RADU-4004 - Neuroradiology

RADU-4004 - Neuroradiology

Elective Type: clinical
Course Number
Prerequisites: Successful completion of Year 3 
      Additional Requirements:
Responsible Faculty Director:
John Heymann, MD
Other Faculty:
Location to Report on First Day
Lycia Champagne-Buckley, lcchampa@utmb.edu
Periods Offered
1-7, 9-13
excluding holiday period 8
Maximum Enrollment

The main goal of this course is to acquaint the student with the basic essentials of Neuroradiology and Neuroanatomy. The usefulness and limitations of various specialized neuroradiology procedures will be emphasized. Through various conferences the student will observe clinical and neuroradiologic correlation. The student will have enough time to work closely with Neuroradiology faculty, fellow and residents and watch them perform or supervise various procedures.

At the end of the course it is expected that the student will understand the indications for neuroradiologic procedures and the available alternatives in the workup of neurological, neurosurgical, spinal orthopedic and otolaryngolgy patients. Significant exposure to CT and MRI will be emphasized.

Description of course activities
Students observe daily readings of CT and MRI as well as observe neuroradiologic examinations such as cerebral angiography, endovascular treatments, discography and myelography and transpedicular biopsies. They will work closely with the Radiology residents, fellows and faculty. They will attend various weekly conferences with the Neuroradiology, Neurosurgery, Neurology, Radiation Oncology and Neuropathology staff.

The student will be required to prepare an oral presentation utilizing powerpoint during their rotation; the topic will be assigned in the first week. The oral presentation will review a neurological disease with appropriate imaging and treatment options to be presented to the Neuroradiology faculty, fellow and residents during their 3rd or 4th week. They will be graded on a pass/fail basis. Cases from a teaching file will be available for study. Reading assignments from available Neuroradiology textbooks and introduction to MRI physics will be assigned.

The students will be urged to complete and submit the course and faculty evaluation forms provided by the Office of Enrollment Services via email during the 3rd week of the course.

Type of students who would benefit from the course
It is particularly useful for students aiming at a career in Radiology, Neurology, Neurosurgery, ENT, Orthopedics or Psychiatry. Appropriate for other students also.

Weekly Schedule
  Clinical Activities (estimated schedule)
  Day of Week AM PM
  Monday 8:00 5:00
  Tuesday 8:00 5:00
  Wednesday 8:00 5:00
  Thursday 8:00 5:00
  Friday 8:00 5:00
   Average number of patients seen per week:  
   Call Schedule:   none  

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Neuroradiology faculty, fellows, and residents
  B. Frequency / Duration of Presentation(s)?
    1 per month
  C. Format - What guidelines are set for the student's presentation?
    Oral presentation with review of current literature regarding Analysis of a common neurological disease. Imaging, DDX and treatment options will be emphasized.
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    A multiple choice and T/F exam will be given to the student in the 4th week. This will be graded on pass/fail with a passing score of 70% or higher.
  B. Format - What guidelines are set for the student's written work?
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
    Texts or journals in Neuroradiology available through the web, library and reference texts in the department.
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    The students are expected to attend weekly Neuroradiology-Neurosurgery-Neurology Wednesday 8:00 a.m. multidisciplinary conferences and Noon Lectures given to the radiology residents by the Neuroradiology Staff. Other multi-disciplinary conferences are available.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.
    Daily evaluation. The students are routinely asked questions regarding anatomy, pathophysiology, basic science, clinical findings, laboratory values and treatment options of neurological diseases in the context of interpretions of neuroradiological exams at the daily faculty readouts on the PACS stations.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.