The radiology academiesBMJ 2007; 335 doi: https://doi.org/10.1136/bmj.335.7615.s62 (Published 18 August 2007) Cite this as: BMJ 2007;335:s62
Ben Rock describes academy training for the 21st century
Three new radiology academies based in Plymouth, Norwich, and Leeds opened in 2005. What are they like and how do they differ from traditional training?
What is a radiology academy?
The radiology academies are an innovation in specialist training. In simple terms, they are schools for training radiologists through a mixture of clinical experience, computerised tutorials, simulators, use of archive material, and classic teaching methods. They are an integral feature of the Radiology-Integrated Training Initiative (R-ITI)—a collaboration between the Department of Health, the Royal College of Radiologists, the NHS, and existing training schemes, which aims to increase the number of trained clinical radiologists to reduce a perceived bottleneck within the hospital system caused by patients waiting for radiological investigations.
How does a radiology academy work?
The storable nature of x ray films underpins the existence of the radiology academies: over the years a vast archive of radiological experience has been amassed, initially in the form of x ray films and more recently as digital pictures. This process has been facilitated immensely by the digital revolution and the nationwide implementation of the picture archiving and communication system (PACS), which allows digital storage and transfer of radiographic images. Thus every patient who has a radiological investigation adds to the image pool. This film archive enables trainees to gain experience without the need for a patient to be present. While in other specialties experience can often be gained only by meeting a patient who has a given condition, in radiology a trainee can gain experience of the radiological presentations of virtually any condition which has been imaged by recalling the films.
This raw pool of experience is being amalgamated into a formal archive known as the validated case archive (VCA). This is an electronic museum of examples of normal anatomy, normal variants of anatomy, and pathological presentations that have been validated, both through screening by consultant radiologists and through histological diagnoses. Users will be able, for instance, to search for examples of a given pathology or test themselves at identifying radiological abnormalities on a given film and generating a diagnosis.
Electronic learning database
This bank of radiological experience is complemented by the electronic learning database, a series of electronic tutorials written by experienced radiology trainers. These electronic tutorials cover the theory required to interpret radiological investigations and do radiological procedures, and equip trainees with the knowledge needed to make use of the archive.
These learning tools complement existing training methods. Thus, academy trainees spend half their time using these new learning resources and half their time in a more traditional apprenticeship within the radiology department.
These facilities have a number of advantages: they ensure consistency in training and permit self directed learning, enabling trainers to maintain service commitments within the NHS. The progress of trainees can be reviewed electronically by monitoring their use of the various resources and through electronic assessments, allowing validation (and revalidation) of learning.
Day in the life of an academy trainee
Each academy has a similar syllabus of learning—defined by the standards required of a clinical radiologist by the Royal College of Radiologists. However, the exact way in which this syllabus is delivered varies between institutions.
For example, trainees may spend a month in the academy followed by a month in a hospital based within the rotation, gaining hands-on practical experience and putting skills that have been learnt in the academy into clinical context.
While in the academy, a typical day may involve the following:
Film reporting. This may include “hot” films of “real” patients, such as the previous day's accident and emergency plain films, allowing a service provision to the attached hospitals. It may also include reporting of “cold” PACS or VCA cases set by the trainer—for example, on more complex investigations such as computed tomography, magnetic resonance imaging, and ultrasound
Electronic tutorials via the electronic learning database—for example, a trainer may assign a trainee a worklist of archive computed tomograms of various presentations of lung cancer, for which the trainee can prepare by completing an electronic tutorial on radiographic appearances of lung cancer
The use of simulators—for example, angiography simulators allow trainees to become familiar with techniques, equipment, and anatomy before hands-on experience with real patients within the hospital. Ultrasound simulators allow the practice of interventional techniques such as nephrostomies and biopsies, while practice in diagnostic ultrasound techniques can be gained using volunteers
Classic teaching methods such as lectures, tutorials, and the use of literary resources are also accessed electronically using online texts, electronic lecture theatre equipment, and the potential for live video link-ups with a hospital and other academies.
In summary, the radiology academies offer an innovative solution to the problem of balancing training with experience. While training can lead to competence, only experience can lead to proficiency, and the academies aim to achieve this balance through the combination of electronic training resources, experience afforded by the radiological archive, and a traditional apprenticeship.
Thanks to Dr Bruce Fox for his advice and comments in writing this article
Competing interests: BR is a trainee at the Peninsula Radiology Academy.