Radiology education and training is of paramount clinical importance given the prominence of medical imaging utilization in effective clinical practice. The incorporation of basic radiology in the medical curriculum has continued to evolve, focusing on teaching image interpretation skills, the appropriate ordering of radiological investigations, judicious use of ionizing radiation, and providing exposure to interventional radiology. Advancements in radiology have been driven by the digital revolution, which has, in turn, had a positive impact on radiology education and training. Upon the advent of the corona virus disease 2019 (COVID-19) pandemic, many training institutions and hospitals adhered to directives which advised rescheduling of non-urgent outpatient appointments. This inevitably impacted the workflow of the radiology department, which resulted in the reduction of clinical in-person case reviews and consultations, as well as in-person teaching sessions. Several medical schools and research centers completely suspended face-to-face academic activity. This led to challenges for medical teachers to complete the radiology syllabus while ensuring that teaching activities continued safely and effectively. As a result, online teaching platforms have virtually replaced didactic face-to-face lectures. Radiology educators also sought other strategies to incorporate interactive teaching sessions while adopting the e-learning approach, as they were cognizant of the limitations that this may have on students' clinical expertise. Migration to online methods to review live cases, journal clubs, simulation-based training, clinical interaction, and radiology examination protocolling are a few examples of successfully addressing the limitations in reduced clinical exposure. In this review paper, we discuss (1) The impact of the COVID-19 pandemic on radiology education, training, and practice; (2) Challenges and strategies involved in delivering online radiology education for undergraduates and postgraduates during the COVID-19 pandemic; and (3) Difference between the implementation of radiology education during the COVID-19 pandemic and pre-COVID-19 era.

Diagnostic imaging is under-represented in medical curricula globally. Adaptive tutorials, online intelligent tutoring systems that provide a personalized learning experience, have the potential to bridge this gap. However, there is limited evidence of their effectiveness for learning about diagnostic imaging.

We performed a randomized mixed methods crossover trial to determine the impact of adaptive tutorials on perceived engagement and understanding of the appropriate use and interpretation of common diagnostic imaging investigations. Although concurrently engaged in disparate blocks of study, 99 volunteer medical students (from years 1-4 of the 6-year program) were randomly allocated to one of two groups. In the first arm of the trial on chest X-rays, one group received access to an adaptive tutorial, whereas the other received links to an existing peer-reviewed Web resource. These two groups crossed over in the second arm of the trial, which focused on computed tomography scans of the head, chest, and abdomen. At the conclusion of each arm of the trial, both groups completed an examination-style assessment, comprising questions both related and unrelated to the topics covered by the relevant adaptive tutorial. Online questionnaires were used to evaluate student perceptions of both learning resources.

In both arms of the trial, the group using adaptive tutorials obtained significantly higher assessment scores than controls. This was because of higher assessment scores by senior students in the adaptive tutorial group when answering questions related to topics covered in those tutorials. Furthermore, students indicated significantly better engagement with adaptive tutorials than the Web resource and rated the tutorials as a significantly more valuable tool for learning.

Medical students overwhelmingly accept adaptive tutorials for diagnostic imaging. The tutorials significantly improve the understanding of diagnostic imaging by senior students.

The primary purpose of this article is to review the career outcomes of a research training program specifically targeted to young psychiatric researchers from minority populations underrepresented in psychiatry. The aims of the program were (1) to support psychiatric investigators from under-represented populations in the development and maintenance of research careers and (2) to identify the factors which influence successful research career development.

Demographic data from 99 program participants were collected from an online survey as part of a systematic program evaluation, and through a follow-up internet search. Outcome measures included current academic position, number and types of post-training grants received, number of peer-reviewed publications, and comparison of post-training career outcomes with those from other highly regarded research training programs.

Of the 99 psychiatrists accepted into the program, 55 responded to the online survey; additional information on non-responders was obtained through a follow-up internet search. Results indicated that 64% of program trainees identified their primary employment setting as academic/research; 70% reported publication of their research findings, and 64% reported the award of post-training research grants. The percentage of program graduates appointed to academic faculty positions and their receipt of R01 and/or K awards, exceeded that of two highly regarded national training programs. The study further identified major factors influencing successful research career development.

Findings from this study strongly suggest that research training programs targeted to young minority psychiatrists can be successful in supporting the development and maintenance of their research careers. The decline in the availability of such programs does not portend well for increasing the numbers of underrepresented minority psychiatric researchers.

