At many institutions, radiologists and physicists are often asked to provide educational content to staff, faculty and students in addition to clinical responsibilities. Through the development of web-based content, lectures and demonstration videos can be distributed throughout a medical enterprise and can be repurposed for multiple applications and audiences.
METHODSLectures were produced using a combination of PowerPoint™ for slideshows, Audacity™ for audio voiceover and iSpring™ for conversion of the materials to a video/web format. Produced content included the fundamentals of radiography, fluoroscopy, mammography and ultrasound physics. Over 350 short segments were created (~ 5-7 minutes each in duration). These shorter segments were believed to benefit over longer lectures for maintaining attention and ease of navigation for review.In addition, approximately 70 short quality control videos (ranging in 1-3 minutes in length) were created using digital video cameras and Final Cut Pro™ editing software. Topics focused on routine technologist and physicist equipment testing procedures.Total content was approximately 3 GB in size. Ultrasound content (140MB) was placed on an internal hospital web-server and HTML links were sent to attendees. In some cases, distribution on the enterprise web servers was not feasible due to bandwidth and security restrictions and therefore materials were dispensed on USB or CD media.Approximately 3000 multiple choice review questions were created using the Moodle™ learning management system to supplement the content. The system was hosted on an externally accessible website to provide greater access. Short quizzes were created that randomly pulled items from this question bank.
RESULTSContent was assembled based on the audience and need. Approximately 35 hours of radiography and fluoroscopy lectures were integrated into flipped undergraduate radiologic technology (RT) physics courses. 4 hours of mammography and ultrasound content was distributed separately to radiology residents and medical physics graduate students. 20 hours of fluoroscopy–specific content was reassembled for physicians specializing in pain management. A 20 hour radiographic review guide was distributed to RT students in preparation for their national exam.While no official outcomes or surveys were obtained from residents, fellows or medical physics graduate students, the content was generally well received. However, informal canvassing of fellows and residents showed a preference toward in-class training compared to video delivery.RT course final examination scores were tallied between 2001 and 2015 and showed improvements with the flipped RT classes compared to the in-classroom experience. On average, students performed 13% better for the subjects covered in the quality control videos and 8% better for didactic lectures covering radiography and fluoroscopy.The RT program’s national certification examination scores (ARRT-R) in physics-related categories showed an average improvement of 0.15 points (0-10 point scale) on the exam. Although this was not a statistically significant improvement it was also combined with a 60% increase in class size. (from 13.8 pre-flip to 22.7 students post-flip)
CONCLUSIONCreation of web-lectures and video segments requires extensive up-front work but accessibility of screen capture and slide conversion software can make this transition easier. The repurposing of the content to multiple audiences can reduce the additional overhead in teaching especially when courses and content repeat on a year to year basis. As radiological procedures become more widespread throughout an institution, an even greater need for this type of training will exist.In the RT program it was seen that despite an increase in class size the flipped classroom produced an improvement in academic exam performance. This was believed to be from the ability to review content multiple times and at a pace to each student’s preference. While it is debatable to use the standardized test scores as a metric of student aptitude, flipping these classes appears to show promise and does not seem to have an adverse effect on national exam scores.With increased class sizes, hands-on quality control experiments can be difficult to manage and coordinate by a single instructor due to limitations on specialized test equipment, radiographic phantoms and x-ray room size. The video segments allowed all students to experience the same “over-the-shoulder” view of the experimental setup.In the evolving radiology department, equipment and technology will change over time. The creation of legacy videos allows students to gain some experience for systems no longer available. In this video library, testing with film processors (e.g: sensitometry, specific gravity) and analog systems (e.g: film/screen contact, mammography spatial resolution) are still reviewable for historical purposes.