E1921. Do Online Electives Add Value to In-Person Radiology Electives if Medical Students Have Dictating Privileges?
  1. Katie Harris; Memorial University of Newfoundland
  2. Angus Hartery; Memorial University of Newfoundland
Traditional medical student radiology electives are predominantly observerships with dictation privileges only granted to residents. Previous publications have argued for implementing senior medical student dictation privileges to increase on-site radiology elective engagement. However, during COVID-19, many schools across Canada and the United States moved their radiology electives for senior medical students to an online format, with great success. Students reported improved engagement during online modules due to their active role in image interpretation. To the best of our knowledge, comparison of student engagement at a site where the 2-week on-site elective has both dictation privileges and an online component has not been completed.

Materials and Methods:
Using the cohort of 2021 - 2022 at one Canadian site, we analyzed the pre/posttest data from the online component of the radiology elective, summed the elective student dictation reports, and performed thematic analysis on standardized feedback forms provided to students post-elective. We used a generalized linear mixed model (GLMM) to compare student scores on pre- and post-module section quizzes, accounting for individual and section-specific variation in performance. A second GLMM was fit to assess differences in a cumulative test taken before and after the entire elective.

Forty-six students completed at least one on-site radiology elective at our site from August 2021 - June 2022. Only 4 students (9%) dictated films during their elective, despite all students having access to dictating software. Forty-five students (98%) fully completed the online component of the elective in tandem with their clinical duties, with significant improvements in percentage points on section quizzes (ßpost = 15.9%, p < 0.001) and the cumulative test (ßpost = 28.1%, p < 0.001). Students reported that the online portion of the elective was highly engaging and tailored to their learning needs, while dictation privileges were not mentioned in the post-elective feedback.

Dictation privileges, while theoretically likely to increase in person student engagement, were under-utilized at our center. Small numbers of student-dictated reports precluded a full statistical analysis of dictation privileges versus online teaching. However, the online elective component, implemented during the COVID-19 pandemic, continued to provide increased engagement and learning in a low pressure setting even after return to fully on-site electives. This retrospective study suggests that resources should be directed to the development of mixed online/in person electives for ideal student engagement at the senior medical student level. Future work should focus on the benefits of and barriers to student dictation at the senior medical student level.