BACKGROUND. Admission decisions require that information about an applicant be combined using either holistic (human judges) or statistical (actuarial) methods. For optimizing a defined measureable outcome, there is a consistent body of research evidence demonstrating that statistical methods yield superior decisions compared to those generated by judges. It is possible, however, that the benefits of holistic decisions are reflected in unmeasured outcomes. If such benefits exist, they would necessarily appear as systematic variance in raters' scores that deviate from statistically-based decisions. PURPOSE. To estimate this variance, we propose a design examining the interrater reliability of difference scores (i.e., the difference between observed committee rankings and rankings based on statistical approaches). METHODS. Example calculations and G study models are presented to demonstrate how rater agreement on difference scores can be analyzed under various circumstances. High interrater reliability of difference scores would support but not prove the assertion that the holistic process adds useful information beyond that achieved by much less costly statistical approaches. Conversely, if the interrater reliability of difference scores is near zero, this would clearly demonstrate that committee judgments add random error to the decision process. RESULTS. Evidence to conduct such studies already exists within most highly selective medical schools and graduate programs and the proposed validity research could be conducted on existing data. CONCLUSIONS. Such research evidence is critical for establishing the validity of widely used holistic admission approaches.

Change in medical education has brought with it new perspectives on content, process, assessment and evaluation. With this change has emerged a new discourse. New words and phrases, used by many but not always fully understood, have infiltrated every aspect of our academic lives. One such term which we believe is used relatively freely but which is not well understood or implemented is "learnercentred" or "student-centred" education.

These twelve tips, drawn from experience, attempt to clarify the implications of learner-centred education and provide a structure upon which to ensure that all stakeholders have the same understanding of the implications of what being learn-centredness involves.

Without a common understanding of learner-centreness, the true educational concept may not be appropriately implemented, resulting in considerable faculty and student stress. We should practice what we preach and consider the "whole" student.

Surgical education has always been challenging and is being made more difficult with the changes in the surgical environment. In the past decade, the number of patients available for educational purposes has decreased because of the development of technology that has significantly reduced their time of stay in the hospital and has also moved many surgical procedures to ambulatory services. Technologic advances also create the demand for more specialized training. The increased number of undergraduate, postgraduate students, and clinical fellows has also affected the educational mandate of the academic hospitals. Alternative ways to teach medicine, and especially surgery, are becoming inevitable. One such method is to teach students outside the operating room in a simulated environment. This article reports on the developments of surgical education centers and provides guidance for those who might wish to develop such educational facilities. For further information, visit www.cesei.org.

Incorporating clinical content into medical education faculty development programs has been proposed as a strategy to consolidate faculty continuing medical education time and enhance learning. We developed a faculty development program for ambulatory internal medicine preceptors that integrated primary care genetics with ambulatory precepting. The instructional strategies addressed both areas simultaneously and included facilitated discussions, mini-lectures, trigger tapes, and role plays. To evaluate the program, we conducted a pre-post trial. Skills were measured by retrospective pre-post self-reported ratings and behaviors by self-reported implementation of commitment to change (CTC) statements. Participants' (N = 26) ambulatory precepting and primary care genetics skill ratings improved after the intervention. They listed an average of 2.4 clinical teaching CTC statements and 2.0 clinical practice CTC statements. By 3 months after the workshop, preceptors, as a group, fully implemented 32 (38%), partially implemented 35 (41%), and failed to implement 18 (21%) CTC statements. The most common barrier to clinical teaching change was insufficient skills (8 of 25; 32%) and to clinical practice change was lack of a suitable patient (15 of 25; 60%). Integrating clinical content with clinical teaching in a faculty development workshop is feasible, can improve clinical and teaching skills, and can facilitate behavior change.

The underrepresentation of certain minorities within medical education and the medical profession continues to be a problem. A review of the relevant research literature suggests current strategies are inadequate to address this important problem. Psychometric issues important in differentiating the unique concerns of medical education must be defined.

A new model that may attain diversity goals and meet standards related to validity and legality is presented. Admissions data describing applicants for one year at a large midwestern medical college are analyzed. The impact of selection techniques on both majority and underrepresented minority applicants is presented.

The results of the analyses support further research designed to meet the quantitative objectives implied by diversity goals and suggests initiatives aimed at enhancing minority representation within medical education.

To examine graduating medical students' perceptions of the adequacy of instruction in managed care and in 11 curricular content areas identified by experts as a necessary part of managed care education. This study sought to determine whether medical students perceived these content areas as relevant to managed care and to evaluate the extent to which students' perceptions of the adequacy of instruction varied as a function of managed care penetration in the locations of their respective medical schools.

Data from the Association of American Medical Colleges' 1999 Medical School Graduation Questionnaire (GQ) were analyzed. Students' ratings of adequacy of instruction were summarized. Correlations between ratings of instruction in managed care and 11 related content areas were calculated, as well as correlations between managed care penetration in the locations of the students' schools and the proportion of students rating instruction as inadequate.

