Beyond the Reading Room: Integrating Radiology into a Longitudinal Integrated Framework

IntroductionAlthough longitudinal integrated clerkship models have a growing evidence base and prevalence, the integration of radiology in such models is rarely explored. Institutions that have included radiology in longitudinal programs favor block rotation-style models, which do not capture longitudinal clinical care relationships with patients. We aimed to incorporate radiology learning objectives in a patient-centered and systems-based approach in a Longitudinal Integrated Clerkship pilot radiology program. MethodsMedical students participating in the Longitudinal Integrated Clerkship model (N=9) chose imaging encounters from their patient panel or longitudinal clinical experiences and coordinated individual reviews with radiology faculty. 25 unique imaging encounters were required for this pilot program. This replaced discrete, asynchronous half-day experiences across radiology subspecialties that did not leverage patients that Longitudinal Integrated Clerkship students saw in clinic. Post-encounter and end-of-clerkship surveys were distributed to pilot students, and feedback surveys were distributed to faculty. Results were analyzed using descriptive statistics; end-of-clerkship data was compared to three pre-pilot academic years. ResultsLongitudinal Integrated Clerkship students logged 237 unique radiology encounters with a maximum individual encounter log of 33 encounters and a mean of 26 encounters. All students were exposed to at least three of the most common imaging modalities: radiographs, computed tomography scans, and magnetic resonance imaging examinations. According to faculty evaluations, 100% of students were prepared for each imaging discussion and were above (39%) or at (61%) the level expected of their training. All students reported an increase in their skills and knowledge related to imaging or procedure indications. DiscussionLeveraging the Longitudinal Integrated Clerkship framework to include radiology experiences was feasible at our institution, and student and faculty survey responses suggest that students meet their faculty expectations and that the pilot provided students with improved radiology knowledge and skills.