Subscribe to RSS
DOI: 10.1055/s-2007-963509
© Georg Thieme Verlag KG Stuttgart · New York
Radiologie in einem prägraduellen problembasiert-integrierten Medizincurriculum
Diagnostic Imaging in Pregraduate Integrated CurriculaPublication History
                     eingereicht: 6.11.2006
                     
                     angenommen: 9.8.2007
                     
Publication Date:
19 October 2007 (online)

Zusammenfassung
Prägraduelle medizinische Curricula unterliegen gegenwärtig einem Reformprozess mit einer Abkehr von traditionellen, nach Fächern aufgebauten Studien und einer Hinwendung zu problembasiert integrierten Studien. Von dieser Entwicklung ist auch der Fachbereich Radiologie betroffen, in dem durch kürzer werdende Innovationszyklen bei bildgebenden Verfahren dieser Paradigmenwechsel weiter beschleunigt wird. Für den radiologischen Unterricht erscheint die Festlegung von aus didaktischen Kernkompetenzen abgeleiteten Lernzielen für die drei Schwerpunkte In-vivo-Visualisierung von Anatomie und Organfunktion, Diagnostik sowie interventionelle Therapie sinnvoll. Darauf aufbauend sind adäquate Unterrichtsformen zu entwickeln, in die E-Learning-Angebote einbezogen werden sollten. Das Konzept des fallbasierten Lernens bietet eine sinnvolle Unterstützung. Durch die Erstellung und Nutzung radiologischen Bildmaterials zu Lehrzwecken kann sich das Fach Radiologie, indem Aufgaben aus den Bereichen Anatomie, Pathologie und Entscheidungsfindung übernommen werden, zu einem zentralen Gegenstand moderner Curricula entwickeln. Am Beispiel des Wiener Curriculum-Modells wird die Implementierung eines unter diesen Prämissen gestalteten radiologischen Unterrichts dargelegt.
Abstract
Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula.
Key words
curriculum - education - medical - undergraduate methods - radiology education - professional practice standards - clinical competence - computer-assisted instruction - e-learning
Literatur
- 1 
            Harden R, Sowden S, Funn W. 
            Educational strategies in curriculum development: The SPICES-model. 
            Med Educ. 
            1984; 
            18 
            284-297 
            
            Reference Ris Wihthout Link
- 2 
            Christensen L. 
            The Bologna Process and medical education. 
            Med Teach. 
            2004; 
            26 
            625-629 
            
            Reference Ris Wihthout Link
- 3 
            WFME .
            Global Standards for Quality Improvement - Basic Medical Education. 
            2003; 
            , www.wfme.org
            
            Reference Ris Wihthout Link
- 4 
            Buckenham T. 
            Teaching imaging to undergraduates: strategies and expectations. 
            N Z Med J. 
            2005; 
            118 
            U1698 
            
            Reference Ris Wihthout Link
- 5 
            Elnicki D M, Londen van J, Hemmer P A. et al .
            U. S. and Canadian internal medicine clerkship directors’ opinions about teaching
            procedural and interpretive skills to medical students. 
            Acad Med. 
            2004; 
            79 
            1108-1113 
            
            Reference Ris Wihthout Link
- 6 
            Gunderman R B. 
            Ingredients of successful medical student teaching. 
            AJR Am J Roentgenol. 
            2004; 
            182 
            1115-1117 
            
            Reference Ris Wihthout Link
- 7 
            Collins J. 
            Medical education research: challenges and opportunities. 
            Radiology. 
            2006; 
            240 
            639-647 
            
            Reference Ris Wihthout Link
- 8 
            Chew F S. 
            Distributed radiology clerkship for the core clinical year of medical school. 
            Acad Med. 
            2002; 
            77 
            1162-1163 
            
            Reference Ris Wihthout Link
- 9 
            Collins J, Dotti S L, Albanese M A. 
            Teaching radiology to medical students: an integrated approach. 
            Acad Radiol. 
            2002; 
            9 
            1046-1053 
            
            Reference Ris Wihthout Link
- 10 
            Ekelund L, Elzubeir M. 
            Diagnostic radiology in an integrated curriculum: evaluation of student appraisal. 
            Acad Radiol. 
            2000; 
            7 
            965-970 
            
