critical thinking in radiologic technology

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• Published: 24 May 2023

Embracing critical thinking to enhance our practice

• Luis Martí-Bonmatí   ORCID: orcid.org/0000-0002-8234-010X 1  

Insights into Imaging volume  14 , Article number:  97 ( 2023 ) Cite this article

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Miguel de Cervantes, the great Spanish writer, once wrote that those “who read much and walk much, go far and know much" [ 1 ]. The same is true in medicine; reading and gathering experience are the main pillars on which one should develop the knowledge of solving clinical problems in the ever-changing field of healthcare. If properly done, these newly acquired skills will continuously enhance our critical thinking strategies with which we try to identify the best possible improvements in the clinical pathway of radiology. As gaps in knowledge are always present, medicine is rooted in consolidated knowledge based on validated scientific studies and clinical experience reproducibility and accuracy [ 2 ]. This represents our best approach to evidence-based decisions. Medical knowledge must be well-established before it can be considered as the basis for decision making and patients guidance in daily practice.

The practice of critical thinking helps us understand the disease manifestations and the related processes and actions that might be relevant to prevent, diagnose and treat diseases. To critically appraise the way we perform evidence-based practice, we must combine best quality research with clinical expertise. This link between exploration and practice will allow radiologists and related disciplines to impact the way medicine is practiced.

These concepts are the cornerstones of Insights into Imaging , and it is my privilege as editor-in-chief to describe in this editorial how the journal, and each author, can contribute quality through critical thinking, and hence improve the way we practice radiology by re-shaping our understandings.

It is universally recognized that, in medical imaging, strong levels of evidence are needed to assess the results of the different possible actions and to guide decisions (i.e., to demonstrate a sufficient causal relationship between a specific diagnostic criterion and a disease grading, or a given radiological intervention versus another option in a given condition) toward the most effective or safe outcome considering the benefit of patients and value-based healthcare pathways. Consequently, solid levels of evidence are required to assess the results of different possible actions derived from imaging findings. And, in doing so, we continuously generate more data in our diagnostic and therapeutic activities, whether they are processes or outcomes. This new information will then be transformed into new evidence, real world evidence. In this way, the observed relationship between action and outcome generates causality course actions that will improve our understanding of the best clinical pathways, eliminating the many confounding thoughts that we unconsciously carry during the process of learning and implementing our clinical practice.

Socratic inquiry and Skepticism as foundation. Critical thinking can be understood as the process of analyzing and questioning existing and established knowledge with the intention of improving it. Previous knowledge, either eminence- or evidence-based, should continuously be critically reconsidered and reevaluated for the benefit of the patients, as knowledge is always changing in Precision Medicine. In the real world of medical imaging, this critical thinking must be focused on the evaluation of the effectiveness and clinical impact of all those processes in which images are involved, from the acquisition with different modalities to the processing of the data, from the biological correlation of radiomics as an image biomarker to the therapeutic orientation, and finally in image-guided interventional treatments. Developing critical thinking helps to improve any medical discipline by asking ourselves how to establish better and more precise processes based on existing accumulated evidence, how to recognize and control the biases when approaching a clinical problem, and how to adapt the new clinical information in service of the best solutions. Socratic inquiry and a skeptic attitude can be used to consolidate the best knowledge and construct new associations to be more efficient and to approach excellence in our daily work. Critical thinking is therefore necessary to improve both clinical practice and research in radiology, avoiding disruptive uncertainties and wrong assumptions.

These “questioning and solving” skills require learning, practice, and experience [ 3 ], but mainly a recognition of the many uncertainties we do have despite the important scientific advances. Precisely, a good example of the importance of critical thinking is its contribution to Precision Medicine through medical imaging data and information. In daily practice, we should ask ourselves why should we accept a reliable diagnostic method that fails 15% of the time, or an appropriate treatment that is not effective in almost 25% of patients? As scientists, we can improve these clinical decisions in the daily practice. Artificial intelligence (AI) solutions integrating different imaging, clinical, molecular, and genetic data as inputs are being implemented as a suitable pathway to solve clinical problems. The design and methodology of these AI algorithms must allow for their explainability and critical thinking evaluation before they are implemented in clinical practice [ 4 ].

In summary, critical thinking develops evidence-based knowledge, provides continuous improvements, and avoids spurious technical and clinical misconceptions. Insights into Imaging is dedicated to manuscripts with a clear critical approach, focusing on excellence in clinical practice, evidence-based knowledge and causal reasoning in radiology. Science is based on long-lived critiques and authors are encouraged to systematically identify, analyze, and solve problems by identifying inconsistencies and correcting errors.

