Education Research: Neuroradiology Curriculum and Competencies Among Canadian Adult Neurology Residency Programs: A Cross-Sectional Study

Abstract

Background and objectives: While benefitting from neuroradiologists' reports, neurologists use their own image interpretation to guide clinical decisions, especially in acute care settings. This calls for robust neuroradiology training in neurology residency, informed by current educational gaps and practices. This study aims to (1) characterize the formal neuroradiology curriculum among Canadian neurology residency programs; (2) assess neurology residents' neuroimaging interpretation competencies; and (3) define neurology residents' and program directors' (PDs) attitudes toward the current curriculum and future directions.

Methods: Anonymous surveys were sent to Canadian neurology residents and PDs, querying neuroradiology learning activities, imaging modalities covered, assessment modalities, perceived residents' competencies to interpret different modalities, and attitudes regarding neuroradiology training. Residents were asked to interpret 15 neuroimaging cases. Descriptive and inferential analyses were performed. Potential differences in residents' interpretation success rates by seniority, self-perceived proficiency, and perception of curriculum sufficiency were examined using 2-tailed Welch tests with a 95% CI and Holm-Bonferroni comparison adjustment. Statistics were computed using Excel.

Results: Seventy-eight (32.6%) residents and 11 (68.8%) PDs participated. Ten of 11 PDs reported including a mandatory neuroradiology rotation, and 9/11 offered a formal neuroradiology curriculum covering head CT, head and neck CT angiography (CTA), spine MRI, and head MRI. Programs predominantly offered additional didactic lectures (9/11), teaching cases (8/11), and imaging websites (8/11). Most of the residents agreed with a minimum 1-month long rotation and desired regular didactics from neuroradiologists. Residents favored learning about head MRI (88.5%), head and neck CTA (76.9%), and spine MRI (69.2%). Senior residents' self-perceived competencies were highest for head CT, head MRI, and head and neck CTA, but lower than PDs' perception. Senior residents had greater interpretation scores than juniors (84.5% ± 13.2% vs 69.1% ± 19.9%; p < 0.0001). Most PDs (7/11, 63.6%) expressed satisfaction with current curricula vs 32.1% of residents. PDs identified time and educator shortages as main barriers to increased training.

Discussion: Neuroradiology training varies among programs. Residents expressed strong interest in commonly taught modalities, for which they also expressed high self-perceived competencies. However, PDs expressed greater satisfaction than residents with the current training. Leveraging interactions with neuroradiologists and online case-based learning while emphasizing trainees' interests can enhance postgraduate neuroradiology training for this useful skill.

Figure 1. PDs' Perceived Senior Residents' Competencies to Interpret Neuroimaging Modalities

CTA = CT angiography; PD = program director.

Figure 2. PDs' and Residents' Perception of the Current Neuroradiology Curriculum

PD = program director.

Figure 3. Senior and Junior Residents' Self-Perceived Competencies to Interpret Neuroimaging Modalities

CTA = CT angiography.