OBJECTIVE: To propose a model of a program of medical residence in radiology and diagnostic imaging comprising theoretical and practical training. MATERIALS AND METHODS: The program was based on a literature review and critical analysis, following recommendations from Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (Brazilian College of Radiology and Image Diagnosis) and Comissão Nacional de Residência Médica (National Commission for Medical Residency), and based on the program of Accreditation Council for Graduate Medical Education. RESULTS: The present proposal has been developed for a three-year-duration program divided into modules by subspecialties or diagnostic methods. Objectives have been described and targeted proficiencies specified. Evaluation models have been presented and discussed. CONCLUSION: Changes in the current teaching-learning model have become necessary because of the increasing information availability and fast technological development in the latest years. The hierarchical organization of the knowledge acquisition process with essential programmatic contents allows an appropriate education of the future specialist. It is anticipated that the present proposal may contribute to improve the medical residency programs, thus stimulating the implementation of a countrywide model.

Keywords: Medical residency, Radiology, Imaging diagnosis, Medical education

OBJECTIVE: The present study was aimed at developing and delivering a course in the modality "Internet-conducted distance education". MATERIALS AND METHODS: The theme "Sentinel lymph node, prevention, early diagnosis and biopsy - a new technique for approaching breast cancer" was utilized as an application model, and the didactic material for distance-learning was targeted to a selected audience of physicians involved in the treatment of breast cancer. The course was structured in a virtual learning environment, allowing interaction among participating students. RESULTS: The coursework took place over a 12-week period. Nine gynecologists with at least eight years of professional experience participated in some way in the course, but only two of them accomplished exercises and interacted. In the distance-education modality, the course reached eight cities in four Brazilian states. A full engagement did not occur, although most of participants have remained until the end of the course. Possibly, there was a lack of motivation. CONCLUSION: The results demonstrate that it is necessary to break the barriers to the culture related to this form of learning. A pro-active participation of the coordinator is essential for integrating and mobilizing the participants.

Keywords: Continuing medical education, Telemedicine, Distance education, Internet, Course management system

In 2003, the National Committee of Medical Residency established new criteria for the accreditation of Radiology and Imaging Diagnosis Residency programs. Although these rules represent an advance to the resident's training, other specific abilities and skills should be developed in order to keep up with the technical and scientific advances and with the new requirements of the career. The authors' present the must important competencies and skills that complement the radiologist's education and suggest a change in current programs so that the resident can acquire these competencies and skills.

Keywords: Medical residency, Radiology, Image diagnostic, Resident; Education

Objective: To validate the proposal for development of a virtual collaborative environment for training of nuclear medicine personnel. Materials and Methods: Organizational assumptions, constraints and functionalities that should be offered to the professionals in this field were raised early in the development of the environment. The prototype was developed in the Moodle environment, including data storage and interaction functionalities. A pilot interaction study was developed with a sample of specialists in nuclear medicine. Users’ opinions collected by means of semi-structured questionnaire were submitted to quantitative and content analysis. Results: The proposal of a collaborative environment was validated by a community of nuclear medicine professionals and considered as an aid in the training in this field. Suggestions for improvements and new functionalities were made. There is a need to establish a program for education of moderators specifically for this environment, considering the different interaction characteristics as the online and conventional teaching methods are compared. Conclusion: The collaborative environment will allow the exchange of experiences and case discussions among professionals from institutions located in different regions all over the country, enhancing the collaboration among them. Thus, the environment can contribute in the early and continued education of nuclear medicine professionals.

Keywords: Collaborative environment; Nuclear medicine; Medical education; Distance education.

