Effectively Incorporating Peer Teaching to Improve Radiology Education— Radiology In Training
2022; Radiological Society of North America; Volume: 303; Issue: 3 Linguagem: Inglês
10.1148/radiol.212052
ISSN1527-1315
Autores Tópico(s)Clinical Reasoning and Diagnostic Skills
ResumoHomeRadiologyVol. 303, No. 3 PreviousNext Reviews and CommentaryFree AccessPerspectivesEffectively Incorporating Peer Teaching to Improve Radiology Education—Radiology In TrainingEric L. Tung , Laura L. AveryEric L. Tung , Laura L. AveryAuthor AffiliationsFrom the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114.Address correspondence to E.L.T. (e-mail: [email protected]).Eric L. Tung Laura L. AveryPublished Online:Mar 8 2022https://doi.org/10.1148/radiol.212052MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Dr Eric L. Tung is a chief resident in the department of radiology at the Massachusetts General Hospital (MGH). He is an aspiring pediatric radiologist who is passionate about medical education. He currently serves as a member of the MGH Clinician Educator Track and enjoys teaching radiology to Harvard medical students.Download as PowerPointOpen in Image Viewer SummaryAlthough not traditionally associated with radiology education, peer teaching is a valuable educational opportunity featuring evidence-based benefits for trainee participants and many applications in radiology training when facilitated by attending physicians.IntroductionTraditional radiology education features three central components: case-based learning in the reading room, didactic case conferences and lectures, and self-directed studying. One educational technique not typically associated with resident education is peer teaching, a strategy where learners are educated by their peers (eg, trainees of the same postgraduate level). Similarly, near-peer teaching features trainee educators with slightly more experience than the learners (eg, resident educators at a higher postgraduate level). These educational techniques have unique and evidence-based benefits for both trainee instructors and learners, and should be regularly incorporated into radiology resident curriculum.Benefits of Peer TeachingBenefits for TeachersTeaching forces educators to engage with material in unique ways, promoting deeper processing of information. In preparation for lectures, teachers frequently reflect on their own understanding of lecture content to competently teach this material. The self-reflective nature of teaching and its requirements to logically organize, clearly describe, and answer questions about a topic promote deeper understanding and mastery of the material. Radiology residents who have served as peer educators identified preparing and delivering lectures as a highly effective method of learning (1). One study showed that medical students who engaged in peer teaching demonstrated increased knowledge retention of teaching material compared with those who did not, an effect that persisted 60 days after teaching sessions (2).Another benefit of peer teaching for educators is the opportunity to hone teaching skills. Academic radiologists are tasked with teaching trainees, whether informally at the workstation or formally in a classroom setting. All radiologists, even those outside of academia, benefit from refined teaching skills, which can translate into more effective consultation with referring providers. While radiologists receive rigorous training on imaging interpretation, few receive formal training in medical education despite its importance to their profession. Peer teaching provides valuable opportunities to foster teaching skills, especially when supplemented with structured teaching feedback and formal education seminars, as featured in clinician-educator tracks offered by some residencies (3,4). Opportunities for radiology residents to teach during residency promote enthusiasm for teaching and inspire pursuit of academic radiology careers (5).Benefits for LearnersRadiology education is enhanced when taught by instructors familiar with their learners' level of knowledge. Attending educators, some of whom may have decades more experience than trainees, may be more susceptible to the "curse of knowledge" while teaching, the belief that learners know more than they actually do. Given their proximity to learners' level of training, peer educators can empathize with their audience, resulting in presentation of highly practical material. Additionally, learners may feel more comfortable asking honest questions or engaging in active learning with peer instructors compared with attending instructors.Radiology educational activities employing peer teaching have proven effective in teaching residents, as demonstrated by knowledge assessments (6) and qualitative surveys (1,5,7–9). Radiology resident learners have reported higher satisfaction with peer-teaching educational experiences than conventional teaching methods (1,7). Despite often lacking formal teaching training, radiology resident peer educators have been perceived as effective, knowledgeable, and helpful teachers by learners (8,9) and were at times preferred to faculty educators (7,9). A systematic review analyzing 19 studies concluded that when applied in select scenarios, peer teaching in undergraduate medical curriculum achieves equivalent student learning outcomes when compared with conventional teaching methods (10).Other BenefitsThe advantages of peer and near-peer teaching extend beyond