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Society for Pediatric Radiology – Poster Archive
Final ID: Poster #: EDU-056
Opportunities and Challenges in Teaching Radiology in a New Radiology Residency in Rwanda
Purpose or Case Report: Review the experience teaching pediatric radiology to first year radiology residents in the first year of a new residency program in Rwanda.
One of the goals of the Human Resources for Health (HRH) program is to build a residency-trained physician workforce to create a sustainable health education infrastructure in Rwanda. Establishing a radiology residency program in a resource-poor African nation is a challenge being addressed by combining curricula from South Africa, Kenya, and United States and supplemented with ACGME materials. In Rwanda, the pediatric specialty is especially critical due to the high pediatric population as the country continues to recover from the 1994 genocide.
Approximately 12 months of general radiology training, visiting faculty offered a two-month rotation in pediatric radiology. To assess efficacy, a pre- and post-rotation evaluation program was implemented. Objective, case-based tests consisting of 100 cases were implemented on the first and last day of the eight-week rotation, which comprised from nine to fifteen hours of formal lecture and case-based teaching each week. A paired t-test was used to compare pre- and post-rotation test results.
View box examination scores for four first-year residents were recorded. Pretest mean: 27% (range 12-33% correct), Post-test mean 49% (range 27-62% correct), Average overall improvement: 22 percentage points (95% CI 12-32, p=0.005).
Pediatric radiology knowledge did not increase as much as would be expected for developed world learners under the same curriculum. Complicating factors leading to complexity include basic medical knowledge, number of learning hours at view box vs didactic lecture, and the inconsistent caseload mix at local hospitals. Expected routine cases in the Western world are not commonplace in Africa; however, more challenging cases such as ischiopagus tetrapus, accessory limb, and extensive fat necrosis are seen. Language and cultural barriers impede teaching and uptake of new information. Diagnosis and communication must consider social, financial, and nutrition limitations. Equipment limitations, coupled with supply shortfalls, frequently influenced the exam recommendations.
The challenges identified during this two-month experience should inform future efforts to teach medicine in low-resource countries. Curricula modifications may be needed to address language, social, financial and caseload challenges as well as equipment/resource shortages.
Methods & Materials:
Results:
Conclusions:
One of the goals of the Human Resources for Health (HRH) program is to build a residency-trained physician workforce to create a sustainable health education infrastructure in Rwanda. Establishing a radiology residency program in a resource-poor African nation is a challenge being addressed by combining curricula from South Africa, Kenya, and United States and supplemented with ACGME materials. In Rwanda, the pediatric specialty is especially critical due to the high pediatric population as the country continues to recover from the 1994 genocide.
Approximately 12 months of general radiology training, visiting faculty offered a two-month rotation in pediatric radiology. To assess efficacy, a pre- and post-rotation evaluation program was implemented. Objective, case-based tests consisting of 100 cases were implemented on the first and last day of the eight-week rotation, which comprised from nine to fifteen hours of formal lecture and case-based teaching each week. A paired t-test was used to compare pre- and post-rotation test results.
View box examination scores for four first-year residents were recorded. Pretest mean: 27% (range 12-33% correct), Post-test mean 49% (range 27-62% correct), Average overall improvement: 22 percentage points (95% CI 12-32, p=0.005).
Pediatric radiology knowledge did not increase as much as would be expected for developed world learners under the same curriculum. Complicating factors leading to complexity include basic medical knowledge, number of learning hours at view box vs didactic lecture, and the inconsistent caseload mix at local hospitals. Expected routine cases in the Western world are not commonplace in Africa; however, more challenging cases such as ischiopagus tetrapus, accessory limb, and extensive fat necrosis are seen. Language and cultural barriers impede teaching and uptake of new information. Diagnosis and communication must consider social, financial, and nutrition limitations. Equipment limitations, coupled with supply shortfalls, frequently influenced the exam recommendations.
The challenges identified during this two-month experience should inform future efforts to teach medicine in low-resource countries. Curricula modifications may be needed to address language, social, financial and caseload challenges as well as equipment/resource shortages.
Methods & Materials:
Results:
Conclusions:
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Poster____EDU-056.pdf
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