To foster this, Insights into Imaging welcomes critical thinking papers and will incorporate a new “Critical Relevance Statement” in all their publications, where authors are asked to summarize in one sentence the question they are trying to answer and the improvement they are providing to the issue at hand.

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De Cervantes M (1986) The adventures of don Quixote de la Mancha. New York, Farrar, Straus, Giroux

Martí-Bonmatí L (2021) Evidence levels in radiology: the insights into imaging approach. Insights Imaging 12(1):45. https://doi.org/10.1186/s13244-021-00995-7

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Ho YR, Chen BY, Li CM (2023) Thinking more wisely: using the Socratic method to develop critical thinking skills amongst healthcare students. BMC Med Educ 23(1):173. https://doi.org/10.1186/s12909-023-04134-2

Cerdá-Alberich L, Solana J, Mallol P et al (2023) MAIC-10 brief quality checklist for publications using artificial intelligence and medical images. Insights Imaging 14(1):11. https://doi.org/10.1186/s13244-022-01355-9

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Medical Imaging Department and Biomedical Imaging Research Group, Hospital Universitario y Politécnico La Fe and Health Research Institute, Valencia, Spain

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Martí-Bonmatí, L. Embracing critical thinking to enhance our practice. Insights Imaging 14 , 97 (2023). https://doi.org/10.1186/s13244-023-01435-4

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Teaching Critical Thinking in Graduate Medical Education: Lessons Learned in Diagnostic Radiology

The 2014 Institute of Medicine report, Graduate Medical Education that Meets the Nation’s Health Needs , challenged the current graduate medical training process and encouraged new opportunities to redefine the fundamental skills and abilities of the physician workforce. This workforce should be skilled in critically evaluating the current systems to improve care delivery and health. To meet these goals, current challenges, motivations, and educational models at the medical school and graduate medical education levels related to formal training in nonclinical aspects of medicine, especially critical thinking, are reviewed. Our diagnostic radiology training program is presented as a “case study” to frame the review.

Introduction

A 2014 Institute of Medicine (IOM) report, Graduate Medical Education that Meets the Nation’s Health Needs , suggested that the current funding structure for training our US physician workforce lacks accountability. 1 The report describes the unique nature of public financing for graduate medical education (GME) via the Medicare program and therefore the unique accountability for serving the public good that such financing affords. The IOM suggests that significant changes to GME financing and governance could fundamentally improve physician training.

The first recommendation is the creation of “. . . a physician workforce better prepared to work in, help lead, and continually improve an evolving health care delivery system that can provide better individual care, better population health and lower cost.” The second is to encourage “. . . innovation in the structures, locations and designs of GME programs to better achieve Goal 1.” 1 Shifting resident training from an in-hospital–based structure to more diverse practice environments would help achieve these goals. 2 However, this training infrastructure does not yet exist and will be costly to build. In addition, although there are currently explicit Accreditation Council for Graduate Medical Education (ACGME) expectations that trainees participate in research and scholarly activity, these activities are uncommon in many residency programs. 3

Motivation for Critical Thinking

The goal of this review is to propose a generalizable framework that GME training programs could use to meet the IOM report goals. We review current challenges, motivations, and educational models at the medical school and GME levels related to formal training in nonclinical aspects of medicine, especially critical thinking. To frame the review, we present our own training program as a “case study.”

Adding dedicated critical thinking training in residency programs’ curriculum will address some of the IOM 2014 report goals. Critical thinking is, by definition, a mode of thinking in which the thinker analyzes his or her thought process, assesses it, and then reconstructs the thought process. The goal of critical thinking is to eliminate the tendency toward bias, prejudice, and otherwise uninformed conclusions. 4 Given the complexity of medical systems and the need to respond correctly, it is important that physicians actively learn to recognize biases, prejudices, and incorrect thinking.

A workforce that is capable of leading and improving health care delivery systems will be skilled in critically evaluating the current systems. This will require learning how to ask answerable questions and how to perform background analyses. This background analysis can then be used to discover ways to innovate and improve. They can then assess the benefits these innovations have on direct patient care, population health, and cost of care delivery. This skill set can be achieved through formal and sustained training in critical thinking throughout the process of becoming a practicing physician. Rather than requiring all learning to take place in the direct care of patients, this opens opportunities to invest in nonclinical skills training, including research and quality improvement, during residency.

Current Initiatives and New Efforts

To boost the critical thinking skills of our trainees, we are implementing a trifold strategy that could be modeled by other training programs. The goal is to produce the workforce of the future—physicians who have the skills to innovate and improve health. This strategy shifts the focus from self-reliance, self-preservation, and passivity to team building and collaboration.