the learning environment. Peer teaching can improve camaraderie among trainees, fostering both professional relationships and friendships (7). Learning from near-peer teachers can allow trainees to appreciate the expertise that they will soon develop and inspire them to serve as future peer educators (7,8).Resident peer teaching can benefit attending physicians by reducing their teaching load (7). Teaching is valuable but time intensive. With the increasing volume of imaging studies, attending radiologists may better manage increasing clinical demand if some of the Accreditation Council for Graduate Medical Education–required structured educational responsibilities are shared with trainees.Potential Pitfalls of Peer TeachingWhile peer teaching in medical education has many strengths, the inexperience of trainee teachers regarding clinical knowledge and teaching experience may be a disadvantage. Faculty educators with greater knowledge and practice experience are often better equipped to answer learners' questions, offer nuanced and expert opinions, and include personal anecdotes or interesting patient cases to enhance their teaching. Trainee instructors who are still learning are more likely to inadvertently teach incorrect information. Faculty instructors with greater teaching experience may design more effective educational materials and better use pedagogical techniques to engage learners.One solution to circumvent these pitfalls related to inexperience is to involve attending physicians in the design and implementation of radiology peer-teaching activities. In this case, although peer teaching may reduce the teaching load of attending physicians, their time investment required for successful implementation of peer-teaching curriculum may still be substantial. Nevertheless, attending involvement in curriculum planning would decrease the demands on resident educators without detracting from the peer-teaching experience. Attending physicians often have collections of lectures that have been delivered and refined over many years, which could serve as a starting point for trainees tasked with developing presentations on subjects they are still mastering. Radiology residencies can build and maintain a repository of lectures contributed by attending physicians to be used repeatedly for peer-teaching activities. This would facilitate the preparation work of the trainee and ensure that information in the final curriculum is likely to be complete and correct.The involvement of attending radiologists in the design and implementation of peer-teaching activities is critical to combat peer instructor inexperience, as their clinical expertise and educational resources can provide a strong foundation for lesson planning. Active attending supervision of peer-teaching activities creates opportunities to add clinical context, clarify difficult questions, and provide teaching feedback to trainee educators. Implementing peer teaching at an appropriate frequency can prevent overburdening trainee educators with lesson preparation.Incorporating Peer Teaching into Radiology TrainingThere are many opportunities to integrate peer teaching into radiology resident education (Table). Senior residents are ideal instructors for introductory lecture series targeting 1st-year radiology residents given their familiarity with the junior residents' elementary radiology knowledge and the clinical demands of resident rotations (8,9). Attending-radiologist consultation in introductory radiology lecture planning is invaluable in ensuring accuracy and providing educational example cases.Opportunities to Incorporate Peer and Near-Peer Teaching in Radiology Resident EducationSimilarly, near-peer instructors have been effective in call preparation for junior residents, in part because of their profound awareness of the learners' level of knowledge and practical concerns when facing this new responsibility (5). Senior radiology residents at the University of Maryland (Baltimore) successfully implemented an online course to prepare 1st-year residents for calls that featured scrollable emergency radiology cases and virtual readouts (5). Attending radiologists were critical to its success by vetting cases and instructional materials before presentation. Among the resident learners, 100% found the activity effective and 78% expressed interest in expanding this type of educational activity to other subspecialties.Peer teaching has been successfully implemented for more complex radiology topics, such as physics, with increased attending involvement and supervision. The University of Pittsburgh (Pittsburgh, Pennsylvania) radiology residency created a resident-led physics curriculum where near-peer educators facilitated small group sessions reviewing RSNA and the American Association of Physicists in Medicine physics modules (1). While senior residents led the sessions, clinical faculty and medical physicists were present to provide expert opinions when needed. At the University of California, San Francisco, senior radiology residents similarly served as near-peer teachers in a radiologic physics lecture series targeting 1st-year residents (7). Program faculty developed and oversaw the implementation of the course while residents were responsible for organizing and teaching course material. In-service examination physics scores significantly improved after the implementation of both of these near-peer teaching activities (1,7).Hands-on