Objective: To analyze the Brazilian technological innovation in the field of radiology and imaging diagnosis, in terms of patent indicators. Materials and Methods: Exploratory analytical study of information retrieved through cross queries in databases of intellectual property offices in Brazil (State Industrial Property Office [Instituto Nacional da Propriedade Industrial – INPI]), United States (United States Patent and Trademark Office – USPTO) and Europe (European Patent Office – EPO). Results: There were 277,057 patents in the field of radiology and imaging diagnosis. Of this total, 7,800 were registered at INPI (3%), 65,428 (24%) registered at the EPO and 203,829 (73%) issued by USPTO. Brazil is a signatory to 1,732 patents published by the INPI, 80 by the EPO and 26 by the USPTO. Overall, 219,993 (79%) patents were related to electronic devices strongly linked to information technology in health care, ultrasonography, tomography, magnetic resonance imaging procedures as well as to images generation, communication and archiving, and 57,064 patents (21%) dealt with technologies related to radiation protection and dosimetry, nuclear physics, electrotherapy, magnetic therapy and radiotherapy. Conclusion: The results indicate the weakness of the domestic production of patented technological innovation in the field of radiology and imaging diagnosis.

Keywords: Medical education; Science and technology; Technological innovation; Intellectual property; Research.

OBJECTIVE: To construct a Portuguese language index of information on the practice of diagnostic radiology in order to improve the standardization of the medical language and terminology. MATERIALS AND METHODS: A total of 61,461 definitive reports were collected from the database of the Radiology Information System at Hospital das Clínicas - Faculdade de Medicina de Ribeirão Preto (RIS/HCFMRP) as follows: 30,000 chest x-ray reports; 27,000 mammography reports; and 4,461 thyroid ultrasonography reports. The text mining technique was applied for the selection of terms, and the ANSI/NISO Z39.19-2005 standard was utilized to construct the index based on a thesaurus structure. The system was created in ^*html. RESULTS: The text mining resulted in a set of 358,236 (n = 100%) words. Out of this total, 76,347 (n = 21%) terms were selected to form the index. Such terms refer to anatomical pathology description, imaging techniques, equipment, type of study and some other composite terms. The index system was developed with 78,538 *html web pages. CONCLUSION: The utilization of text mining on a radiological reports database has allowed the construction of a lexical system in Portuguese language consistent with the clinical practice in Radiology.

Keywords: Radiology reports; RadLex; Medical education; Information technology; Health informatics.

OBJECTIVE: To investigate the learning about management of the technology (efficient use, acquisition and maintenance of imaging diagnosis equipment) in the radiology residency program of Escola Paulista de Medicina - Universidade Federal de São Paulo, with a view to improving the education of radiologists. MATERIALS AND METHODS: Exploratory research where residents, faculty staff and tutors of the program were quantitative and qualitatively approached with Likert scale questionnaires (46), and deepening with recorded interviews (18) and categorization based upon meaning units (thematic analysis). RESULTS: Among the participants, 66% agreed that they had the opportunity of learning about the use of radiological equipment; for 61% the program should include knowledge on the importance of acquiring equipment; and 72% emphasized the lack of learning about equipment management and maintenance. CONCLUSION: As the major moment in the education of specialists, the medical residency program provides residents with a favorable environment to the learning of the skills required to the future of their professional practice, but with limited emphasis on the management of the technology: efficient use, acquisition and mainly maintenance of equipment, still poorly explored. Both the investigated program and the medical residency in radiology should incorporate, whenever possible, the commitment with the training in supplementary skills related to equipment management, developing the competence of the future radiologists.

Keywords: Medical education; Medical residency; Health management; Radiologic technology; Radiology; Imaging diagnosis.

OBJECTIVE: To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina - Universidade Federal de São Paulo, aiming at improving radiologists' education. MATERIALS AND METHODS: Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. RESULTS: According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. CONCLUSION: Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists.

Keywords: Medical education; Medical residency; Health personnel management; Radiology; Imaging diagnosis.