Our training program devotes a minimum of 8 hours per week to protected education for trainees. Although much clinical medicine is learned during direct interaction with patients, formal and protected classroom-based instruction is of value. 5 Classroom teaching provides an avenue for in-depth exploration of topics outside the pressure of clinical decision making. Group teaching and discussion promote peer learning. In addition, critical and uncommon diseases are introduced during didactic teaching that are not reliably encountered during training. Although the IOM idea of moving all education into the clinical spaces where health care is delivered 1 , 2 is appealing, classroom-based and clinical-based teaching are complementary. 5 Trainees value time dedicated to the consolidation of clinical and theoretical knowledge. 5 Didactic lectures and defined educational programming remain important in realizing a more capable physician workforce.

We are transitioning from a traditional didactic lecture model to the flipped classroom model. In the flipped classroom, didactic materials are provided to the learners prior to the scheduled lecture time. The face-to-face time is used to fill in knowledge gaps and further solidify understanding of the key concepts. 6 This puts the onus on the resident to review and learn the material independently as there will be limited time in which the resident is a passive recipient of knowledge. Group time is used to foster active discussions in which trainees articulate their thought processes. In addition, the faculty, because the conference is not scripted, are often presented with opportunities to model critical thinking techniques. This mode of learning creates an environment that is conducive to discovering knowledge gaps, biases, prejudices, and other limitations of understanding that might lead to incorrect or uninformed clinical decisions.

There are many intersections between ACGME 7 -mandated general competencies for trainees and critical thinking. In radiology specifically, most of the activities of noninterpretive skills mandated by ACGME 8 build the skill sets that are the foundation of critical thinking. For example, in the domain of Systems Based Practice, competence in Quality Improvement is mandated. In Quality Improvement projects, the trainees look at the processes and systems that interfere with optimized care delivery and work to fix them. These projects often focus on scenarios that the trainees believe negatively affect their ability to deliver optimized patient care. These interventions are explicitly designed to address quality of care and often implicitly address underlying contributors to physician burnout. The problem solving that is embodied in the Plan-Do-Study-Act model of Quality Improvement encourages reflection and progressive problem solving. 1 , 9 , 10 This gives trainees an opportunity to understand that some errors may be unavoidable, that physicians are independent drivers of health, and that the system can improve. Knowing how to develop, implement, and evaluate quality improvement projects is a way one can add value to a health care organization and improve patient care. 11 These quality improvement activities are intrinsically aligned with the IOM report recommendations.

However, quality improvement projects are a relatively new concept. The lack of departmental support or resources for such projects could be a hindrance at some institutions. In addition, some programs may not have mentors who are comfortable in guiding residents through these projects as they themselves are new to these concepts. 3 However, proving the “value” and impact on patient outcomes of health care interventions is a required skill set in the new payment models of health care and training. This means trainees must learn these tools to become the workforce that is envisioned by the IOM report. 1

The second domain in ACGME Systems Based Practice is Health Care Economics. 8 Understanding economic concepts are essential to making informed recommendations and understanding potential barriers to change. Neither residents nor practicing physicians have a firm understanding of cost or the business aspect of medicine. 12 There are external resources available to teach these concepts, including the American College of Radiology via offerings in their Radiology Leadership Institute. 13 Some residency programs have dedicated business curricula. By teaching practice management, malpractice, informational technology, and personal finance, we believe that trainees will be positioned to incorporate these factors into their decision making when in practice. A lack of understanding of the economics of health care can produce the types of knowledge gaps, biases, and prejudices that limit a physician’s ability to make informed decisions.

Practice-based learning and improvement is an additional ACGME general competency. 7 An introduction to the tools and process of evidence-based radiology provides a forum for teaching and promoting practice-based learning. Evidence-based medicine training is now required in every medical school’s curriculum in the United States. 14 The goal is to provide all physicians with a basic understanding of statistics, how studies are conducted, and how to evaluate studies. 14 It is important to understand key concepts such as diagnostic accuracy, sensitivity, and specificity. The application of these concepts to make recommendations for patient care is even more important and elusive. 15 Medical school provides an introduction to these topics, and many residency programs try to expand on this foundation and tailor it to their specialty through formal lectures or journal clubs.

