E5353. Innovation to Promote Lifelong Learning: Implementation of a Structured Prospective Case Follow-Up Initiative for Radiology Residents
  1. Marina Corines; Memorial Sloan Kettering Cancer Center
  2. Michio Taya; University of California San Francisco
  3. Andrew Schweitzer; New York-Presbyterian/Weill Cornell Medicine
  4. Harry Agress; New York-Presbyterian/Columbia University Irving Medical Center
Practice-based learning and improvement, an ACGME core competency and an essential component of lifelong learning, is challenging in diagnostic radiology as feedback on radiologists’ interpretations is variable and often suboptimal. Existing peer review and M&M conferences partially address this need but are limited by their retrospective nature. A prospective practice of case follow-up with subsequent imaging and clinicopathologic data mitigates hindsight bias and yields multiple educational advantages. Here we describe our experience with implementation of a structured prospective case follow-up program within our radiology residency curriculum and its educational benefits.

Educational Goals / Teaching Points
First, explain principles of case-follow up, emphasizing role in addressing ACGME core competencies for residents and unique advantages of prospective compared to retrospective follow-up. Second, describe goals and methodology for implementation of an innovative structured prospective case follow-up program into radiology residency curriculum. Third, discuss educational advantages of the prospective follow-up initiative during residency training.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
All residents recorded cases (at least one per week) on all clinical rotations where there was uncertainty regarding the diagnosis, equivocal findings, or the significance of findings. Case-relevant questions were recorded prospectively. To answer these questions, residents followed subsequent imaging findings, laboratory results, operative reports, pathology reports, and discharge summaries. All residents presented 2–3 cases and what they learned from each to residents and faculty over three 90-minute noon conference sessions. Cases were presented in an engaging first-person narrative format, in a positive atmosphere geared towards community learning.

A structured prospective case-follow up program has been successful in promoting individual habits of continually seeking feedback as well as a departmental culture of continuous practice improvement. Educational advantages included refinement of individual diagnostic thresholds, acquisition of discrete teaching points that alter approach to interpretation of future imaging studies, and obtaining unique insights into cognitive biases in radiologic reasoning, altogether improving diagnostic knowledge, confidence, understanding of clinical significance, curiosity, and personal involvement in patient care.