OBJECTIVE: To investigate the learning on the management of resources of the Unified Health System (Sistema Único de Saúde - SUS) and its interfaces with private institutions in the radiology residency program of Escola Paulista de Medicina - Universidade Federal de São Paulo, in order to improve radiologists' training. MATERIALS AND METHODS: Exploratory research with quantitative and qualitative approach to residents, faculty staff and preceptors of the program, utilizing Likert questionnaires (46), deepening interviews (18) and categorization based upon meaning units (thematic analysis). RESULTS: Sixty-three per cent of the respondents claim the non-existence of an opportunity for the residents to be acquainted with the management of SUS resources, and were even more categorical (76%) regarding the knowledge about resources from private institutions in the intersection with SUS. CONCLUSION: The learning on the management of SUS resources represents a relevant challenge to be overcome by residency programs, considering the extensiveness and complexity of the Brazilian health system, that is not sufficiently approached during the program, even in its most basic aspects, with daily experiences involving an excessive number of patients and a busy agenda, besides the inadequate public health infrastructure. The present study indicates the need for a greater emphasis on the development of the learning on aspects related to the management of resources from the SUS, assimilating particularities and overcoming the frequent difficulties, thus improving the training of radiologists.

Keywords: Medical education; Medical residency; Unified health system; Private health institutions; Radiology; Imaging diagnosis.

OBJECTIVE: To investigate the learning on the management of resources of the Unified Health System (Sistema Único de Saúde - SUS) and its interfaces with private institutions in the radiology residency program of Escola Paulista de Medicina - Universidade Federal de São Paulo, in order to improve radiologists' training. MATERIALS AND METHODS: Exploratory research with quantitative and qualitative approach to residents, faculty staff and preceptors of the program, utilizing Likert questionnaires (46), deepening interviews (18) and categorization based upon meaning units (thematic analysis). RESULTS: Sixty-three per cent of the respondents claim the non-existence of an opportunity for the residents to be acquainted with the management of SUS resources, and were even more categorical (76%) regarding the knowledge about resources from private institutions in the intersection with SUS. CONCLUSION: The learning on the management of SUS resources represents a relevant challenge to be overcome by residency programs, considering the extensiveness and complexity of the Brazilian health system, that is not sufficiently approached during the program, even in its most basic aspects, with daily experiences involving an excessive number of patients and a busy agenda, besides the inadequate public health infrastructure. The present study indicates the need for a greater emphasis on the development of the learning on aspects related to the management of resources from the SUS, assimilating particularities and overcoming the frequent difficulties, thus improving the training of radiologists.

Keywords: Medical education; Medical residency; Unified health system; Private health institutions; Radiology; Imaging diagnosis.

OBJECTIVE: To map the different methods for diagnostic imaging instruction at medical schools in Brazil. MATERIALS AND METHODS: In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. RESULTS: Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. CONCLUSION: The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

Keywords: Schools, medical; Education, medical/standards; Program evaluation/methods; Diagnostic imaging.

OBJECTIVE: To evaluate the impact of artificial intelligence (AI) on undergraduate medical students’ choice of radiology as a specialty. MATERIALS AND METHODS: In February 2019, an anonymous online survey was sent to medical students. The research contemplated questions on how much students think they know about AI technologies, how much AI discourages them from choosing radiology as a specialty, and whether they believe there is a threat to the radiology job market. RESULTS: A total of 101 students, most of them doing their internship, answered the questionnaire. More than half of them (52.5%) said they believe AI poses a threat to the radiology job market, but 64.3% claimed not to have proper knowledge about these new technologies, and 31.7% said they would like more information on the technologies’ operation and progress before making a decision on whether or not to practice radiology as a specialty. CONCLUSION: A significant proportion of the surveyed students perceive AI as a threat to the radiological practice, which impacts their career choice. However, the majority claims to have insufficient knowledge of it and believes more information is needed for decision-making.

Keywords: Artificial intelligence; Radiology; Medical students; Education; Specialty.

