1. Medical Student Perception of Diagnostic Radiology after Implementation of an Evening Emergency Radiology Rotation
Anuj Rajput, Don Nguyen, Toshie Ahluwalia, Michael Goodman, Rayeed Islam, Jared Nesbitt, Dharmesh Tank

2. No disclosures

3. Introduction
Over the recent decades, the availability and technological capability of radiologic imaging has dramatically increased nationwide.
This increased availability in the setting health care’s litigious nature has led to defensive medical practice becoming more dependent on radiologic imaging to assist in diagnostic and therapeutic medical making decisions.
In particular, the emergency department (ED) have come under scrutiny over the recent years for concern about overutilization of medical imaging.1

4. Studies have demonstrated that from 1997 to 2006, the number of ED visits that included a CT examination has increased from 2.7 million to 16.2 million, which constitutes a 5.9-fold increase.1

5. Radiologists are pressured to cope with the increase in volume with faster turnaround time, but at the same time maintain high accuracy interpretation.

6. As the field of radiology continues to evolve with new health care changes and advances in technology
…we believe many people’s perception of the field has not changed

7. Prior Perceptions
In 1989, Duke University Medical Center conducted a study to assess the perception medical students had of radiology before and after a four-week elective course.
The results showed that radiology was perceived to have the lightest workload with the exception of psychiatry before completion of the elective and responses did not significantly change after completion of the course.2

8. We hypothesize that medical students currently view the field of radiology in a similar way, despite drastic changes in our current healthcare climate.

9. WHY? Substantial increases in diagnostic imaging
Typical medical school radiology experience does not include the more stressful aspects of radiology and fails to demonstrate…
Substantial increases in diagnostic imaging
Faster turnaround time
High expectations for accurate interpretation

10. Now to our study…

11. PURPOSE
To assess if there is a change in medical students’ current perception of diagnostic radiology after the implementation of an evening emergency radiology rotation.

12. METHODS AND MATERIALS
A questionnaire was given to a combination of 80 third and fourth year medical students after a 2-week required diagnostic radiology rotation during a 10-month interval
The rotation included time spent in all the radiology specialties with the addition of a new evening ER rotation
The rotation consisted of spending time after hours with junior and senior radiology residents, as well as an on-call attending during a typical ER call shift

13. Questionnaire Included
Gender and Medical School Class
Male/Female
3rd/4th Year

14. Questionnaire Included
What is the optimal time to spend on each rotation? (Each rotation individually scored)

15. Questionnaire Included
Was there sufficient time spent on each rotation? (Each rotation individually scored)

16. Questionnaire Included
Was there a sufficient volume of cases on each rotation? (Each rotation individually scored)

17. Questionnaire Included
Was there a sufficient teaching on each rotation? (Each rotation individually scored)

18. Questionnaire Included
At the start of the radiology rotation, what was your interest in radiology? (Scored 1-10)

19. Questionnaire Included
At the end of all radiology rotations, what was your interest in radiology? (Scored 1-10)

20. Questionnaire Included
At the end of the ER evening radiology rotation, how much did your perception of radiology change? (Scored 1-10)

21. RESULTS

22. Exit responses
10% increase in interest in Diagnostic Radiology after the entire rotation
10%

23. Exit responses
33% (26/80) of students’ perception of Diagnostic Radiology changed after the ER rotation
33%

24. 10 were female and 16 were male.
Exit responses
Of the 26,
10 were female and 16 were male.
Breakdown of 33% of the females surveyed and 33% of the males surveyed

25. Exit responses
A mean of 2 hours was considered an optimal amount of time spent on a night ER rotation to accurately evaluate the rotation

26. Exit responses
A mean of 4 hours was considered an optimal amount of time spent on additional rotations to accurately evaluate the rotation

27. Exit responses
63% of students’ felt there was an insufficient amount of time spent teaching during the evening ER rotation
63%

28. Exit responses
No other rotation demonstrated that there was insufficient time spent teaching

29. Exit responses
63% of students’ felt there was sufficient volume during the evening ER rotation
63%

30. Conclusions
At our institution, medical student perception of diagnostic radiology after the implementation of an evening ER rotation has not changed substantially. Approximately 1/3 of medical students, of either gender, viewed radiology differently from this experience.

31. Conclusions
They demonstrate awareness of the increased workload and expectations of the night ER radiologists, evidenced by the less teaching, sufficient volume, and less time needed to accurately evaluate an evening ER shift.
Despite these views, a small subset appears to be more interested in radiology as a specialty after this experience.

32. Conclusions
Thus, an evening emergency radiology rotation does not dissuade students from learning and pursuing Diagnostic Radiology.

33. References
Elster, A.d. "National Trends in CT Use in the Emergency Department: 1995–2007." Yearbook of Diagnostic Radiology 2012 (2012):
Novelline, Robert A., D. Skip Sallee, Cirrelda Cooper, and Carl E. Ravin. "Medical Student Perceptions of Diagnostic Radiology Influence of a Senior Radiology Elective." Investigative Radiology 24.9 (1989):
Shinagare, Atul B., Ivan K. Ip, Sarah K. Abbett, Richard Hanson, Steven E. Seltzer, and Ramin Khorasani. "Inpatient Imaging Utilization: Trends of the Past Decade." American Journal of Roentgenology (2014)
"Medical Students' Attitudes toward Radiology: Comparison of Matriculating and Graduating Students." National Center for Biotechnology Information. U.S. National Library of Medicine, 5/abstract. 23 Oct
Raja, Ali S., Koenraad J. Mortele, Richard Hanson, Aaron D. Sodickson, Richard Zane, and Ramin Khorasani. "Abdominal Imaging Utilization in the Emergency Department: Trends over Two Decades." Int J Emerg Med International Journal of Emergency Medicine 4.1 (2011): 19.
Blane, CE, Ten Haken, JD, Vydareny, KH et al, Medical student attitudes toward radiology: a multi-institutional survey. Invest Radiol. 1989;24:77–80.
Schlesinger, AE, Blane, CE, Vydareny, KH. First-year medical students' attitudes toward radiology. Invest Radiol. 1992;27:175– 178.

34. Anuj Rajput, MD PGY-4 Stony Brook University Hospital