This is the session on the future of radiology education and sort of innovations in education. And I'm Dr. Priscilla Simon, your moderator. And I'm gonna give you a brief, like literally five minute overview so you know sort of the structure and what to expect as part of this session. And I have no disclosures. So this is the learning objectives that we had created for this session. So we're gonna envision how to interact with learners and educators across space and time. That sounds kind of fun. We're gonna incorporate some effective evidence-based active learning techniques into workstation teaching and didactic hybrid presentations. And also talk about how can we design creative sessions to teach non-interpretative skills. Because I think for many of us, those are kind of the most challenging areas. How do you actually teach those non-interpretative skills that all of us are supposed to have? So I actually think the field of radiology is kind of like the sorcerer's apprentice here. We have the radiologist here doing all this magic as we're interpreting imaging. And we've got those eager students and trainees who are like, wow, I wanna be like that person. And so that person enters into our training programs and they start practicing and practicing and practicing. And we as educators try to keep them up to speed. But sometimes we fail them and they kinda get a little overwhelmed. But that's where we need to step in so that by the end of residency and fellowship training, we're sending them out as very competent and confident radiologists to join our workforce and really become the next generation of leaders, whether that's leading in education, research, advocacy, or administration. So this session's all about how can we as educators become more innovative, engage our learners so that they really do graduate and really join and make meaningful contributions to the workforce. So as I was thinking about this presentation, what are our challenges? Because as a 21st century radiology educator, we all face some challenges. There are definitely generational differences that we feel as the teacher. So many of us, we were educated years ago in using very different methods. So some of us are very technologically naive. We tend to sometimes really rely on that Socratic method of sort of not necessarily pimping, but asking very directed questions that may not be perceived very well from our adult learners of this new generation that have very short attention spans. There's clearly been a lot of tools and techniques that have come along the way, audience response being one of them, but gaming. But there are some really good low-tech methods to really engage our learners. And then more importantly, with the pandemic, we're now facing variable settings. So it's not just in-person teaching. We actually have to deal with the virtual audience and the hybrid audience. And so how do you really create those safe learning spaces in those different variable settings? How do you engage your learners, and how can you become more effective at teaching? So that's what this session's about. So just a couple quick things on creating that safe learning space. You need to know what defines a safe learning space. Clear expectations. So your presentations, whatever you're doing, have to have clear learning objectives. You need to be non-judgmental, and it needs to be a space where people are safe to ask questions so that people are willing to take risks. So you need to really set up your learning space so that failure is actually viewed as an opportunity to grow. You need to focus on team-based collaborative learning. That's what our adult learners like. They like to work in groups and do things collaboratively. So encourage teamwork. If you're doing a case-based conference, encourage phone a friend, pass the pointer, or set up a team-based approach so you have teams competing with each other on the cases. And embrace that learner diversity, which I think is one of the challenges that we all face. You really need to know your learners. And if you have introverts in your audience, you need to give them a role, because otherwise they're not gonna speak up or engage at all. And you also need to know how to kind of quiet down some of those extroverts that may take over the conversation. So how do you move from passive to active learning? One of the things that many of you are probably well aware of is the flipped classroom where you give somebody an assignment, but no more than 20 or 30 minutes. So and then you may actually even assess them with some kind of quiz or assignment they have to complete prior to the session. And then the session's really an active session where you're basically having some kind of in-class activity to apply that content or new knowledge. If you're interested in the flipped classroom, these were just three papers that have been recently published that I think are a really good resource if you wanted to start engaging in this way. And of course, you can always incorporate technology. And one of our speakers later this morning will be talking about sort of how to use that effectively. Now to become a more effective teacher, one of the things I've learned over the years is that you really need to watch the master teachers. You can