The aim of this study was to compare virtual reality simulation with other methods of teaching interventional radiology. We searched multiple databases—Cochrane Library; Medline (PubMed); Embase; Trip Medical; Education Resources Information Center; Cumulative Index to Nursing and Allied Health Literature; Scientific Electronic Library Online; and Latin-American and Caribbean Health Sciences Literature—for studies comparing virtual reality simulation and other methods of teaching interventional radiology. This systematic review was performed in accordance with the criteria established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Best Evidence Medical Education (BEME) Collaboration. Eligible studies were evaluated by using the quality indicators provided in the BEME Guide No. 11 and the Kirkpatrick model of training evaluation. After the eligibility and quality criteria had been applied, five randomized clinical trials were included in the review. The Kirkpatrick level of impact varied among the studies evaluated, three studies being classified as level 2B and two being classified as level 4B. Among the studies evaluated, there was a consensus that virtual reality aggregates concepts and is beneficial for the teaching of interventional radiology. Although the use of virtual reality has been shown to be effective for skill acquisition and learning in interventional radiology, there is still a lack of studies evaluating and standardizing the employment of this technology in relation to the numerous procedures that exist within the field of expertise.

Keywords: Radiology, interventional; Virtual reality; Education, medical; Simulation training.

OBJECTIVE: To profile the use of educational materials by radiologists and radiology residents in Brazil. MATERIALS AND METHODS: This was a cross-sectional, descriptive, observational study in which an electronic questionnaire was sent via email to physicians working in the field of radiology. The questionnaire contained questions regarding the profile, education, and place of work of the physicians, as well as their access to educational resources and the types of educational materials they used most. RESULTS: The questionnaire was completed by 265 physicians. The mean age of the respondents was 38.2 years. Of the 265 respondents, 212 (80.0%) worked with ultrasound, 206 (77.7%) worked with computed tomography, 170 (64.2%) were board-certified, 166 (62.6%) were male, 174 (65.7%) worked at private facilities, and 167 (63.0%) had no academic affiliation. The mean weekly total study time was 9.6 h (median, 6 h), being higher among physicians in training, among those who worked at public facilities, and among those who worked at teaching hospitals. Regarding the device employed in order to access educational materials, there was a trend toward greater use of computers, which were employed by 65.3%. The majority of the respondents (61.9%) chose to access educational materials that were free of charge, the most common sources being websites, eBooks, and online journals. CONCLUSION: Electronic and digital resources are the main means of access to educational materials used by radiologists in Brazil, the most commonly used resources being web sites, eBooks, and online journals.

Keywords: Radiology; Teaching materials; Education, continuing; Multimedia.

OBJECTIVE: The Laudo Estruturado e Léxico em Oncologia (LELEX, Lexicon and Structured Reporting in Oncology) initiative was established to develop a standardized lexicon and structured reporting system applicable across cancer types.
METHODS: The São Paulo Radiology Society and Brazilian Society of Medical Oncology assembled a 27-member multidisciplinary consensus panel that included radiologists, medical and radiation oncologists, surgeons, and a patient representative. A literature review identified relevant oncologic reporting frameworks to guide the creation of a draft template and lexicon by the LELEX executive committee. Panelists were surveyed to assess current reporting practices and preferences between free-text and structured reports. Consensus (i.e., agreement by more than 80% of panelists) on the final lexicon and reporting system was reached through post-survey panel discussions.
RESULTS: Compared with a traditional free-text report, a structured report incorporating the LELEX lexicon received significantly higher ratings for precision and was deemed better for guiding clinical decisions by > 88% of panelists. In post-survey discussions, consensus was achieved for all lexicon components, including diagnostic certainty terms, lesion count descriptors, and longitudinal comparison language. The structured report template was also agreed upon by the panel members.
CONCLUSION: The LELEX initiative established a consensus-driven structured reporting system and lexicon for general oncologic imaging baseline and follow-up assessments.

Keywords: Radiology information systems; Radiology/education; Medical records/standards; Terminology as topic; Neoplasms/diagnostic imaging; Medical oncology/education; Decision making; Uncertainty; Longitudinal studies; Follow-up studies.