Incorporating evidence-based medicine practices into clinical activities leads to better retention of concepts and, in theory, better patient care. 14 The criticality of understanding and using evidence-based medicine in practice is enforced by the coverage of this content in physician basic licensing examinations as well as specialty board licensing examinations. For example, the American Board of Radiology has emphasized noninterpretive skills, including critical thinking, in their certification examinations. 16

A third means to improve resident critical thinking is to provide dedicated academic time. This includes dedicated block research time to work with faculty on completing research projects with the intention of presentation at national meetings and publication. Through participation in scholarly activity and by prioritizing that as valued time, the trainees learn to advocate for the importance of nonclinical activities in practice. To succeed when provided with this protected time, a trainee must be effective when gathering and evaluating existing evidence. To design studies that may further contribute to existent knowledge, identify new opportunities, and/or validate current behaviors, a trainee has to question current truths. The goal of this time is to give trainees the chance to solidify a base skill set in evidence-based medicine, upon which he or she will build. 17 By creating space outside of the clinical realm to process existing information, trainees are encouraged to take the time necessary to explore new information and break down biases.

Improving critical thinking training in residency is necessary to meet the IOM goals as well as to meet the medical care needs of our patients. There are many current threats to clinical care that the physician workforce needs to be prepared to address. In medicine, and especially in Radiology, volumes have been increasing steadily since 2008. 18 , 19 With the unsustainable costs associated with medical care in the United States, there has been increased scrutiny of the contribution of imaging to overuse of health care services in the United States. 20 , 21 For example, among Medicare recipients, there was 85% cumulative growth in imaging from 2000 to 2009. 22 Over the 1996-2010 period, the number of computed tomographic examinations has tripled and the number of magnetic resonance imaging scans has quadrupled among members of integrated health care systems, whereas the number of radiographic examinations has remained relatively stable. 22

At our institution, we have seen a steady growth of more than 10% in volume each year in radiology as well as multiple other specialties. This increasing volume creates tension between resident education, quality of care, and efficiency. The demand to meet the increasing work leads to less time for teaching of residents. This also means less time to incorporate the patient’s history and current clinical status into making diagnoses. To meet the increasing volume pressures, the radiologist truncates the time spent in examining and interpreting each study. When interpreting a study, the radiologist needs to incorporate information from multiple resources, including the electronic medical record, the images themselves, the limitations of the modality, and other patient factors. To reach the correct diagnosis, the radiologist must access his or her prior experience, training, and ability to think critically about the factors that might make a particular patient unique.

Increasing volume can also be a factor in the raise of physician burnout. This is a significant issue that will negatively affect the ability of health systems and will force trainees to adapt to new models of care delivery. 23 , 24 A provider workforce that actually improves health care delivery will have to have the bandwidth to take on further risk, given the uncertainty inherent in developing something new. Radiology, despite being a profession that is often cited as a good choice for work and life balance, most recently was ranked as having the fifth highest rate of burnout (61.4%) among all surveyed specialists. 24 The metrics of success in these future training systems will need to improve the health and satisfaction of caregivers, in addition to the quality of care delivered. If interventions merely help physicians cope with stress but do not address the root causes of physician burnout, the overall improvements may be limited. 23

Building Evidence

Radiology has long been criticized for the lack of high-quality evidence to inform the practice and recommendations that a radiologist makes when diagnosing a particular condition and patient. A 2006 article by Blackmore and Medina 32 argues that what is described as truth in radiology relies heavily on a paternalistic approach that is associated with traditional eminence-based medicine. In an eminence-based mode, experts provide guidance on the basis of their own experience and judgment. The accurate synthesis of evidence is required to provide high-quality and cost-appropriate care. The randomized control trail (RCT) is considered the epitome of high-quality evidence for medical decisions. There is a relative paucity of radiology RCTs in the medical literature. A recent review of RCTs over the past 20 years revealed only 358 radiology trials, of which most were characterized by relatively poor methodologic quality. 26 If the evidence that predicated the training of the diagnostic radiologist is weak, then the decisions a radiologist makes are inherently uninformed. This is a problem that the specialty as a whole must realize. The incorporation of systematic critical thinking into specialty training will help radiologists recognize the strength or weakness of the evidence that informs decisions. The goal of critical thinking is to eliminate the tendency toward bias, prejudice, and otherwise uninformed conclusions. 4

Adding Value

Health care in the United States is in transition from a fee for service (volume-based) system to an outcome (value-based) system. 27 – 29 Increasingly, both government and private payers are indexing payment to quality and other outcome metrics. Research is necessary to support this move and define these metrics. A challenge for radiologists is a lack of discrete and quantitative measures of the radiologists’ work that links patient outcomes to imaging and the interpretation of the imaging. 10 , 30 , 31 Thus, current recommendations emphasize the development of performance measurement tools that promote the use of evidence-based criteria in radiology. 30 , 32 – 34

In addition to this, radiologists are trying to find ways to add value to the increasing team-based approach to medicine. Many residency programs, including radiology residency programs, now seek not only to involve but also to have residents function in multidisciplinary committees. 12 , 35 We are trying to incorporate this mind-set into our program by giving senior residents the responsibility to prepare and present patients in these committees. The goal is to better understand the complexity of the multidisciplinary medical team and demonstrate how the radiologist effects and optimizes decision making regarding patient care. Through these means, the trainees are encouraged to both question current practice and discover the means to improve care.

