Resident Education in the time of the COVID-19 Pandemic

2060 Objectives: The COVID-19 pandemic began in the United States and California in March 2020. At that time numerous academic Radiology programs began efforts to increase the safety of their trainees and minimize exposure of trainees, faculty, staff, and patients. In this presentation, we will address the methods undertaken at our institution, University of California in San Diego, CA in the Radiology Department and the Nuclear Medicine Division. Decreasing exposure while maintaining daily workflow and quality teaching will be explored. Methods and Results: At the beginning of the pandemic, PACS support was engaged quickly with radiology leadership, agreeing to an organized approach moving workstations within the department such that the 6 foot distancing requirement was met in the reading rooms and offices. The clinical coverage system initially created by the Radiology department was a 2-tiered trainee team approach with on campus and off campus radiology residents. In case 1 team became exposed or ill, requiring time away, then a back-up team was in place. A similar approach to portions of the faculty was utilized, however, Nuclear Medicine faculty remained onsite given the daily workflow that includes physician performed procedures, including all myocardial stress perfusion studies. Readouts were conducted in a variety of settings: in person with appropriate distancing and PPE, telephone readouts, and increasing utilization of Zoom for readouts as the UCSD health system made available Zoom accounts for faculty and trainees. While logged into their individual PACS, the trainee could also login to an invited Zoom meeting where the attending could project the study on the resident’s side monitor. Zoom allowed for audiovisual interaction including allowing the trainee or attending to “take over” the mouse as needed. Zoom was utilized for attending teaching simulating side-by-side seating at the PACS for case review and also powerpoint presentations. In our Nuclear Medicine division and with department chair approval, the decision was made early to continue to have the residents participate in therapies with appropriate PPE and distancing such that the residents could fulfill low-dose and high-dose I-131 therapy requirements and fulfill requirements for authorized user status. While on the Nuclear Medicine service at each hospital site, residents obtain familiarity with laboratory, clinic, and camera equipment. The residents don gloves and PPE, handle equipment, measure doses, and have other hands-on experiences, as was done prior to the pandemic. They are encouraged to participate in procedures such as lymphoscintigraphy and diagnostic studies as can be done safely to continue to enhance their education. Conclusions: The feedback from the residents has been positive especially with the utilization of Zoom, continuing in person readouts at our main hospital site and onsite teaching. Currently, the Radiology department is in process to obtain cameras for the PACS such that residents, especially the more junior who may not be as familiar with the faculty, will have an enhanced interactive experience more akin to traditional in person readouts. Nuclear medicine presents a weekly lecture series that is given via Zoom and depending on the location of the presenting attending, the presentations are sometimes given in the traditional conference rooms with appropriate distancing and PPE. Overall, a combination of methods including in person, on site, and teleradiology methods have been employed in the education of our residents. The key lessons that we have learned include quickly adapting to each phase of the pandemic, while optimizing safety and educational experiences.