Dr. Zuhair Ali Dr. Michael Farrell

Introduction: The move towards body system based integrated curricula at undergraduate education level: * North America (since 1950s) * Western Europe, eg. UK &Ireland (Late 1990s) * Dundee University, early pioneers. * Sudan: Gezira University SPICES model of curriculum review. Student- centeredTeacher-centered Problem-based Information gathering IntegratedDiscipline-based Community-basedHospital-based ElectivesStandard program SystematicOpportunistic

Introduction: Features Postgraduate level??? RADIOLOGY The move towards body system based integrated, Learner centeredness, Standard core with electives, Competency, and outcome based curricula:

Introduction: RCR model Modification of Royal College of Radiologists Exam Format: From one paper to 6 modules; Body system based: 1\ Chest and cardiovascular system. 2\ Muscloskeletal system. 3\ Gastrointestinal system. 4\ Genitu-urinary system, breast and adrenals. 5\ Paediatric radiology. 6\ Central nervous system and head and neck. ** well defined core curriculum with oprions; Flexibility in Rotation planning. RCR model 3 years pre fellowship core curriculum 2 years subspecialty training Irish model 1 year basic radiological sciences 3 years clinical pre-felowship 1 year subspecialty training

Introduction: ** Waterford Regional Hospital = 537 beds hospital, = one of 8 national cancer treatment providing services in Ireland Radiology Department: ** 8 Radiologists, 4 Registrars, 8 modalities Radiological modalities in WRH Plain radiography FlouroscopyUltrasoundCTMRIInterventionalBreast imaging Nuclear medicine

Objectives: 1\ Identify the learning opportunities in WRH in three years period that would meet the RCR core curriculum clinical outcomes. 2\ Developing structured teaching and learning body- system based spiral two-phases rotation, with a third advanced level rotation. 3\ Develop local learning documentation forms and templates that meet training standards and enhances learner centeredness.

Competency based rotation planning: Four steps of competency based medical training Defining competencies Devise training program Devise assesment Define pass stansdard

Competency based planning: ** dividing ability to conduct & report exams into 3 phases: 1\ Introductory phase: (first year) essential competencies to run basic registrars workload and do on-call duties. 2\ Foundation phase: (year2-3)be able to conduct % of a routine list to the satisfaction of supervising consltant, & pass the relevant theoretical module exam. 3\ advanced phase: (year4-5) in depth involvement in studies, audits and optional procedures, complete fellowship final exam.

STEPS ADOPTED: ** dividing ability to conduct & report exams into 3 phases: I\ RCR core curriculum analysis: Very detailed documents showing core and optional outcomes. II\ Workload analysis: five categories depending on the frequency of test, : very frequent, frequent, common, less frequent and rare. III- matching curriculum outcome to learning opportunities: Dividing the core curriculum competencies according to the four body-system based rotations.

Structure: ** Four essential & one optional Rotations: 1\ Chest & oncology 2\ GIT & Paediatric imaging. 3\ GU & Breast Imaging. 4\ MSK, CNS & Head& neck. 5\ An optional interventional Radiology rotation. ** 2 consultants supervising every rotation, some involved in more than one rotation. ** each rotation has 3 levels: 1\ introductory phase. 2\ foundation phase, 3\ advanced phase. 4-5 Rotations Chest & Oncology Interventional GU & Breast imaging GIT & pediatrics Imaging. MSK, CNS & head & Neck imaging

Structure: ** 3 phases: 1\ Introductory phase: (first year) 3 monthsX4, commonly encountered (daily) investigations: as ED plain films, oncall CT scan, common barium studies, abdomen/pelvic Us e.t.c. 2\ Foundation phase:(year2-3); common examination seen on weekly bases: prepare theoretical basis of every module. 3\ advanced phase: (year4-5) in depth involvement in studies, audits and optional procedures.

Learner centeredness: ** 3 features: A\ learning contracts design: trainees participate in designing learning contracts for every rotation including intended competencies, reading lists, courses and exam modules. B\ Peer Assisted learning: evening weekly tutorials presenting topics from agreed refrences and websites, e.g. Radiology consult, the radiology assistant and Priemr Radiology book. Solving 20 sample questions. C\ Frequent Tutorials: 3 consultant lead tutorial per week, early mornings and lunch hour, Monday, Tuesday Wednesday and occasionally fridays. Random topics, different levels. Friendly environment, NO STRESS.

Progress so far: Since the adoption of the new system 32 months ago: 1\ One trainee is finishing his second phase in June 2012, 2\ one trainee is starting the second phase and 3\ a third is in his first phase. Trainees are progressing successfully through exam modules. They are satisfied with taking more responsibility towards their learning plan design and evaluation.

Take home messages: Body-system based training can be adopted at postgraduate level in designing comprehensive training rotations. Assessment format, e.g. Body system modular format, can be aligned to help direct learning to meet planned core curriculum outcomes. Flexibility in tailoring educational methods would allow adoption of new innovations at postgraduate level rotations designs.

Thanks for your attention ANY QUESTION??