The evolution, explosion, and significance of medical imaging in today’s practice of medicine have made the process of both teaching and learning clinical and nonclinical radiologic skills a formidable task to accomplish during 4 years of Diagnostic Radiology residency. 36 , 37 Faculty and future practitioners may have only their experience to inform decisions. There is no guarantee that such experience is insulated from bias, prejudice, or basic incorrect thinking. Even the guidelines developed by radiology societies, to which a practicing radiologist may refer to support a recommendation for the appropriate use of imaging tests, are often dependent on the experience of an expert committee over evidence. 32

Conclusions

Training programs can transition from a traditional hospital-based structured teaching method to a more diverse practice environment by thinking broadly about their current efforts that encourage critical thinking and active learning. Realizing the long-term benefits imagined in the IOM report will require substantive, dedicated, and continuous training. Many of the changes in our program represent initial steps needed to begin this process. To fully realize the IOM report goals, residency training must teach trainees to critically appraise and synthesize information rather than focus on fact memorization. Physicians with a critical thinking skill set are positioned to adapt to and to help shape ever-changing models of health care delivery. Although the specifics in each medical specialty may be different, the theme of producing physicians that solve clinical problems is a universal goal.

Graduate medical education residency training should embrace the goal of developing lifelong learning skills in trainees so that independent practicing physicians will be able to question current practices, synthesize information, recognize study design flaws, including statistical biases, and develop meaningful solutions and processes for their practice. This ability to question biases, expose uncertainty, and innovate is necessary to improve the health of our patients, our communities, and our profession. Residency provides the perfect place for young physicians to hone these skills, but for this to happen critical thinking must be an explicit focus of resident education.

Peer Review: Four peer reviewers contributed to the peer review report. Reviewers’ reports totaled 1480 words, excluding any confidential comments to the academic editor.

Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Author Contributions: Both authors contributed equally to drafting, revising and approving the final version of the manuscript.