learn a lot on how do they engage learners? How do they set up a good group dynamic? What kind of strategies are they using in their teaching? And one of the things you can do is something called peer observation where you can actually pair yourself with another teacher or maybe a small group of teachers. And each of you can take turns observing the person, not for the content of their talk, but how they go about teaching. And then debriefing afterwards and sharing what worked, what didn't work, why did you do it that way? To really discuss the actual element of teaching. So this has actually been shown to really make people better teachers very quickly and is something that you definitely should consider incorporating into your sort of armamentarium. Because we all wanna be innovators in radiology education and all of you in this room, I believe, can become innovative. You need to, though, sort of embrace the concept of experimentation in your teaching, be willing to share your ideas with others, be open to getting feedback. So we welcome feedback from all of you. If we did something really well, let us know, but if we could have improved, that's actually really, really helpful. And be open to sort of learning from your colleagues because that's how we're gonna be innovative in our education. This is where we were years ago. I remember this is how I learned. I sat in the back row and just watched people reading off images off the alternator. Now we have many places where we're teaching, small groups, the larger workstations, reading rooms. We still have conferences. We're doing virtual conferences. There's a lot of online interactive tools that are out there and there's also a lot of hands-on teaching. So where are we going? I actually suspect, which we're not gonna get there today, but AI is probably gonna play a role even in education. We're gonna probably be able to assess learners where they are and the AI algorithm's gonna allow them to grow at different rates so that we'll have more developmentally appropriate sort of education so that everybody will eventually get to the same milestone but some may get there faster and some may take a little longer and that's okay. So here's my challenge for you guys today. We are going to have a question and answer kind of session at the end but really I want people to engage and share some of the things that they do in addition to what you hear about from the panel today. And I also want all of you to go home with one or two things that you actually might do back at your home institution or your home practice as you're teaching, an experiment. So you gotta go home with one or two things. We're gonna have four talks, how to transform your virtual lectures with interactive tools, new horizons for peer learning, tips and tricks to efficient teaching at the workstation, which is very challenging these days given how busy we are clinically. And then we're gonna hear from our last speaker once upon a time how to use storytelling and other means to sort of teach some of those difficult non-interpretive sessions. Zoom's a mixed bag and at its best it feels like there's two of you and you can get a lot done. And it has a lot of features but really sometimes it's just we like to have coffee at home, right? That's kind of the best of it. Zoom fatigue is everywhere. We can accept that the technology's great but there's something hollow about the experience oftentimes and so what I want to focus on is how do we make that richer? How do we bring richness to the technology? And one model about thinking about new technology is when you have a new technology, you could just substitute, use the technology, do what you could do without the technology. But then you could also think how could we augment the experience, modify the experience, or completely redefine the experience so we could do something totally different with the technology. And for simplicity I'm just gonna say we're gonna use the technology to substitute or to transform. And with all of this, with our interactive tools, the polls and the whiteboards, we're gonna look to build shared experiences. That is we want to bring the togetherness back in these learning experiences. We all give lectures and so for me in this format we'll think about a lecture in three phases. At the beginning we're gonna try to activate our learners. In the middle we lecture and we're gonna sprinkle in activities and at the end we're gonna look for ways to build a review together. So the literature says that if we activate what the learners already know, then they're gonna remember it longer. It's gonna stick more. So we're gonna look for ways to activate prior knowledge at the beginning and then you can use the time to connect with your learners, teacher to learner. So simple things that you can do with or without technology. If you gave them some homework or in a flipped classroom you could have a poll that's a quiz. You could assess their comfort level with the topic, which is what we did at the beginning. Or you could have a joke like I showed my video guide. And then we can look for ways to transform. We can use polls as that beginning part to make connections. So polls as an icebreaker is a good one. Tooth, Roots, and the Lies is a simple one to make as