Thematic Case Reviews

In these thematic reviews, the organisation and presentation of cases will be based on the latest educational research, including literature exploring the role of expertise in radiologic image interpretation; how to promote active learning in radiology trainees, and activities to simulate how experts through deliberate practice generate a holistic high-level representation of the image, which then fine-tunes the perception of potential lesions. These reviews will leverage on the large database of online published and unpublished (at the moment) "normal" and "abnormal" cases. Selected use of didactic instructional videos will be included.



Tuesday, 26 February 2013

Case 1406 - Acromegaly











Case 1405 -Choroidal fissure cyst












Case 1404 - Cavum septum pellucidum / vergae / velum interpositum










Some tips on motivation, time and effort allocation

As a radiology resident, or subspecialty fellow, consider challenging yourself to achieve "mastery" in one area or subspecialty of radiology

Presentation on mastery training in diagnostic radiology

Having an objective to focus on, and inspire you, will help you expend the effort required to keep working on improving your skills on a daily basis

Regular, focused, committed effort, with feedback, to broaden and deepen your expertise should then be your aim

Personally, I have found regular, daily thoughtful case review; regular reading of the literature; the process of continually building up an online case repository; regular compare and contrast case evaluation; and the scholarly activities of teaching, sharing and dissemination useful strategies


What is "Mastery" in diagnostic radiology training?


Mastery is the ability to recognize all possible presentations of a particular condition, and differentiate this from look-alike’s and differential diagnoses – with speed, accuracy, confidence
Start with common clinical conditions/presentations
Gain exposure to all possible presentations, and go deeper to understand the underlying anatomical/pathological/clinical background
This way will recognize atypical conditions, or a new condition
Systematic deliberate practice (with feedback) is the key à training effect / lots of practice
Aim for at least 40 to 50 examples of each diagnosis
Plan for spaced (distributed) rather than massed practice – allocate time for systematic practice
Use image repositories intelligently – digital, hardcopy, textbooks/journals

above are the take home points from the presentation below

Monday, 25 February 2013

Case review strategy for residents and fellows

A recommended case review strategy for residents and fellows is outlined below:

1. focus initially on mastering the full range of radiological presentations of the most common neuroradiology problems - specifically infarcts, bleeds, tumours



for example a thematic review of acute infarcts and its mimics below









2. this will allow you to recognise unusual presentations of common problems, and also diagnostic categories outside these common categories, which you should next focus your attention on

specifically, direct your efforts to now master the full range of radiological presentations of less common neurological problems - specifically white matter disease including demyelination, and congenital and developmental anomalies

3. you can use a similar approach with the head and neck; and spine

for example, for the head and neck, you can focus on trauma, inflammatory sinus disease and common tumours first; and for the spine, you can focus on degenerative disease, trauma, infection and common tumours first

the "Special Collections" of the American Journal of Neuroradiology (AJNR) mirror this strategy

http://www.ajnr.org/site/specCol/SpecColl11Main.xhtml

make use of textbooks, review articles, and online resources, e.g.

Conventional and Advanced MRI Features of Pediatric Intracranial Tumors: Posterior Fossa and Suprasellar Tumors (AJR, 2013)

http://www.radiologyassistant.nl/en/p47f86aa182b3a/brain-tumor-systematic-approach.html#i47f88dc7cf215



Thematic case review - Infarct, Bleed, Tumours

Use search box top left of blog to enter search term - infarct, bleed or tumours to select neuroradiology cases on this blog by category


Sunday, 24 February 2013

Thematic case review - Hyperdense lesions


what is the predominant location of the bleeds above and below, and what are the likely causes?




what is the likely cause of the findings below?



what are potential causes for the findings below?




what are possible causes for the findings above?



what are possible diagnoses for the findings above?




what are possible diagnoses for the findings above, and why?





what are the significant findings above?



what are the significant findings above?



what are the key findings above?




what are the key findings above?


Saturday, 23 February 2013

Literature on Mastery learning

Mastery learning in the context of university education

Mastery learning principles applied to the public school system

Mastery learning: an effective strategy

Overview of Mastery learning

How do computers enhance learning?

Literature on case based and exemplar teaching and learning

for interested educators and students, the following articles on case based and exemplar teaching give further information and insights on the education and learning process

(google search using key words - "using exemplar cases for teaching")

Case based teaching and learning experiences

Use of exemplars, model answers and past questions

Situated learning with cases: Web enhanced case-based reasoning in teacher education

Online exemplars in teaching history

Teaching and learning by example in mathematics

Using case studies to teach science


Literature on "the learning process", what is learning, and how to optimise learning

the Learning process

Dolmans et.al., 2006 (problem based learning) -  focus particularly on the section, Part 1: learning principles; and reflect on how this can be applied to learning radiology; or teaching radiology / designing a radiology curriculum

Principles of learning

for educators, and interested students; these principles can be applied to radiology training

How radiology experts think and the value of online repositories

Cognitive apprenticeship

and

Mastery training in diagnostic radiology




Imaging of acute stroke (instructional video, powerpoint presentation, and literature)



see also


and




for in depth review, recommend the special collection of articles on the topic of "Imaging acute stroke and its consequences" from the AJNR below


Thematic case review - Infarcts and mimics

The following series of cases are exemplar case examples. 


Imagine them forming the vertical axis of a distribution curve of the manifestations of a particular clinical / radiological presentation.
After you have reviewed them, then expand your experience horizontally along the spectrum by reviewing the cases on the hyperlinked webpage below.



what are the key features of an acute MCA infarct (above), compared with
a chronic MCA infarct (below)



what are the key distinguishing features of an arachnoid cyst (below)


compare and contrast the key features of a chronic infarct with a co-existing arachnoid cyst (below)


what are the key distinguishing features of vasogenic oedema (below), compared with cytotoxic oedema




what are the key features of an intraaxial mass (above)



what are the key features of an extra-axial mass or collection (above)



what are the distinguishing features of this intraaxial tumour (above) compared with an acute infarct



note the features of vasogenic oedema (above)



note the features of cytotoxic oedema (above)



note features of an acute ACA infarct (above)


compared with meningoencephalitis (below)





                                            

First video above shows slides without answers, while video below shows slides without and with annotations and answers

                                            



Journal Articles

(suitable for trainees in clinical disciplines and radiology residents)

(suitable for trainees in clinical disciplines and radiology residents)

(suitable for radiology residents)

(this collections of curated articles from the AJNR is suitable for radiology residents who want to go deeper into this topic, and neuroradiology fellows)


For Educators