Training cardiovascular specialists in imaging: a curriculum based on fundamental concepts required for multimodal imaging.
ABSTRACT Training cardiovascular (CV) imaging specialists is becoming increasingly complex owing to rapidly emerging technological advances and the growing recognition that single modality training is inefficient and results in suboptimal education and practice. The purpose of this document was to propose a multimodality CV imaging curriculum to improve training of future CV imaging specialists.
Relevant national standards relating to aiming training, competence, and quality were reviewed, including current training recommendations from the American College of Cardiology and requirements from the Accreditation Council for Graduate Medical Education. Experts from all imaging modalities identified areas of commonality that could create efficiencies in training. Finally, the proposed curriculum was placed within the context of a standard 3-year fellowship training program with optional advanced imaging training.
Multimodality imaging training can be accomplished efficiently and effectively for most trainees by introducing a curriculum of imaging didactic content broadly based on understanding basic cardiovascular anatomy and physiology, principles of performing quality CV imaging, and imaging in the broader health care environment. A curriculum and training program are proposed that satisfy level 2 training in 2 to 3 modalities and level 3 training in 1 modality in a traditional 3-year fellowship.
Training cardiovascular specialists to be competent in multimodality imaging is possible based on the proposed curriculum and training program within a traditional 3-year cardiovascular fellowship. Imaging specialists may require additional training.
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ABSTRACT: Comprehensive training in cardiac imaging during radiology residency is imperative if radiologists are to maintain a significant role in this rapidly growing field. In this study, radiology chief residents were surveyed to assess the current status of cardiac imaging training in radiology residency programs. The responses to this survey may be helpful in understanding current trends in cardiac imaging training and how such training can be improved in the future. Chief residents at accredited radiology residency programs were sent an e-mail with a link to a 17-question Web-based survey. The survey assessed the organization of cardiac imaging training in each residency program, imaging modalities incorporated into cardiac imaging training, the role of residents on cardiac imaging rotations, and attitudes of residents about their cardiac imaging training and the future of cardiac imaging. Responses were obtained from 52 of 112 (46%) programs. Seventy-one percent had at least one dedicated cardiac imaging rotation during their residencies. Fifty-two percent and 62% of respondents reported <5 hours of cardiac imaging-related case conferences and didactic lectures per year, respectively. Most had cardiac computed tomography or magnetic resonance imaging incorporated into their cardiac imaging training. Although 92% felt that cardiac imaging training is important, only 17% felt that they currently received adequate training in cardiac imaging. The majority of residency programs represented in this survey had at least one dedicated cardiac imaging rotation for their residents. Most of these programs had few cardiac imaging-related conferences and lectures per year. Although most chief residents believed that cardiac imaging training is important, only a minority felt that they currently received adequate training in cardiac imaging.Academic radiology 06/2010; 17(6):795-8. · 2.09 Impact Factor
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ABSTRACT: The prototype for the cardiovascular imager has evolved to necessitate some degree of competency in multimodality imaging (MMI)-defined as expertise in at least 2 of the 4 modalities (echocardiography [ECHO], nuclear cardiology [NUC], cardiovascular computed tomography [CCT], and magnetic resonance [CMR]). Uncertainty exists about the effects of this change. Information detailing the current totals of board-certified practitioners in MMI was collected and organized into groups of 1, 2, and 3 modalities. A randomized stratified sample of names was obtained to identify a representative 10% of each group. Those names were cross-referenced online with information from state medical boards, faculty rosters of academic medical centers, and physician tracking Websites. There are a total of 2209 board-certified MMI practitioners (2 modalities = 1885, 3 modalities = 324) and 6450 single-modality imagers in the United States. Of those sampled, 98.9% were cardiologists, 31.3% were at academic medical centers and mean time from medical school graduation was 17.75 years. MMI practitioners were more likely to have graduated from medical school more recently (P < 0.0001) and to be trained cardiologists (P = 0.003) than those who practice in a single modality. There was a nonsignificant trend toward MMI being practiced more commonly in an academic setting (P = 0.38). Board-certified specialists in MMI tend to be younger cardiologists than those engaged in single-modality cardiac imaging. There are few advanced (3 modality) MMI practitioners in the United States.Echocardiography 12/2013; · 1.26 Impact Factor
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ABSTRACT: To prospectively evaluate the effect of experience with coronary computed tomographic (CT) angiography on the capability to detect coronary stenoses of 50% or more. The institutional review board approved the study protocol. All patients gave consent to undergo CT angiography before conventional coronary angiography after being informed of the additional radiation dose. They also consented to the use of their data for future research. Three radiologists and one cardiologist inexperienced with coronary CT angiography attended this institution's cardiac CT unit for a 1-year fellowship. Fellows were involved in the acquisition and reading of 12-15 coronary CT angiograms per week (about 600 per year). To assess the progression in diagnostic performance, fellows (readers) independently read 50 CT angiographic test cases in patients who also underwent conventional coronary angiography. Cases were repeatedly assigned in random order at baseline and at 4, 8, 26, and 52 weeks. The same cases were examined by two experts in consensus. Sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated and compared with conventional coronary angiography as the reference standard. Respective reader ranges for sensitivity, specificity, and DOR were 33%-72%, 70%-94%, and 3.8-8.1 at baseline; 43%-80%, 71%-88%, and 8.8-15.2 after 6 months; and 66%-75%, 87%-92%, and 14.7-25.8 after 1 year. For expert physicians, respective results were 95%, 93%, and 255.9. Between baseline and 6 months, readers 1-3 showed nonsignificantly improved sensitivities, while specificities remained similar. Reader 4 showed significantly improved specificity, while sensitivity remained similar; all readers nonsignificantly improved DORs. Between baseline and 1 year: readers 1 and 2 significantly improved sensitivity but not specificity; reader 4 significantly improved specificity but not sensitivity; readers 1, 2, and 4 improved DOR significantly; reader 3 nonsignificantly improved sensitivity, specificity, and DOR. Increasing experience with coronary CT angiography improved the diagnostic performance of inexperienced physicians. However, acquiring expertise in coronary CT angiography was slow and may take more than 1 year.Radiology 06/2009; 251(2):359-68. · 6.21 Impact Factor