a poll. You can use crowdsourcing, you can use a whiteboard. So here's one where at the beginning I showed them the final product and I asked the learners, well, what would be the steps that you would need to learn to be able to do this? And so they wrote it out and then I taught them. So they had a platform, they're already activating what they know and then we build on top of that. In the middle of the lecture, we can add in activities. And there are things that you can do without technology. We do imaging and with technology we can have everyone annotate an image, simple. We can play games and we can do those games online. Kahoots is a great one. We can draw on a whiteboard, we can draw on a blackboard, we can do it together. And then I want to emphasize check-ins. That is, we know that about at 10 minutes the learners start to fade. And so we should reactivate them, check in on them and then move on. So you can do it very quickly. So there's a reactions feature. So you could pull up your gallery view and they can click on a thumbs up or any of these icons, you ask them, do you get it, are we ready to move on? And they can give you a reaction very quickly. You can see all your learners. You could draw a simple number line and you could ask them a question, you could ask them their comfort level like we did at the beginning of this lecture. And you can use the stamps feature. So you can not only annotate but there's these different icons you can pick. They can pick any one they want. There's a star one, you can pick it on a number line. How do they like something? And the one I really want to emphasize is the muddiest point concept. That is, you can stop in the middle of your lecture and ask your learners, what would you like me to clarify? And with this one, we stop and we just open a whiteboard and all the learners start typing in their questions and then we could answer their questions real time in the middle of the lecture. And now we can think about the last phase. How can we build reviews together? So question answers is a normal thing that we do. We'll do it here at the end of this session. You can do it with technology where they type in the question. But an extra feature is a lot of these platforms, one learner can type in a question and then other learners can like it. They can promote it. And those questions will move up to the top. And so then you can answer those questions first. You can answer, spend more time on the questions that a lot of learners have, that same question. So. We could build a review together using a word cloud. So you ask a question and everyone puts in their input and you can build a review together. And here's another one is when you do an activity, you can screen save it. And you can also, as you have your whiteboard, you can keep building and layering and layering your information and your activities. Screen save that. Screen save the whole of it and send it back to your learners. So if you're still using Twitter, I will tweet my last slides, two slides to you. And the idea here is forgetting is a normal part of learning. It happens. But if you forget and you remember again, it's gonna be a stronger memory. So give your learners ways to remember again, to revisit the topic again. And screen saves and these reviews that you build together are ways to do that. So we'll end with, we've talked a number, about a number of these interactive tools that you can use virtually. You could even use them in the classroom when you have a hybrid situation. We're gonna promote learning. And with all of this, we're trying to use technology to build the together, together, together, together, together. And we'll think of the lecture in three phases. And with all of these technologies, we're gonna look to transform, transform, transform, transform. Oscar Robbins, and we'll be talking to you about peer learning. We're fresh off of Thanksgiving. Whatever the holiday or occasion, whatever the place, setting, and meal, and whomever is joining, I bet that each of you has rich, visceral memories associated with family traditions. A particular smell or taste can evoke memories of a specific experience. Music can transport you back. Sometimes you may even be able to hear your grandmother say something to you. Radiology education is not like a Thanksgiving feast, but perhaps we can employ alternative ways to learn that enable us to integrate the concepts more deeply. And with that, we'll spend the next few minutes talking about peer learning in radiology. So what is peer learning? When I'm talking about peer learning, I'm referring to learning from and with our peers. Before we get into the weeds of peer learning, let's take a step back and examine how we might generate deeper learning. We'll begin with Bloom's Taxonomy, which is a hierarchical framework of learning objectives. The theory is that learning begins with acquisition of knowledge and builds to the apex of the ability to create new things. I'm sure you're familiar with this triangle of representing Bloom's Taxonomy, especially as you're writing your learning objectives. We start with a simple task of remembering a fact and work our way up to the more complex tasks of creating new content. The learning pyramid is often cited in the medical education