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Potential Pitfalls of Virtual Learning among Radiology Residents

Recent studies show that chief residents have doubts about virtual learning and its efficacy in radiology residents’ training. Virtual learning became necessary during the height of the COVID pandemic, and it offers flexibility. However, several studies uncovered a significant pitfall in virtual learning among chief residents.

  • The 2021-2022 Survey of the American Alliance of Academic Chief Residents in Radiology revealed that most chief residents sensed that virtual learning was less effective than in-person learning.
  • Washington University in St. Louis’s Dr. Allison Khoo’s research team discovered that about one-third of chief residents experienced less procedural experience during the COVID pandemic, with some feeling less comfortable about basic procedures.
  • A task force from the American College of Radiology recently postulated that fellowship-trained radiology graduates were increasingly “unable, uncomfortable, or unwilling” to do basic fluoroscopic and interventional radiology procedures.

Dr. Knoo’s team studied survey data of 110 chief residents from 61 programs. Among this group, 80% of these programs maintained in-person attending readouts during the pandemic, but only 13% had in-person didactics, while 26% changed to all virtual didactics.

The majority of chief residents were in general agreement that virtual options were less effective than in-person modes:

  • 74% – Virtual readouts
  • 62% – Virtual case conferences
  • 53% – Virtual didactic lectures

Chief residents cited 5 reasons that virtual was not as effective.

  1. Diminished attending engagement in radiology education
  2. Inferior value of didactics
  3. Fewer opportunities for mentorships
  4. Fewer professional opportunities
  5. Diminished procedure exposure

Their general lack of enthusiasm for virtual learning led to altered career choices or a lack of overall confidence. The implications of diminished procedure exposure were significant — 21% of chief residents preferred a position not requiring procedures. However, three-quarters expressed adequacy for a job with procedural requirements. About a third of chief residents indicated less procedure exposure during the pandemic.

Some 7-9% of chief residents sensed discomfort/lack of confidence over basic procedures, including standard essential examinations — fluoroscopy, basic aspiration and drainage procedures, and superficial biopsy procedures.

The Washington University study showed that despite the COVID pandemic, 24/7 coverage increased to 49% in 2022 from 35% in 2019. The programs most popular with graduating radiology residents were body radiology, interventional radiology, and neuroradiology.

While virtual learning is likely to remain part of many educational programs, additional studies may help integrate virtual learning more fully and positively “influence decisions that shape the long-term future of radiology education.”

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