A majority of 1999 medical school graduates (60%) rated instruction in managed care as inadequate; other content areas to which majorities of graduates gave inadequate ratings were practice management (72%), quality assurance (57%), medical care cost control (57%), and cost-effective medical practice (56%). Ratings in these four content areas were highly correlated with ratings of instruction in managed care. The correlation between managed care penetration and rating of instruction in managed care was statistically significant (r = -.37); correlations between managed care penetration and instruction in the other content areas were not.

On the 1999 GQ, a majority of medical students responded that they felt they had not received adequate instruction in managed care. Further, the responses suggest that these medical students defined managed care in terms of managing costs, rather than managing health care, or developing population-based approaches to the delivery of health care.

In recent decades, dramatic changes have occurred in the organization, number and type of tests, and role of medical laboratories in healthcare. The role of laboratory professionals has undergone a radical change, which calls for greater analytical accuracy, and more stringent test selection, and interpretation of results.

The ancillary role of clinical laboratories in the past was analyzed in order to understand why the change has taken place, and to identify old and new areas in which laboratory information is largely used for improving upon decision making for treatment, and patient management.

The availability of real-time laboratory results and more effective tests, the enhanced clinical consulting role, the involvement in therapeutic decisions, the efforts to prevent rather than cure disease, the shift from anecdotal care to evidence-based medicine, and the assessment of outcome for laboratory tests have all contributed to the changing role and duties of medical laboratories.

Crucial elements in sustaining the changes in the role and contribution of medical laboratories to a high-quality healthcare are the ability of laboratory professionals to: guarantee the quality of laboratory tests irrespective of where they are performed; improve the quality of services; improve clinical outcomes; and perform joint clinical/laboratory research projects. A key factor in effecting the change has been the awareness of the importance of the knowledge and skills required for the new role of laboratory professionals.

The purpose of this study was to document health care providers' awareness of problem gambling and frequency of recognition and treatment. An exploratory survey was designed to collect data on awareness and knowledge of problem gambling. A structured questionnaire was completed anonymously by 180 health care providers (nurses, physicians, social workers, and other allied health professionals). Almost all respondents (96%) reported knowledge of problem gambling, and 30% reported asking clients about gambling problems when they presented with stress related symptoms. A third of the respondents reported identifying and treating clients for a gambling problem. The most frequently reported intervention was referral to counseling and other gambling resources. Respondents were generally interested in learning more about gambling problems, particularly those providers who have had a client discuss gambling related concerns. There were no significant differences in findings between provider groups.

Although major efforts are underway to improve end-of-life care, there is growing evidence that improvements are not being experienced by those at particularly high risk for inadequate care: minority patients. Ethnic disparities in access to end-of-life care have been found that reflect disparities in access to many other kinds of care. Additional barriers to optimum end-of-life care for minority patients include insensitivity to cultural differences in attitudes toward death and end-of-life care and understandable mistrust of the healthcare system due to the history of racism in medicine. These barriers can be categorized as institutional, cultural, and individual. Efforts to better understand and remove each type of barrier are needed. Such efforts should include quality assurance programs to better assess inequalities in access to end-of-life care, political action to address inadequate health insurance and access to medical school for minorities, and undergraduate and continuing medical education in cultural sensitivity.

Over the past two decades, the majority of medical schools in the USA have embarked upon curricular initiatives to enhance the teaching of ambulatory or office-based primary care. Identifying characteristics of these primary care experiences that make for the most effective learning is a top priority in medical education research. In this paper we examine what is known about the influence of variability in the structure of primary care experiences on student learning outcomes. We examine the questions of how rotations are scheduled, who does the teaching and where the teaching takes place. Given the variability in curricula across the 125 accredited medical schools in the USA and the absence of agreed-upon objectives, outcomes or assessment measures for primary care education, it is not surprising that the current literature has fallen short in providing definitive answers. There is much debate about the benefits of community vs. campus sites, longitudinal vs. block experiences, and the influence of specialty training of the preceptor, but little in the current literature to guide and substantiate a programme's choice. What can be concluded with relative confidence is that clinics currently offer more active student experiences than do private offices, that students may be more satisfied with rural experiences than with urban or suburban experiences, and that longitudinal and block experiences have different learning advantages. Research in primary care medical education will benefit from the current movement towards a cross-institutional consensus on educational objectives and outcome measures and on the general application of a more rigorous research methodology.

To examine the pool of applicants to U.S. medical schools from 1974--1999 for changes in size and demographics and to identify factors that may be associated with such changes.

Data on characteristics of the total applicant pools to U.S. medical schools for 1974--1999 were collected from the Association of American Medical Colleges' Data Warehouse. Data on undergraduates' receiving bachelor's degrees and unemployment rates were obtained from the National Center for Education Statistics and the U.S. Bureau of Labor Statistics, respectively. Variables such as race/ethnicity, gender, age, and first time or reapplicant status were compared across the study period.