literature, especially in reference to retention rates for a particular learning activity. Even though this is widely cited, there is no data to support the actual numeric claims that are often associated with this pyramid. But let's keep the construct. It seems logical that a learner would retain more information from an activity if they are actively engaged with it, such as teaching others, than if they're hearing someone else talk about the content. So as we work our way to the base of this triangle or the foundation of the triangle, the theory is that learners will have more retention of the material. We have the age-old adage of see one, do one, teach one, which we can see working its way through this learning pyramid, starting at the apex and working its way to the base with the higher levels of retention. Hot seat conferences employ the practice-doing step of the pyramid, and the concept of residents as teachers, teaching medical students, or junior residents are found at the deepest level of the learning pyramid. So could we combine the two concepts of Bloom's taxonomy of learning objectives with the framework of the learning pyramid to think about truly deep learning? In this sense, we would find ourselves at the base of the learning pyramid and the apex of Bloom's taxonomy. Might we ask our learners to create content while discussing, practicing, and teaching? So this brings us back to this original concept of peer learning, learning from and with our peers. Again, we'll step back briefly to talk about the theory behind the concept of group learning. Cooperative learning is a concept first described in the social psychology literature by David Johnson and Roger Johnson, educational psychology scholars. In this theory, students work together to achieve joint learning objectives. They work in small groups until all members understand and complete an assignment, and the teacher moves from group to group, proctoring interactions and helping with concepts. When children learn in these cooperative settings, studies have shown that students outperform students in competitive and individualistic settings. The students in the cooperative settings have higher long-term retention of learned material, higher levels of reasoning, and exhibit more creative thinking. So wouldn't it be amazing to combine the deep learning objectives and practice within a cooperative environment? So let's talk about two such examples of cooperative learning, taking advantage of technology, and innovating in the radiology education space. If you're a gamer, you've probably heard of discord.com. It's a social platform originally created for the online gaming community, but is now home to communities of any type. The platform includes multimodal functionality, including chat rooms, voice channels, and video capabilities. Enter RADdiscord. With the onset of the COVID-19 pandemic, a third-year radiology resident created the hashtag RADdiscord community to help radiology residents prepare for the ABR exams and to foster real-time interactions amongst residents to discuss cases, ask questions, and share resources. This has been wildly successful. The hashtag RADdiscord community has evolved into a vibrant international online radiology community with nearly 3,500 members, and there's representation from countries around the globe. Content on the hashtag RADdiscord server includes resident-created and curated content, resident-driven discussion groups, and a community of faculty-led conferences for didactic education. The RADdiscord community is building meaningful relationships, fostering radiology careers, and the preparation of three cohorts of radiology residents for the ABR core exam. This gigantic peer-to-peer learning network is an incredible opportunity for our trainees, bringing together peers with diverse experiences into a rich learning environment. This truly is a remarkable adaptation of the digital world to foster cooperative peer learning and an example of cooperative peer-based learning in an innovative online gaming platform. Peer mentoring is another example of peer learning. Last year, when the radiology education community was preparing to reconvene for the 2022 AUR annual meeting after a COVID-induced hiatus, Reid Omri, Mary Scanlon, and myself wanted to create a venue at the meeting for attendees to present their passions. The response was overwhelming, with 45 participants presenting 45 provocative ideas. Applicants included medical students, residents, early, mid, and late-career radiologists. In fact, one of the selected participants, Joseph Phillip, will also be speaking in this session today. At the time that we solicited applications, Reid, Mary, and I advertised that the presenters would have the opportunity to have their presentations coached by us seasoned radiology educators. Leading up to the annual meeting, there were four video conference-based group sessions. During the first session, the presenters and the coaches got to know each other by presenting the topic of their provocative ideas. What happened next was magic. Rather than the presenters learning from the experts, the cooperative learning blossomed. The radiology peers learned from and with each other, and the presentations that they produced evolve from good to