            Reference Ris Wihthout Link
- 11 
            Gunderman R B, Siddiqui A R, Heitkamp D E. et al .
            The vital role of radiology in the medical school curriculum. 
            AJR Am J Roentgenol. 
            2003; 
            180 
            1239-1242 
            
            Reference Ris Wihthout Link
- 12 
            Gunderman R B, Alexander S, Jackson V P. et al .
            The value of good medical student teaching: increasing the number of radiology residency
            applicants. 
            Acad Radiol. 
            2000; 
            7 
            960-964 
            
            Reference Ris Wihthout Link
- 13 Bloom B. Taxonomy of educational objectives: the classification of educational goals: Handbook
            I, cognitive domain. New York, Toronto; Langmans, Green 1956: 4-88 
            Reference Ris Wihthout Link
- 14 
            Miller G. 
            The assessment of clinical skills/competence/performance. 
            Acad Med. 
            1990; 
            65 
            563-567 
            
            Reference Ris Wihthout Link
- 15 Bürgi H, Bader C, Bloch R. et al .Swiss Catalogue of Learning Objectives for Undergraduate Medical Training. Joint Converence of Swiss Medical Faculties (SMIFK) Geneva; 2002 
            Reference Ris Wihthout Link
- 16 
            Shannon S. 
            Self-directed learning and continuing professional development. 
            Can Assoc Radiol J. 
            2000; 
            51 
            326-327 
            
            Reference Ris Wihthout Link
- 17 
            Peterson C. 
            Factors associated with success or failure in radiological interpretation: diagnostic
            thinking approaches. 
            Med Educ. 
            1999; 
            33 
            251-259 
            
            Reference Ris Wihthout Link
- 18 
            Rogers L F. 
            Imaging literacy: a laudable goal in the education of medical students. 
            AJR Am J Roentgenol. 
            2003; 
            180 
            1201 
            
            Reference Ris Wihthout Link
- 19 Erikson U. Pregraduate Training in Radiology in Europe. European Association of Radiology EAR Access 2000 http://www.ear-online.org/ 
            Reference Ris Wihthout Link
- 20 Shaffer K, Lewis P. AMSER National Medical Student Curriculum in Radiology. Alliance of Medical Student
            Educators in Radiology (AMSER) Access. 2004 http://www.aur.org/amser/ 
            Reference Ris Wihthout Link
- 21 
            Subramaniam R, Beckley V, Chan M. et al .
            Radiology curriculum topics for medical students: students’ perspectives. 
            Acad Radiol. 
            2006; 
            13 
            880-884 
            
            Reference Ris Wihthout Link
- 22 
            Gunderman R, Williamson K, Fraley R. et al .
            Expertise: implications for radiological education. 
            Acad Radiol. 
            2001; 
            8 
            1252-1256 
            
            Reference Ris Wihthout Link
- 23 
            Ernst R D, Sarai P, Nishino T. et al .
            Transition from film to electronic media in the first-year medical school gross anatomy
            lab. 
            J Digit Imaging. 
            2003; 
            16 
            337-340 
            
            Reference Ris Wihthout Link
- 24 
            McLachlan J C, Patten D. 
            Anatomy teaching: ghosts of the past, present and future. 
            Med Educ. 
            2006; 
            40 
            243-253 
            
            Reference Ris Wihthout Link
- 25 
            Arger P H, Schultz S M, Sehgal C M. et al .
            Teaching medical students diagnostic sonography. 
            J Ultrasound Med. 
            2005; 
            24 
            1365-1369 
            
            Reference Ris Wihthout Link
- 26 
            Erkonen W E, Albanese M A, Smith W L. et al .
            Effectiveness of teaching radiologic image interpretation in gross anatomy. A long-term
            follow-up. 
            Invest Radiol. 
            1992; 
            27 
            264-266 
            
            Reference Ris Wihthout Link
- 27 
            Heilo A, Hansen A, Holck P. et al .
            Ultrasound ‘electronic vivisection’ in the teaching of human anatomy for medical students. 
            Eur J Ultrasound. 
            1997; 
            5 
            203-207 
            
            Reference Ris Wihthout Link
- 28 
            Miles K A. 
            Diagnostic imaging in undergraduate medical education: an expanding role. 
            Clin Radiol. 
            2005; 
            60 
            742-745 
            