• Corpus ID: 56761995

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Critical Thinking Skills

CHAPTER 3 Critical Thinking Skills LaVerne Tolley Gurley Outline Need for Critical Thinking What Is Critical Thinking? Qualities of a Critical Thinker Factors that Hinder Critical Thinking Background Beliefs Faulty Reasoning Group Loyalty Frozen Mind-Set Emotional Baggage Becoming a Critical Thinker Humility Respect for Others Self-Awareness Honing Your Skills Conclusion Objectives On completion of this chapter, you should be able to: •  Identify the qualities of a critical thinker. •  Identify the assumptions, ethics, and values in written works. •  Discern fallacies in arguments. •  Control psychologic impediments to sound reasoning. •  Recognize the effects of authors’ background beliefs on reasoning. •  Present valid facts, evidence, and statistics. •  Evaluate advertising claims, statistics, and rhetoric. Key terms critical thinking emancipation emancipatory learning herd instinct All health care providers must be able to make logical decisions and wise choices; it goes without saying. The care of the patient demands that good judgment is exercised in the selection of technical factors for quality imaging and in other patient care tasks. You will be responsible for giving the physician a radiograph that is diagnostically sound and for providing safe care to the patient while performing the examination. Need for critical thinking As a professional, you will be making vital decisions regarding your own career. You will need to make choices regarding the route you follow in the profession to meet your own personal needs and goals. What Is Critical Thinking? Many definitions have been given for critical thinking . One definition calls it emancipatory learning. Emancipation means freedom from restraint or influence. Things that restrain or influence people can be personal, institutional, or environmental. Personal beliefs, rules and regulations of institutions, and physical environments can all work to prevent people from seeing new directions and gaining understanding and control of their own lives and of the world around them. Emancipatory learning means that learners become aware of the forces that have created the circumstances of their lives and take action to change them. Another definition for critical thinking focuses on the use of morality and virtues, making wise judgments about aspects of our lives, and recognizing the impact these judgments will have on others. Some stress the importance of recognizing reality in the context of cultural elements and the process of trying to create order in a changing world. Creating order in a changing world will be a challenge for us all. Never in our history have changes occurred with such rapidity. Global information and communication exchange, worldwide exchange of goods and services, and, most importantly, an exchange of ideas affect our world. Geographic boundaries are becoming blurred, as are the cultures and traditions of separate groups. Learning how to live and work in this changing world makes critical thinking more important than ever. Although the wording of the definitions of critical thinking may differ, they are all made on the assumption that a set of values exists. Each definition assumes that these values are universal; for example, life is better than death, wellness is better than illness, happiness is better than sadness, pleasure is better than pain, and hope is better than despair. Therefore, when we speak of making wise judgments, we have to agree on a set of values. These values are not unique to a specific culture or religion nor are they characteristic of a specific nation or state. They are universal except in rare aberrations of individuals, cult groups, and other deviants. The assumption that you have accepted these values is a fair conclusion because you have chosen to be a health care provider. We may disagree on the specifics of behaviors that will best accomplish the preservation of these values, but if we disagree on the values, then further discussion is no longer needed. When we speak of making wise decisions, we are judging decisions made within the framework of a value system that is universally understood. It is equated with logical reasoning abilities and reflective judgment. Qualities of a Critical Thinker Critical thinkers are valued for their ability to look at a situation from a variety of perspectives. They are able to discern the best possible way to react to a situation, making them ideally suited for work in the health care profession. Box 3-1 summarizes the characteristics that a critical thinker needs to possess. BOX 3-1     Characteristics of a Critical Thinker Human Analytical Rational Open-minded Systematic Inquisitive One of the first traits that one observes in critical thinkers is the presence of heart as well as mind. The definitions regarding critical thinking are reflective of human values and can thus be expected of critical thinkers. Such a thinker will be able to balance compassion with realism. The critical thinker must also be analytical, which means finding evidence in unclear and confusing situations. Being alert to the consequences of accepting a course of action and being able to defend that position are both important. Rushing into a plan without examining the ramifications of hastened actions can be dangerous. Rational thinkers recognize reality; they can discern what is factual and true from what is opinion or misinformation. Seeking truth and making every effort to be honest with yourself is an important characteristic. To accomplish this, we must recognize the difference between what is true and what we wish were true. Making this distinction is more difficult than it may appear on the surface. Recognizing the laws of physics or mathematics as factual is simple enough; however, when the discussions involve government, religion, evolution, or other similar topics, facts become blurred and clouded with emotion. The truth is often elusive, and the evidence is less convincing. Nonetheless, critical thinkers will seek to make rational judgments and act responsibly.

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Critical Thinking: Developing Skills in Radiography

• ISBN-10 0803603436
• ISBN-13 978-0803603431
• Publisher F A Davis Co
• Publication date January 1, 1999
• Language English
• Dimensions 8.75 x 0.5 x 11 inches
• Print length 268 pages
• See all details

Product details

• Publisher ‏ : ‎ F A Davis Co (January 1, 1999)
• Language ‏ : ‎ English
• Paperback ‏ : ‎ 268 pages
• ISBN-10 ‏ : ‎ 0803603436
• ISBN-13 ‏ : ‎ 978-0803603431
• Item Weight ‏ : ‎ 1.52 pounds
• Dimensions ‏ : ‎ 8.75 x 0.5 x 11 inches
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Yes, It’s a Good Time to Become a Radiologic Technologist

Tags: Cleveland University-Kansas City (CUKC) , Radiologic Technology (A.A.S.) , Radiologic Technology (AAS) , radiology tech , X-ray Tech Programs , X-ray Technologist

One healthcare career choice you should discover is that of a radiologic technologist – a diagnostic imaging professional. An influential career information website indicates those who become radiologic technologists have the “builder/helper” orientation. That means they like having a unique, practical set of skills they are specialists in, appreciate technology, and want to feel they’re part of a professional team helping patients get the best care possible.

You can enter the workforce after earning a 2-year Associate of Applied Science (A.A.S.) degree. In fact, more than 60% of “rad techs” working today chose that degree plan because it focuses the bulk of the two years of education on the knowledge, theories, principles, and “how to” aspects of the profession.

Learn More Here

In celebration of National Radiologic Technology Week , Cleveland University-Kansas City’s Radiologic Technology program is highlighting excerpts from some of our most popular blogs. In our communication to prospective students, our blogs seek to describe what it’s like to live the rad tech life and why they might like to become a radiologic technologist.

From August 20, 2018: A Look at Everything They Do

“One of the most attractive aspects of learning to become a radiologic technologist is that it combines two distinct abilities – the ability to interact well with people and operate some of the most advanced equipment being used in healthcare today.

