laurie Morrison Dr. Vicki Leblanc Dr. Weiser Laura Burns

31. Questions or Suggestions?