The percentage of women applicants increased from 20% of the pool in 1974 to 45% of the pool in 1999, while the percentage of men dropped from 80% to 55%. The number of underrepresented minority (URM) applicants increased 45% during the period, from 2,890 to 4,181, but URM applicants represented only 11% of the total applicant pool in 1999. Between 1974 and 1999, the number of URM men applying to medical school dropped by 18%, from 1,984 to 1,629, while the number of URM women nearly tripled, from 906 to 2,552. The number of Asian/Pacific Islander applicants increased dramatically, from 986 in 1974 to 7,622 in 1999, and they now represent a fifth of all applicants. The proportion of reapplicants grew when the applicant pool grew and it shrank when the applicant pool shrank. No relationship was found between the size of the applicant pool and economic indicators, age, or geographic origin.

Changes in the proportions of women and Asian/Pacific Islander applicants were the driving force in the expansion of the applicant pool between 1974 and 1999.

To develop and validate a survey instrument to measure medical students' career-related values.

A literature review yielded seven content domains that consistently correlated with medical students' career choices: biosocial orientation, bioscientific orientation, academic interest, prestige, income, desire to avoid role strain, and desire for role support. Item pools for the content domains were developed by examining previously published questionnaires and research and by interviewing health professionals, medical students, and premedical students. The instrument was tested in two phases. In phase 1, a 96-item questionnaire was mailed to all 847 students at the University of Minnesota School of Medicine. Results were submitted to item analysis and exploratory factor analysis. Construct validity of the questionnaire was assessed by (1) seeing if the seven scales correlated to one another in expected directions, (2) correlating students' survey responses with their self-reported interests in primary care, surgery, or radiology, and (3) seeing if anticipated sex differences were realized across the seven content domains. In phase 2, a random subgroup of 134 students was sent the final 46-item instrument twice to determine its short-term test-retest reliability.

In phase 1, 670 students (79.2%) returned usable questionnaires. Seven scales corresponding to the content domains emerged from factor analyses. Cumulatively, they accounted for 43.9% of the variance in students' responses, and their internal consistency coefficients ranged from.71 to.87. All scales correlated with one another in the directions expected and, with two exceptions, at highly significant levels. High scores on bioscientific orientation, prestige, and income scales correlated positively with students' interest in surgery or radiology careers, but correlated negatively with their interest in primary care. High scores on biosocial orientation and avoid role strain scales correlated positively with students' interest in primary care, but correlated negatively with students' interest in surgery or radiology. Women had higher scores than did men on biosocial orientation, avoid role strain, and role support scales and lower scores on bioscientific orientation, academic interest, prestige, and income. Of these, all but the difference in role support scores were highly significant. In phase 2, 89 students (66%) returned questionnaires. Test-retest reliability for the seven scales ranged from.83 to.92.

The seven scales pertaining to students' career-related values collectively demonstrated high internal consistency, short-term test-retest reliability, and evidence of construct validity. If predictive validity can be demonstrated in future research, the scales could have important applications for researchers, guidance counselors, and students, and they might also be useful to administrators who wish to identify students interested in primary care earlier in the students' training.

The authors describe the history, characteristics, and goals of four innovative programs, each in a medical school, that were established in 1998 to help faculty members of both sexes obtain mentors and thereby facilitate their career advancement. The programs were established as the result of an initiative by the Office on Women's Health (OWH) within the U.S. Department of Health and Human Services. Specifically, the OWH convened the National Task Force on Mentoring for Health Professionals, which determined that two principles are paramount to the success of any mentoring relationship or program: institutional commitment and institutional rewards and recognition to mentors. In accordance with the task force findings, the OWH created the National Centers of Leadership in Academic Medicine, one at each of four medical schools: MCP Hahnemann School of Medicine; the University of California, San Diego, School of Medicine; East Carolina University School of Medicine; and Meharry Medical College School of Medicine. The authors give highlights of each program's goals and progress, and note that, ideally, these programs will eventually serve as models for similar programs at other schools. Programs such as these foster the advancement of a diverse faculty, a more supportive academic environment, and the education of providers who are sensitive to the needs of all their patients, staff, and colleagues.

Medical schools' affirmative action policies traditionally focus on race and give relatively little consideration to applicants' socioeconomic status or "social class." However, recent challenges to affirmative action have raised the prospect of using social class, instead of race, as the basis for preferential admissions decisions in an effort to maintain or increase student diversity. This article reviews the evidence for class-based affirmative action in medicine and concludes that it might be an effective supplement to, rather than a replacement for, race-based affirmative action. The authors consider the research literature on (1) medical students' socioeconomic background, (2) the impact of social class on medical treatment and physician-patient communication, and (3) correlations between physicians' socioeconomic origins and their service patterns to the disadvantaged. They also reference sociological literature on distinctions between race and class and Americans' discomfort with "social class."