            Reference Ris Wihthout Link
- 29 
            Shaffer K, Small J E. 
            Blended learning in medical education: use of an integrated approach with web-based
            small group modules and didactic instruction for teaching radiologic anatomy. 
            Acad Radiol. 
            2004; 
            11 
            1059-1070 
            
            Reference Ris Wihthout Link
- 30 
            Teichgraber U K, Meyer J M, Poulsen Nautrup C. et al .
            Ultrasound anatomy: a practical teaching system in human gross anatomy. 
            Med Educ. 
            1996; 
            30 
            296-298 
            
            Reference Ris Wihthout Link
- 31 
            Novelline R A, Scheiner J D, Mehta A. et al .
            Preparing medical students for a filmless environment: instruction on the preparation
            of electronic case presentations from PACS. 
            Acad Radiol. 
            2001; 
            8 
            266-268 
            
            Reference Ris Wihthout Link
- 32 
            Bowen J L. 
            Educational strategies to promote clinical diagnostic reasoning. 
            N Engl J Med. 
            2006; 
            355 
            2217-2225 
            
            Reference Ris Wihthout Link
- 33 
            Scheiner J D, Novelline R A. 
            Radiology clerkships are necessary for teaching medical students appropriate imaging
            work-ups. 
            Acad Radiol. 
            2000; 
            7 
            40-45 
            
            Reference Ris Wihthout Link
- 34 Armstrong P, Ringertz H, Bischof Delaloye A. Referral guidelines for imaging. Luxembourg; European Commission Directorate-General for the Environment 2001: 44-58 
            Reference Ris Wihthout Link
- 35 Frühwald F, Imhof H, Kletter K. Orientierungshilfe Radiologie. Anleitung zum optimalen Einsatz der klinischen Radiologie.
            3 rd ed. Wien; Verlag der Österreichischen Ärztekammer 2006: 2-47 
            Reference Ris Wihthout Link
- 36 Strauss S, Richardson W, Glasziou P. et al .Evidence-based Medicine. How to practice and teach EBM. 3 rd ed. Edinburgh; Elsevier Churchill Livingstone 2005: 67-99 
            Reference Ris Wihthout Link
- 37 
            Williamson K B, Kang Y P, Steele J L. et al .
            The art of asking: teaching through questioning. 
            Acad Radiol. 
            2002; 
            9 
            1419-1422 
            
            Reference Ris Wihthout Link
- 38 
            Chew F S, Ochoa E R Jr, Relyea-Chew A. 
            Application of the case method in medical student radiology education. 
            Acad Radiol. 
            2005; 
            12 
            746-751 
            
            Reference Ris Wihthout Link
- 39 
            Collins J. 
            Keys to educator effectiveness in radiology. 
            Acad Radiol. 
            2006; 
            13 
            641-643 
            
            Reference Ris Wihthout Link
- 40 
            Committee TMPPTRP .
            Medical Professionalism in the New Millennium: A Physicians’ Charter. 
            Radiology. 
            2006; 
            238 
            383-386 
            
            Reference Ris Wihthout Link
- 41 
            Gunderman R B, Kang Y P, Fraley R E. et al .
            Teaching the teachers. 
            Radiology. 
            2002; 
            222 
            599-603 
            
            Reference Ris Wihthout Link
- 42 
            Hofer M, Abanador N, Modder U. 
            Effektive Didaktiktrainings fur Dozenten von CME-Fortbildungen (Continuing Medical
            Education). 
            Fortschr Röntgenstr. 
            2005; 
            177 
            1290-1296 
            
            Reference Ris Wihthout Link
- 43 
            Levine M S. 
            Primer for clinician scholars in academic radiology. 
            Radiology. 
            2004; 
            231 
            622-627 
            
            Reference Ris Wihthout Link
- 44 
            Amorosa J K. 
            How do I mentor medical students interested in radiology?. 
            Acad Radiol. 
            2004; 
            11 
            91-95 
            
            Reference Ris Wihthout Link
- 45 
            Levine M S. 
            The art of clinical research with medical students. 
            Acad Radiol. 
            2003; 
            10 
            527-535 
            
            Reference Ris Wihthout Link
- 46 
            Gunderman R B. 
            Learning to share. 
            AJR Am J Roentgenol. 
            2005; 
            185 
            844-847 
            