great to exquisite. The cooperative peer-based learning across the country that happened in preparation for this AUR PowerPitch session was based upon a video conference-based platform and resulted in one of the most amazing plenary sessions I've ever had the opportunity to attend. So in summary, peer-based learning or cooperative learning occurs in a cooperative environment. It instills deeper levels of retention and performance. Peer learning across institutions and around the world is far greater than an individualistic learning situation. I thank you for your attention. So I'm gonna talk a little bit about workstation teaching. Realize there's more than one way to skin a cat. There are many ways to teach at the workstation. I'm gonna try and give you a few suggestions of where you might want to up your workstation teaching and I'm certainly very happy to hear suggestions from the audience afterwards. We are just trying to keep our heads above water at the moment. I mean, it is a tough work world out there. We are drowning in the length of our work lists. We're just trying to get through them and then somebody says, oh, and you gotta teach residents as well. Oh, and there's a student on the rotation as well and you have to teach them. And sometimes it's just really hard to get the energy up. I mean, you're just surviving and then to try and get the energy and enthusiasm to teach well is tough. And then, of course, now we've got remote reading. I'm not gonna talk about trying to do remote workstation reading because, frankly, we don't do any at my institution. So I'm not the best person to talk about it. But this is unquestionably a super challenge. Now, there are different readout styles you can do with your residents. You can do the side-by-side going through studies, the resident reviews and prelims, a bunch of studies or maybe one complicated study and then you sit down with them side-by-side and you go through the study with them. And this is definitely probably the better teaching method but it's certainly not necessarily the most efficient. And if you have a heavy work list, you may resort to the second method of independent readout. So the resident reads a bunch of studies, you back-read them and you get them over to look at anything that you disagree about or some sort of important points that you feel that you want to teach them about. So that tends to be a little bit more efficient but it really depends on what your learner level is. So for novice learners, they really benefit most by the side-by-side process where you've got your fourth year residents or you've got your fellows, by that point they're independent enough that you can generally just read through and touch in with them with any discrepancies. So first of all, when you start your morning or you start your afternoon back, wherever you are, whatever section you're in, you need to set the stage. So at the session start, identify the readout faculty. And for most residents, it's really helpful to know that Dr. Lewis is the readout person in CT this afternoon as opposed to they're kind of trying to find someone to read the study out. So if you have more than one faculty back in a section, assign somebody who is gonna have lower productivity but they're gonna be doing the teaching that afternoon and obviously share that around between different sections. Define your expectations with the resident. So what kind of a volume do you expect them to be getting through? Residents will rise to the challenge. We have very clear volumes in things like mammographic screening and they fulfill them. Before we had clear volumes, they didn't fulfill them. Sometimes they fulfill them plus one study which is always a little irritating. But give them, say, I would hope that this afternoon you're gonna get through at least four CTs or whatever it happens to be depending on the stage of the learner. You also want to probably give them an idea of what kind of case complexity or case mix in terms of study types you might want to get through. And again, this is gonna really depend on your learner level. Are they a first year in which you're gonna say, you know, I just want you to focus on chest X-rays this afternoon or I just want you to, I want you to really do the cardiac and the more complex CTs this afternoon because you're a fourth year. Agree on when you're going to read out with them. So I'd like to read out with you every time you've done four studies or every one study or let's read out in an hour. Give them some idea of when they need to accomplish these tasks. When you read out with a resident, it is super important that you share your thought process during the review. Why, you know, why you put this finding together with that finding to come up with this specific diagnosis. It's really helpful for learners for you to verbalize that process. And then really try to make at least one teaching point about every case that you're reviewing with them. There's always something, even if it's just a sort of a little anatomy point that maybe just check in that they know that anatomy on cross-sectional imaging. So however small it is, make at least one point. I'm just gonna talk briefly about three techniques you might want to try and some of these use the concepts that have