demonstrations of imaging or interventional radiology techniques are excellent opportunities for peer teaching given their requirement for multiple facilitators. At the University of Pennsylvania (Philadelphia), workshops facilitated by senior residents were successfully implemented to improve knowledge of and comfort with musculoskeletal US examinations for residents of all levels (6). To ensure adequate resident instructor preparation, an attending musculoskeletal radiologist provided background reading material to and led two 1.5-hour-long training sessions with resident educators. Additionally, the attending radiologist was present to supervise these workshops.Educational activities led by attending radiologists can still incorporate the principles of peer and near-peer teaching. One strategy during attending-led case conferences is to have cases taken in small groups comprised of trainees of different levels. The junior trainees with the least amount of experience can provide initial input, and senior residents can provide feedback and additional insight. The attending radiologist can monitor these small group discussions, offer expert insight, and review each case as a full group. This tactic promotes collaboration through near-peer teaching while decreasing anxiety of the traditional "cold-calling" strategy that can distract from productive learning.ConclusionPeer teaching in radiology offers important, unique, and evidence-based benefits for all residents. However, attending supervision and consultation is critical to avoid pitfalls related to resident educator inexperience. Learning from successful examples set by many programs, radiology residencies should incorporate peer-teaching activities to enhance resident learning and create opportunities to foster teaching skills and passion for education.Disclosures of Conflicts of Interest: E.L.T. No relevant relationships. L.L.A. No relevant relationships.References1. Shankar PR, Woodard J, Heller MT, Agarwal V, Orons PD . Implementation and outcomes of a resident-led physics curriculum with integration of the RSNA/AAPM physics modules. Acad Radiol 2013;20(10):1306–1310. Crossref, Medline, Google Scholar2. Gregory A, Walker I, McLaughlin K, Peets AD . Both preparing to teach and teaching positively impact learning outcomes for peer teachers. Med Teach 2011;33(8):e417–e422. Crossref, Medline, Google Scholar3. Naeger DM, Phelps A, Shah V, Avrin D, Qayyum A . Clinician-educator pathway for radiology residents. Acad Radiol 2011;18(5):640–644. Crossref, Medline, Google Scholar4. Mendoza D, Peterson R, Ho C, Harri P, Baumgarten D, Mullins ME . Cultivating Future Radiology Educators: Development and Implementation of a Clinician-Educator Track for Residents. Acad Radiol 2018;25(9):1227–1231. Crossref, Medline, Google Scholar5. McRoy C, Patel L, Gaddam DS, et al . Radiology Education in the Time of COVID-19: A Novel Distance Learning Workstation Experience for Residents. Acad Radiol 2020;27(10):1467–1474. Crossref, Medline, Google Scholar6. Berko NS, Le JN, Thornhill BA, et al . Design and Validation of a Peer-Teacher-Based Musculoskeletal Ultrasound Curriculum. Acad Radiol 2019;26(5):701–706. Crossref, Medline, Google Scholar7. Kansagra AP . Early resident-to-resident physics education in diagnostic radiology. J Am Coll Radiol 2014;11(1):59–62. Crossref, Medline, Google Scholar8. Dolan RS, Theriot D, Mendoza D, Ho C, Mullins ME, Peterson RB . Developing a Resident-led First-year Radiology Resident Lecture Series. Curr Probl Diagn Radiol 2020.https://doi.org/10.1067/j.cpradiol.2020.10.010. Published online November 15, 2020. Google Scholar9. Gaetke-Udager K, Maturen KE, Barr DC, Watcharotone K, Bailey JE . Benefits of a resident-run orientation for new radiology trainees. J Educ Eval Health Prof 2015;12 24. Crossref, Medline, Google Scholar10. Yu TC, Wilson NC, Singh PP, Lemanu DP, Hawken SJ, Hill AG . Medical students-as-teachers: a systematic review of peer-assisted teaching during medical school. Adv Med Educ Pract 2011;2(2):157–172. Medline, Google ScholarArticle HistoryReceived: Aug 12 2021Revision requested: Sept 7 2021Revision received: Nov 30 2021Accepted: Dec 7 2021Published online: Mar 08 2022Published in print: June 2022 FiguresReferencesRelatedDetailsRecommended Articles Fellowship Training: Navigating the Decision to Be a Generalist or a Subspecialist—Radiology In TrainingRadiology2022Volume: 305Issue: 2pp. E63-E65Creating a Radiology Quality and Safety Program: Principles and PitfallsRadioGraphics2018Volume: 38Issue: 6pp. 1786-1798The Future of Radiology ConsultationRadiology2016Volume: 281Issue: 1pp. 6-9Opioid Use and Respiratory Compromise in the Interventional Suite: A Wake-up CallRadiology2019Volume: 292Issue: 3pp. 711-712Why and How to Increase Diversity in the Radiology Trainee WorkforceRadioGraphics2022Volume: 42Issue: 3pp. E82-E85See More RSNA Education Exhibits Feeling the Burn: Occupational Burnout in Interventional RadiologyDigital Posters2020Mastering Basic Machine Learning Principles Without Coding Experience: A Tutorial on Googles Teaching MachineDigital Posters2022The Radiology Patient Experience: Key Concepts And Strategies To Maximize SuccessDigital Posters2021 RSNA Case Collection Superior Vena Cava SyndromeRSNA Case Collection2020AchondroplasiaRSNA Case Collection2020Agnathia-otocephaly complexRSNA Case Collection2021 Vol. 303, No. 3 Metrics Altmetric Score PDF download
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