At times, you may be the only one in the exam room with them, so “soft skills” are always part of a radiologic technologist’s job description. Employers look for staff members who

• Use effective communication skills to relate to people of all ages and from all cultures
• Have attained competency in procedures and have critical thinking skills
• Be compassionate with patients, helping them feel less alone and fearful
• Provide encouragement for patients in pain.”

From November 8, 2019: 7 Fast Facts You Should Know

“ Medical imaging roles offer a long-term career. The credentialing organization  American Registry of Radiologic Technologists (ARRT)  lists five areas as the primary pathways to becoming a radiologic technologist:

• Radiography (R)
• Nuclear Medicine (N)
• Radiation Therapy (T)
• Magnetic Resonance Imaging (MR)
• Sonography (S)

More than 300,000 radiologic technologists are certified by the American Registry of Radiologic Technologists . The career source owlguru.com gives the profession an overall “A” rating, noting the pay scale, the ability to earn a two-year degree, and a “high growth” career forecast.”

From May 26, 2022: Radiologic Technologist: Salary is Attractive

“…Rad techs are responsible for obtaining high-quality, specific-view images of a patient using innovative scanning technologies, as requested by a doctor. These images are vital for correct diagnoses and tremendously safer than invasive procedures.

You’d expect a competitive yearly wage for a job so essential to a patient’s well-being, right?

• A salary survey from the American Society of Radiologic Technologists, using data from rad techs active in the field, reports that the average wage for all certified radiologic technologists was $58,876 to $72,382.
• A newly certified radiologic technologist in the Midwest can anticipate an  average yearly compensation between $43,827 and $48,000 , according to data from the U.S. Bureau of Labor Statistics.

From June 21, 2022: 6 Great Reasons for Radiologic Technology Degree

“The diagnostic imaging field is expanding rapidly because innovations in imaging technology allow for earlier and better diagnosis of conditions, diseases, and disorders. Diagnostics that are more accurate lead to more precise treatments. That’s a primary reason noninvasive imaging is quickly replacing invasive exploratory procedures.”

Another way to assess the value of earning a radiologic technology degree is to see how it ranks in the annual survey of occupations published by  U.S. News and World Report . As of May 2021,  radiologic technologists ranked in the top 25 health care support jobs . Rad tech has been in the top 25 every year since 2018.”

Become a Radiologic Technologist in 2 Years at Cleveland University-Kansas City

Cleveland University-Kansas City (CUKC) is a nonprofit, private, chiropractic and health science university in Overland Park, Kansas, a part of the Kansas City metro. Within our College of Health Sciences, CUKC offers an Associate of Applied Science (A.A.S.) in Radiologic Technology degree that most students complete within two years.

Features of the CUKC radiologic technology degree include:

• Focused, eight-week evening courses designed for deep understanding
• Experienced radiologic technologists as instructors and program coordinators
• Hands-on training in the University’s on-campus radiologic equipment rooms, demonstration suites, and use of human body replicas
• Classroom knowledge combines with in-the-field clinical experiences throughout Kansas City and surrounding regions
• Prerequisite courses available in fall, spring, and summer terms.
• Enrollment in radiologic technology classes begin in spring and fall terms.

Want to know more about how to become a radiologic technologist? Request information from a CUKC admissions advisor and receive our free eBook: Your Complete Guide to a Career as a Radiologic Technologist .

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Radiologic Technology

Program Overview

This program prepares the you with the necessary technical skills of imaging and interpersonal patient care skills to qualify as contributing members in today’s healthcare environment. Upon completion of the program, you will be eligible to write the American Registry of Radiologic Technology examination to attain professional status as entry-level radiographers.

Read more about the Application Process and checklist . 

The Radiologic Technology application deadline is April 15.

Program Structure

The Radiologic Technology Program is a combination of classroom instruction, laboratory experiences and onsite clinical participation. Selected students begin the program in the fall semester and graduate five semesters later. Upon completion of  the program, you will earn an Associate of Applied Science degree in Radiologic Technology and be eligible to take the American Registry of Radiologic Technology examination.

Many radiologic technologists go on to earn higher degrees such as a bachelor's or a master's degree. The program of study includes the areas of human anatomy and physiology, pathology, radiation physics, radiation protection, pharmacology and mathematics. Other courses throughout the program provide instruction on diagnostic procedures and examinations, equipment, patient assessment, trauma, geriatrics, pediatrics, critical care and the application of clinical practice through clinical education.

Job Opportunities

According to the Bureau of Labor Statistics, “Overall employment of radiologic technologists is projected to grow 6% from 2022 to 2032, faster than average for all occupations.”

The mission of the Radiologic Technology Program at National Park College is to provide selected students the clinical and didactic education necessary to create a sound foundation for graduates to qualify as contributing members in the professional career of Radiologic Technology.

