RADU-4004 - Neuroradiology

RADU-4004 - Neuroradiology

Elective Title: Neuroradiology
Course Number: RADU-4004
Elective Type: clinical Duration/Weeks: 4 Max Enrollment: 1
Prerequisites: Successful completion of Year 3
Additional Requirements: None
Responsible Faculty Director: John Heymann, MD Periods Offered: 1-7, 9-13 excluding holiday period 8 
Coordinator: Lycia Champagne-Buckley Other Faculty:
Location to Report on First Day:
Lycia Champagne-Buckley, lcchampa@utmb.edu

Goals
The goal of this elective is to provide medical students with a foundational understanding of neuroradiology, neuroanatomy, and the appropriate use of neuroimaging in the evaluation of neurological disease. Students will develop familiarity with common neuroradiologic imaging modalities, observe image-guided procedures, and participate in multidisciplinary conferences to appreciate the integration of imaging into clinical decision-making. Through close interaction with faculty, fellows, and residents, students will gain insight into the role of neuroradiology in patient care.

Objectives
Upon successful completion of this elective, the student will be able to:
1. Describe the basic anatomy of the brain, spine, head, and neck as demonstrated on CT and MRI.
2. Explain the indications, advantages, limitations, and potential risks of commonly used neuroradiologic imaging studies, including CT, MRI, angiography, myelography, and image-guided procedures.
3. Identify common neuroradiologic imaging findings associated with frequently encountered neurological, neurosurgical, spine, and head and neck disorders.
4. Select appropriate neuroimaging examinations for common clinical presentations using evidence-based imaging principles.
5. Recognize the role of neuroradiology in the multidisciplinary evaluation and management of patients with neurological disease.
6. Summarize the basic principles of MRI physics relevant to clinical image acquisition and interpretation.
7. Communicate neuroradiologic concepts effectively through an organized oral presentation that integrates clinical findings, imaging features, and current management strategies.

Description of course activities
Students will participate in the daily clinical activities of the Neuroradiology Division under the supervision of faculty, fellows, and residents. Educational experiences include:
• Observation of daily interpretation sessions for CT and MRI examinations.
• Observation of neuroradiologic procedures, including cerebral angiography, endovascular interventions, myelography, discography, image-guided spinal procedures, and transpedicular biopsies, as available.
• Participation in multidisciplinary conferences involving Neuroradiology, Neurosurgery, Neurology, Radiation Oncology, and Neuropathology, with emphasis on clinicoradiologic correlation.
• Independent review of teaching cases and assigned readings in neuroradiology and introductory MRI physics.
• Interaction with faculty, fellows, and residents to discuss imaging findings, differential diagnosis, and clinical management.

Students are expected to complete the institutional course and faculty evaluations distributed electronically by the Office of Enrollment Services during the final week of the elective.

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
          Estimated Course Activities (Start-Time/Finish-Time):
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
Saturday
Sunday

 Average number of patients seen per week:
 Call Schedule: none

Research / Other Course Activities
(estimated schedule)
Activity Hours per Week
Faculty Contact-Time
Self-Directed Study
Data-Collection/Analysis
Other


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?
    Daily
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Presentations will be evaluated by the Neuroradiology faculty on a pass/fail basis based on organization, accuracy, integration of clinical and imaging information, and effective communication.
  B. Frequency / Duration of Presentation(s)?
    1 per month
  C. Format - What guidelines are set for the student's presentation?
    Each student will prepare and deliver a 15–20-minute oral presentation using PowerPoint on an assigned neurologic disease during the third or fourth week of the rotation. The presentation should include: • Clinical presentation and epidemiology • Relevant neuroanatomy • Imaging findings across appropriate modalities • Differential diagnosis • Current treatment options and the role of imaging in patient management
  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?
    N/A
  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.?
    N/A
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

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

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".
    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.
   
 
B.
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.
   
 
C.
How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?
   
 
D.
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)?
   
 
E.
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?
   
 
F.
How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?
   
 
G.
How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
   
 
H.
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.