already been talked about by Dr. Phillips and Dr. Robbins so far, so it's been kind of interesting seeing how our ideas mesh together. And these three points are gonna be identify the muddiest point, teaching through drawing, and then utilizing learners as teachers. So starting with identifying the muddiest point. What this is really utilizing is just-in-time teaching. So this is teaching that's not planned for, that you're doing spontaneously. So when you've read through a complex case, identify the muddiest point in the case. So what did they not get? Is this something they missed the finding or they misinterpreted the finding? Perhaps it was a complete misunderstanding of a basic or more complex concept. Perhaps it's that they didn't understand the criteria for making that diagnosis or staging criteria, for example, trauma staging of a splenic rupture or something like that. And then provide on-the-spot teaching on that point just for a couple of minutes. So you're obviously not gonna do this with every case, but just for a couple of minutes. Use readily available web sources, so say, okay, I'm just gonna call up a bunch of other examples of this in Google Image. It's very fast and it provides very focused just-in-time teaching about the concept they've been doing. Something I love doing is teaching through drawing. I'm a big drawer. I'm a terrible drawer, but I'm a big drawer. And what this employs is a learning skill called generation. And this is a very, very powerful learning and memory tool. You can do it in a couple of different ways. You can have, and usually we're doing a mixture between these, the faculty be drawing something. So, for example, I just wanna show you how we're gonna biopsy a very superficial breast mass in stereo. Or you're gonna ask the learner to draw, draw me the different types of uterine anomalies, for example. And this is not a test of artistic skill. You have to make sure, because sometimes they're like, oh, I can't draw. We're not judging you on the quality of your drawing. And I usually sort of formally say that the first time I do this with them. And there's actually some evidence out there that the simpler the drawing, the more powerful it is as a learning tool. So super simple drawings are simple. So what can you use to do this? Well, I tend to use a tablet. And I always have, I have a little iPad mini that I put out on my workstation as soon as I get there. There's a whole bunch of different whiteboard apps. Explain Everything is a nice one. Show Me is free. I tend to use that because it's very quick and clean and easy to call up. There are also a whole bunch of free whiteboard apps on the web. This is Microsoft Whiteboard. You can just call it up at the beginning of a session. It's there. You just alt-tab over to it and just start drawing. It's super easy to do with a mouse. So just to give you an example of something that I'm doing. So this is me explaining to, hopefully, yeah, me explaining to a resident how to do different ultrasound-guided breast biopsies depending on how deep a lesion is and some ways that we modify a technique. You know, I've not put the sound on here, obviously to not totally irritate you, and different ways we can modify it. So as you can see, you know, the drawing is terrible, but the concepts are really easy to learn from this. And I'll just pull this up and I'll do it quickly. You can also just snap an image straight off the PAX workstation onto your tablet and then draw on the image itself. Some people's PAX software have these drawing tools in it. Ours doesn't because it's a terrible PAX system and we can't do a thing with it. And I really like to be able to draw like this. So this is just me drawing, literally taking a picture and then drawing on top of it on my iPad to explain something. And you can also do this on the web apps. So you can just do a screen grab or, you know, select a little area, copy it, paste it straight into the app, and then be able to further explain with it like this. And it's just really nice for residents and it really focuses them incredibly and uses that generation skill. Now, Dr. Robbins has already talked about this and, you know, I agree with her. These numbers are just pulled out of somebody's butt, but, you know, the concept is there that teaching others is a super strong learning skill. So how do I utilize this? I have the residents do micro-presentations. So develop a list of micro-topics. And a micro-topic is something that somebody could teach in, you know, five minutes or 10 minutes at most, but somebody can teach. So it's not, you know, you're not gonna say sarcoidosis, but you might sort of do something very specific about, you know, neurosarcoid involving the dura or something, I don't know, I'm not a neuroradiologist. These micro-topics should be variable difficulty levels and so you can use them for all types of residents and you can do it a couple of ways. You can ask the resident to choose their own topic and so if I do that, it's like, what's something that you're planning to learn this week in ultrasound that you, you know, you think you need a bit of reading about and then we're gonna talk about it on Thursday. And I don't do this more than one or two topics a week, usually one per resident. If I have a