            Reference Ris Wihthout Link
- 47 
            Gessel van E, Nendaz M R, Vermeulen B. et al .
            Development of clinical reasoning from the basic sciences to the clerkships: a longitudinal
            assessment of medical students’ needs and self-perception after a transitional learning
            unit. 
            Med Educ. 
            2003; 
            37 
            966-974 
            
            Reference Ris Wihthout Link
- 48 
            Myint P K, Sabanathan K. 
            Role of grand rounds in the education of hospital doctors. 
            Hosp Med. 
            2005; 
            66 
            297-299 
            
            Reference Ris Wihthout Link
- 49 
            Collins J. 
            Education techniques for lifelong learning: writing multiple-choice questions for
            continuing medical education activities and self-assessment modules. 
            Radiographics. 
            2006; 
            26 
            543-551 
            
            Reference Ris Wihthout Link
- 50 
            Aitken V, Tabakov S. 
            Evaluation of the e-Learning material developed by EMERALD and EMIT for diagnostic
            imaging and radiotherapy. 
            Med Eng Phys. 
            2005; 
            27 
            633-639 
            
            Reference Ris Wihthout Link
- 51 
            Gotthardt M, Siegert M J, Schlieck A. et al .
            How to successfully implement E-learning for both students and teachers. 
            Acad Radiol. 
            2006; 
            13 
            379-390 
            
            Reference Ris Wihthout Link
- 52 
            Wagner M, Heckemann R A, Nomayr A. et al .
            COMPARE/Radiology, an interactive Web-based radiology teaching program evaluation
            of user response. 
            Acad Radiol. 
            2005; 
            12 
            752-760 
            
            Reference Ris Wihthout Link
- 53 
            Maleck M, Fischer M R, Kammer B. et al .
            Do computers teach better? A media comparison study for case-based teaching in radiology. 
            Radiographics. 
            2001; 
            21 
            1025-1032 
            
            Reference Ris Wihthout Link
- 54 
            Seitz J, Schubert S, Volk M. et al .
            Evaluation radiologischer Lernprogramme im Internet. 
            Radiologe. 
            2003; 
            43 
            66-76 
            
            Reference Ris Wihthout Link
- 55 
            Tello R, Davison B D, Blickman J G. 
            The virtual course: delivery of live and recorded continuing medical education material
            over the Internet. 
            AJR Am J Roentgenol. 
            2000; 
            174 
            1519-1521 
            
            Reference Ris Wihthout Link
- 56 
            Trumm C, Dugas M, Wirth S. et al .
            Digitales Lehrarchiv Konzept, Implementation und Erfahrungen im universitaren Umfeld. 
            Radiologe. 
            2005; 
            45 
            724-734 
            
            Reference Ris Wihthout Link
- 57 Niegemann H, Hessel S, Hochscheid-Mauel D. et al .Kompendium E-Learning. Heidelberg, Berlin; Springer 2004: 19-94 
            Reference Ris Wihthout Link
- 58 
            Jedrusik P, Preisack M, Dammann F. 
            Vereinfachte Herstellung multimedialer radiologischer Lernobjekte mit dem Flash-Format. 
            Fortschr Röntgenstr. 
            2005; 
            177 
            1009-1015 
            
            Reference Ris Wihthout Link
- 59 
            Hoa D, Micheau A, Gahide G. 
            Creating an interactive Web-based e-learning course: a practical introduction for
            radiologists. 
            Radiographics. 
            2006; 
            26 
            e25; quiz e25 
            
            Reference Ris Wihthout Link
- 60 
            Teplick S K, Berlin L, Cascade P. et al .
            Medical professionalism in the new millennium: a physicians’ charter. 
            Radiology. 
            2006; 
            238 
            383-386 
            
            Reference Ris Wihthout Link
- 61 Praschinger A, Stieger S, Kletter K. et al .Diagnostic rounds in undergraduate medical education - are they an effective teaching
            method?. Genua; International Association for Medical Education AMEE 2006: 215 
            Reference Ris Wihthout Link
Prof. Franz Kainberger
         Universitätsklinik für Radiodiagnostik
         
         Waehringer Güertel 18 - 20
         
         1090 Wien, Österreich
         
         Phone: ++ 43/1/4 04 00 48 18
         
         Fax: ++ 43/1/4 04 00 48 98
         
         Email: franz.kainberger@meduniwien.ac.at
         
         
 
     
      
    