Download 2013 CuRe Preclerkship Presentation Jeffrey Mottola, M.D.

2013 CuRe
Preclerkship Presentation
Jeffrey Mottola, M.D.
Diagnostic Imaging
Health Science Centre, University of Manitoba
Outline
• Background
• Overall objectives
• Suggested systems
• Investigation and interpretation (ex)
• Where radiology fits in?
Background
• Currently
• DI contributes 15h of preclerkship modular based
teaching
• Respiratory (2h), Gastrointestinal (2h),
Neurosciences (2h), Musculoskeletal (4h),
Genitourinary (1h), and ITC (4h)
• 40% didactic 60% PBL 0% e-learning
• Currently no multidisciplinary sessions
• No dedicated sessions for radiology anatomy,
techniques, appropriateness criteria, or radiation
protection
Overall Goals
• Ensure undergrads are equipped with the
knowledge and interpretation skills to practice
safely and effectively during clinical rotations
• To demonstrate familiarity with:
• Anatomy and physiology pertaining to radiology
• Imaging physics and radiation protection
• Radiology requisition and DI expectations
• The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
• Anatomy and physiology pertaining to radiology
• Imaging physics and radiation protection
• Radiology requisition and DI expectations
• The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
• Anatomy and physiology pertaining to radiology
• Imaging physics and radiation protection
• Radiology requisition and DI expectations
• The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
• Anatomy and physiology pertaining to radiology
• Imaging physics and radiation protection
• Radiology requisition and DI expectations
• The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
• Anatomy and physiology pertaining to radiology
• Imaging physics and radiation protection
• Radiology requisition and DI expectations
• The characteristics of Imaging techniques (Xray,
US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
•
•
•
•
Anatomy and physiology pertaining to radiology
Imaging physics and radiation protection
Radiology requisition and DI expectations
The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
•
•
•
•
•
Anatomy and physiology pertaining to radiology
Imaging physics and radiation protection
Radiology requisition and DI expectations
The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
•
•
•
•
•
•
Anatomy and physiology pertaining to radiology
Imaging physics and radiation protection
Radiology requisition and DI expectations
The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
The clinical role of imaging techniques
The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in
common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
• Anatomy and physiology pertaining to radiology
• Imaging physics and radiation protection
• Radiology requisition and DI expectations
• The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the
remainder of the clinical curriculum by exploiting
imaging to elucidate normal anatomy and pathology
(Themes and longitudinal courses)
• To raise the profile of radiology as a career choice for undergraduates
Overall Goals
• To ensure undergraduates are equipped with the knowledge and interpretation skills
they require to practice safely and effectively on clinical rotations
• To demonstrate familiarity with:
• Anatomy and physiology pertaining to radiology
• Imaging physics and radiation protection
• Radiology requisition and DI expectations
• The characteristics of Imaging techniques (Xray, US, Nuc, CT, MR, IR)
• The clinical role of imaging techniques
• The use of appropriateness criteria (ACR)
• Appropriate investigation and interpretation in common medical conditions
• To support undergraduate learning across the remainder of the clinical curriculum by
exploiting imaging to elucidate normal anatomy and pathology (Themes and
longitudinal courses)
• To raise the profile of radiology as a career choice for
undergraduates
Suggested Systems
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Gastrointestinal
Repiratory
Cardiovascular
Genitourinary
Musculoskeletal
Endocrine – Thyroid/Adrenal
Neurobiology
Obstetrics and Gynecology
Oncology – including breast
Infectious diseases
Pediatrics
ENT
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Dr. J Mottola
Dr. R Kreml
Dr. I Kirkpatrick
Dr. M Vivian
Dr. J Koenig
Dr. J Mottola
Dr. V. Wadhwa
Dr. N Milo
Dr. J Reynolds
Dr. B Memauri
Dr. H Moffatt
Dr. A Sam
Breatnach et al. ESR 2011
Investigation and Interpretation
• The Chest Radiograph Approach
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Positioning and film quality
Views (PA, AP, lateral, Lat – decubitus, supine …)
Patient demographics
Normal anatomy
• Musculoskeletal (bones and soft tissues)
• Upper abdomen (Gastric bubble etc)
• Mediastinum (interfaces, lines, and stripes)
• Lungs (lobar and bronchial)
• Pleura
EXAMPLE
Investigation and Interpretation
• The Chest Radiograph
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Cardiac enlargement
Cardiac failure and pulmonary edema
Pleural effusion
Collapse and consolidation
Misplaced ETT and Catheters
Pneumothorax
Pneumomediastinum and subcutaneous emphysema
Hyperinflation of lungs
Free gas beneath the diaphragm
Pulmonary and mediastinal mass detection
Acute vascular dissection and traumatic aortic injury
EXAMPLE
Investigation and Interpretation
• Radiology in management of disease (multimodality)
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Chest and cardiac emergencies
Airway disease: asthma and COPD
Aneurysm and vascular dissection
Pleural effusion
Pneumonia
Embolic disease
Pulmonary neoplasms
Hemoptysis
Congenital heart disease
Pediatric respiratory disease
EXAMPLE
Where we fit in?
MO (WGS)
Introduction to Diagnostic Imaging
- General Overview
- Characteristics and role of various
imaging techniques
- Technique related physics and
safety (*)
Where we fit in?
M1(WGS and SGS)
System based:
- Anatomy and physiology in radiology
- Approach to interpretation of normal
images
- Multidisciplinary sessions (Anatomy)
Where we fit in?
M2(WGS and SGS)
System based:
- Investigation and interpretation in
common medical conditions (Rads)
- Radiology incorporated into
multidisciplinary sessions
Where we fit in?
M3 and/or M4 TTC (WGS and SGS)
- Case based sessions (Investigation and
interpretation – as in ITC)
-Appropriateness criteria (ACR)
-Radiology requisitions and expectations
Where we fit in?
CS/CR (WGS and SGS)
- CS - Ultrasound (+/- Interpretation)
- CR - Multidisciplinary sessions
- Longitudinal e-learning curriculum