student there, I'm gonna do one for student. Or you can assign appropriate topic to them. So, and then you're gonna plan a day for them to do it. So let's say, why don't we try and do this, you know, end of the day on Thursday and we're doing this on Monday and then they're gonna present that micro-topic to you and any other learners who happen to be around and any other faculty who happen to be interested. And I tell them, you can do this however you want. You can just do it purely verbal. They often make quick, short, you know, messy PowerPoints. They just download images off the web. We're not worried what it is they might want to draw. However they want to do it, however they're comfortable doing it. So for example, this is a list of some of the topics I have in ultrasound when I'm teaching with the residents. You know, these are things that they can talk about very quickly and very concisely and really learn it and teach the others. And I actually have a little flash card app on my phone. I forget what this one's called, to be honest. On my phone, I have all the topics for both breast and ultrasound in here and I say, do you want to select it or should we spin the wheel? And I'll spin the wheel and I said, take it or leave it. And they'll go, take it, no, leave it, leave it and we'll do this. So it sort of turns it into a little bit of a game and that's been pretty fun. So in summary, when you're doing your PACS workstation teaching, set the stage when you start so that the expectations and the process is very clear to your learner. As you're going through studies, verbalize your thought process. It's so, so powerful. Try and identify the muddiest point in any resident's study that clearly they need some clarification on and just spend an extra couple of minutes digging a little deeper into that so that just-in-time teaching. And then consider trying to do some of these techniques I've shown you. So doing drawing, it's so much fun. The residents like it. It really, really clarifies to them and then doing learning through teaching using these micro-topics. Thank you for having all of us come today and talk about a lot of creative areas of teaching. I want to really start off by asking the group who out here are either artists, musicians, writers? Raise your hands. Does dressmaking count? What? Does dressmaking count? Yeah, dressmaking counts. Okay, now how many of you have used those talents to teach your residents or trainees? That's pretty good, actually. We're gonna be talking about ways that we can use those kind of talents to teach your trainees. Every day when we go into the radiology reading room, we actually start off developing a story, right? The patient has a clinical history. Lots of times we're not too happy with how much history is given. More often than not, after looking through all the images, we have a sense of what's going on with the patient more so than the referring physician. And I'll give a perfect example. I actually like showing this case to medical students. So although this is a case, I'm actually telling a story about a situation that happened to me when I was reading this case. The ER calls me up, can you confirm that there's a fracture in this 85-year-old female, status post-fall? So I was surprised, because usually with the fractures, they don't bother you. But this was a great case for teaching. And I show medical students this case all the time because it gives them some insight into what we do as radiologists. So I saw that there's a fracture. I saw that there's a lytic lesion, and there's a pathologic fracture through it. And I even saw that there was a pleural effusion. So I was able to develop more to the patient's story and then use that story to tell other stories so that students can learn from it. We asked for a chest CT. It confirmed a pleural effusion. There's a large left breast mass, pleural nodularity. So this story was a sad story, but it was more so than what the ER thought. So this story that I give is a clinical story. We're going to be talking about non-interpretative skills. Many, many years ago, I don't know, many years ago, the chief residents and myself ran into a problem. One of our residents was showing up to work consistently 10, 15, 20 minutes late. Faculty was complaining. So we got together. We're like, how should we take care of this? So the chief residents felt like they should start the initial conversation and try to see if they can understand why this resident was coming late, try to get a better handle on it, and explain to the resident that you've got to show up on time. Worked for a few days. The following week went right back to coming 10, 15, 20 minutes late. So I was like, OK, so I guess it's my turn. Now I have to talk to him. And I told him to come at the end of the day to my office. We're going to talk about it. I was expecting an argumentative and a frustrating potential session. He came upstairs, he closed the door, and he burst out crying. So I was floored. I was shocked. It wasn't part of the narrative in my mind that what was going through with him. It was a great learning point for me at that time and the chief residents. And I used that same story to teach other colleagues, residents, for something that most of us know intuitively, that