General Rotation

Learner Objectives

  • Understand and be able to discuss the principles, technology, benefits, and limitations of diagnostic imaging as used in solving clinical problems and how it impacts patient care.
  • Appreciate the performance and interpretation of assorted imaging studies in multiple clinical scenarios and settings through observation and active participation.
  • Effectively communicate the medical knowledge gained by being an active participant assisting the faculty or residents during review and readout sessions by looking up prior imaging studies, clinical information, lab data, and references..
  • Learn and demonstrate approaches to interpreting basic radiologic imaging and with medical knowledge be able to formulate an appropriate differential diagnosis.
  • Acquire basic interpretative skills for reading images and learn how to correlate radiologic and clinical information?
  • Be able to determine the appropriate imaging techniques recommended by the American College of Radiology that will be utilized in the learner’s future as a professional colleague of Radiology. Gain knowledge and experience in order to make you informed, and therefore, a better consumer of diagnostic imaging services.

Questions You Should Answer During the Rotation

  • What imaging modalities are available?
  • Which modalities use ionizing radiation? If a modality does not use ionizing radiation, what is the principle behind that imaging modality?
  • Are there any side effects to ionizing-radiation, sound waves or magnetic resonance?
  • What are the common contrast agents used in radiologic imaging, how are they administered (what routes), and what are the potential complications of using these agents? When should a contrast agent not be used? What is considered to be a serious contrast reaction? As a clinician, when should you and how can you prepare a patient (using pharmaceuticals) to decrease the likelihood of a serious contrast reaction?
  • What is a routine chest or abdominal plain film series? What other plain radiography views can be used to supplement the standard views, and when should the extra views be ordered? How do portable plain films compare to standard films performed in the radiology department?
  • Which examinations require patient preparation prior to the scheduled appointment? What are these preparations?
  • What do the various examinations cost in regard to money, time, and risk to the patient?
  • What are "STAT" radiology examinations? Does this add to the cost of an examination?
  • When you order an examination, what is in store for your patient?
  • Why is it important to provide an adequate clinical history and “clinical questions to be answered” on the requisition for an imaging study?
  • When is it important to communicate directly with the radiologist?
  • How do you determine which imaging study is appropriate?

General Instructions

  1. Please dress appropriately and professionally. All of the rotations have the possibility of patient contact. This includes the wearing of a white coat and name tag and radiation badge (if applicable).
  2. Kim Desbrough, desbroug@med.umich.edu, (734) 647-4144, Clerkship Administrator, along with Dr. Leslie Quint (Clerkship Director) are available to answer your questions and help solve problems that arise during your rotation.
  3. This is a four week rotation and any absences will be documented. We must be notified of any absence from the rotation, planned or unexpected. Please call or email Kim if this occurs. Absences must be made up by documenting comparable time in the radiology department arranged by Dr. Quint or your instructor.
  4. Your grade will be determined by a combination of the following:
    1. Participation and observations documented during your clinical rotations (4 weeks total)
    2. 10-minutecase-based PowerPoint presentation in PowerPoint.
    3. Attendance at clinical lectures (if applicable)

Oral Presentations

When: The oral case based seminar presentations are held during the last week of your rotation, usually on Wednesday, Thursday and/or Friday.

Content: Find a case illustrating a topic which interests you. The presentation should focus on the role that imaging played in your particular patient. IMAGING IS THE KEY FOCUS OF THE PRESENTATIONS, and images should be shown within 1 minute after starting your presentation. Most of your discussion should revolve around the role of imaging. **These are not internal medicine presentations or CPC cases with complete history and physical findings, extensive lab values, etc. Please succinctly present only the PERTINENT clinical findings.**

Mentor: Find a radiology faculty mentor to help you choose your case. Ask the mentor to review your presentation with you and give you feedback.

Grade: Refer to the Oral Seminar Presentation evaluation form to see what aspects are important in your presentation. It must center on a real U of M case with original images and not images that were copied off the web. The presentation must show thought, focus, and integrate the clinical story and images that you have learned from your references. It must not just be a “book report” on a topic from the web.  Use references only from peer reviewed literature, not non-peer reviewed websites such as Radiopedia, Wikipedia, e-Medicine, WebMD, MedicineNet. etc.

Mechanics:

  • YOU MUST USE THE PROVIDED POWERPOINT TEMPLATE.
  • Ten (10) minutes, no more; you will be penalized if you exceed this. This is very difficult and will require careful planning and editing. You will be asked to focus and edit presentations throughout your medical career.
  • The focus of each presentation should be a U of M case in which diagnostic imaging examinations and/or interventions were used to work-up a clinical problem.
  • Present the case clearly. Explore pertinent aspects of the topic and conclude with summary.
  • What was the clinical problem? What was the role of imaging to better define and solve the clinical problem?
  • What modalities were used? What did they show? Might other imaging modalities have been considered or used? What modality? Reference the ACR Appropriateness Criteria https://www.acr.org/Clinical-Resources/ACR-Appropriateness-Criteria
  • How much do these studies cost? What are the advantages & disadvantages of the modalities which were used or which could have been used?
  • Presentations must be professional, standardized and free of superfluous information, slides, or editorials.
  • Patient identification must be removed from the presentation to maintain patient confidentiality and to maintain HIPAA compliance. This includes patient initials, names, medical registration numbers, dates (just the month or just the year are fine, but not BOTH the month and year). Your grade will suffer if protected PHI is on your slides.
  • If you take material from the web, note the website on the slide on which the material appears. Similarly if you take material from a journal, make sure that the reference is on the slide. It is imperative that you indicate where you received your images and properly cite all sources if obtained outside of the University of Michigan Radiology Department. Include a reference page at the end of your presentation.
  • Your presentation will be given in a seminar format, and each student should use the opportunity to teach the other students as in a graduate student seminar. Present the material as you would like to have had it presented to you. We all learn from each other.
  • Learn from your colleagues and ask questions at the seminars. Save questions for the end of each presentation unless it is concerns a point which absolutely demands an immediate simple clarification. Time taken to answer a question will not be counted as part of your ten (10) minute presentation.
  • Please send your presentation to Kim Desbrough via e-mail. Please print a paper copy of your PowerPoint presentation for the faculty member listening to the presentations that day. DO NOT make paper handouts for the entire class before your presentation.