you don't judge a book by its cover. But this person told me he has severe depression, he has trouble getting up in the morning, and that's why he was coming late to work. Totally changed the way I was going to approach dealing with the situation. That is using imagery stories to teach non-interpretative skills. So what am I doing today? Today I'm going to tell you what a non-interpretative skill is. We're going to talk about some approaches of creative ways of teaching. And then I'm going to go back to a little bit of the storytelling and art just to show you what can be done. So a non-interpretative skills is everything that a radiologist or a physician does that has nothing to do with actual imaging itself. So that's talking about communication, professionalism, quality, safety, leadership, talking about burnout, wellness, health care disparities. The use of art and humanities in medical education is not new. Plenty of medical schools are doing it. It's just a little bit more new for radiologists and a little bit more new for radiology. And what I find actually kind of cool, this is a list of different creative methods of teaching. If you really think about it, these methods were used for us when we were in kindergarten. And obviously, it was successful. So now we're just applying it to adult education. In kindergarten, we drew pictures. We had art. We had music and singing, storytelling. We played games. We performed and had simulations. So why is storytelling good for learning? So the literature out there says that facts will be remembered more by storytellers. Why? Visual learners will imprint the story on their memory. And auditory learners will use the words and the voice of the person giving the talk to imprint the memory. So this is an article from 1997. A patient was writing about her own experiences when she brought her baby to the hospital when she noticed blood in the diaper. And she talks about her experience with the radiologist and the surgeon. And it wasn't a great experience. It was a very cold, robotic type of experience. And Dr. Gunderman took this article and wrote an article in JACR in 2015, saying that we can really learn a lot from patients from hearing their stories, and even about professionalism. And what was interesting about this story was she explained how the radiologist took an ultrasound, was scanning the patient, wasn't telling her what was going on. All she saw was these black and white dots. She asked, is there something there? The radiologist said, maybe, but you have to talk to your doctor. So it really raises the question. And this article wasn't answering the question, but it raises a question that I think all of us still have today in radiology. Are we here for the referring physician, or are we here for the patient? So again, I'm not answering the question, but it definitely raises it. And that talks about a non-interpretative skill. This article was written by one of my residents, talking about her experiences when she was redeployed on the COVID floors. This relates to wellness and burnout. Not only is it related to wellness and burnout for that individual who's writing the story, but for those who are reading the story and who can relate to it. She was able to say that there's no words to describe what was going on, but actually, it was a beautiful time because everyone got together and worked together to be a team. At the AUR in 2018, we kind of decided, let's try to bring some pictures into the sessions and see how that works. And our goal was patient family-centered care. Can we use pictures to connect patients with the radiologists? So our goal was, how can we improve the patient experience? We can explain that the radiologists are actually physicians. We can talk about the physician-patient interaction. We can actually explain what kind of procedure it is that we were going to do. And we can facilitate discussion between patients and radiologists. So again, that was the point of the session. So Terry Vischer brought those pictures. And we were kind of surprised because afterwards, we did a survey to find out what people thought about the session. And again, remember, we were looking at it as a patient family-centered care approach. But people were saying that it was very self-reflective, introspective, brought up issues of, more global issues of diversity and gender or how people are supposed to interact. And the use of art in radiology or in medical education in general is sprouting all over the place. The ACR, a couple of years ago, started using art in their annual meeting. And they have a gallery on their website. The Society of Abdominal Radiology also does. The RCA has done a lot of stuff with art. And next year at the annual AUR meeting, the whole topic is going to be related to creativity. So this conversation is really, to me, just a start for a lot of people. I would hope that everyone can go back, try to see if they can use some of these tools to teach their residents. And many of us actually probably actually do. Many of us tend to tell stories. And we just don't realize we're telling stories. And thank you very much.

radiology education

active learning

virtual learning

peer learning

innovative platforms

storytelling

micro-presentations

creative teaching