The profession of Radiologic Technology is dedicated to the conservation of life, health and the prevention and treatment of disease. The well-qualified technologist has the knowledge and skill to perform all related technical duties and the opportunity to develop health programs.

The goals of the program are as follows:

Goal 1: Students are clinically competent.

Student learning outcomes:

• Students will apply radiographic positioning skills.
• Students will practice radiation protection.
• Students will select appropriate technical factors.

Goal 2: Students possess critical thinking skills.

• Students will demonstrate sound decision making.
• Students will appropriately evaluate images.
• Students will adapt positioning for trauma procedures

Goal 3: Students are professional.

• Students will understand the importance of professional ethics in the didactic setting.
• Students will demonstrate professional behavior in the clinical setting.

Goal 4: Students communicate effectively.

• Students communicate effectively in the didactic setting.
• Students communicate effectively in the clinical setting.

Certificates and Degrees

Associate of applied science in radiologic technology.

The Associate of Applied Science (AAS) in Radiologic Technology is a 68 credit hour program of study.

View complete catalog listings for the following degree plans:

• Radiologic Technology, AAS

Accreditation

The radiologic technology program is accredited by the Joint Review Committee on Education and Radiologic Technology. An 8-year accreditation was awarded in 2023. The most recent site visit was conducted in July of 2023. Accreditation of an educational program by the JRCERT provides students and graduates assurance that the educational program will provide them with the requisite knowledge, skills, and values to competently perform the range of professional responsibilities expected by potential employers nationwide. It also assures they will be eligible for licensure in each of the 50 states. Programmatic accreditation requires programs to teach the entire curriculum developed by the professional society, the American Society of Radiologic Technologists (ASRT). Programmatic accreditation also assures students will have the foundation knowledge to continue to develop as professionals in the various fields of the radiation sciences. Read more on our accreditation page . For more information about Joint Review Committee on Education and Radiologic Technology, visit www.jrcert.org .

Read the radiologic technology's program effectiveness data .

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Critical-thinking abilities of radiologic science students

Affiliation.

• 1 Radiologic Sciences Program, School of Health Related Professions, University of Missouri-Columbia, USA.
• PMID: 7491406

This article reports the results of a survey conducted to determine whether critical thinking abilities differ among radiologic technology students educated at the baccalaureate, associate degree and certificate levels. The sample population was 357 students enrolled in radiologic technology programs in Louisiana, Missouri and Oklahoma who completed the Watson-Glaser Critical Thinking Appraisal. Results showed a significant difference in critical thinking abilities at the three educational levels. Baccalaureate students scored significantly higher in critical thinking abilities than associate and certificate students, and certificate students scored significantly higher than associate degree students.

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• Critical thinking ability of associate, baccalaureate and RN-BSN senior students in Korea. Shin S, Ha J, Shin K, Davis MK. Shin S, et al. Nurs Outlook. 2006 Nov-Dec;54(6):328-33. doi: 10.1016/j.outlook.2006.09.008. Nurs Outlook. 2006. PMID: 17142151
• Use of the Watson-Glaser Critical Thinking Appraisal with BSN students. Frye B, Alfred N, Campbell M. Frye B, et al. Nurs Health Care Perspect. 1999 Sep-Oct;20(5):253-5. Nurs Health Care Perspect. 1999. PMID: 10754848
• Psychometric properties of the California Critical Thinking Tests. Bondy KN, Koenigseder LA, Ishee JH, Williams BG. Bondy KN, et al. J Nurs Meas. 2001 Winter;9(3):309-28. J Nurs Meas. 2001. PMID: 11881271
• Teaching critical-thinking skills through group-based learning. Kowalczyk N, Leggett TD. Kowalczyk N, et al. Radiol Technol. 2005 Sep-Oct;77(1):24-31. Radiol Technol. 2005. PMID: 16218019 Review.
• Collaborative learning in radiologic science education. Yates JL. Yates JL. Radiol Technol. 2006 Sep-Oct;78(1):19-27. Radiol Technol. 2006. PMID: 16998192 Review.

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Exploring the Intersection of Art and Radiology

Radiologists tout art appreciation as a way to feel more connected and improve visual acuity.

Incorporating arts and the humanities into the practice of radiology can help alleviate  stress and burnout—and, at the same time, improve a radiologists’ interpretation skills, ultimately leading to better patient care, according to Erin A. Cooke, MD.

“The arts and humanities can serve as a conduit for connection with others,” she said. “This could be through shared experiences of in-person or virtual arts-based events, through self-expression in art creation or through taking in the art of others, allowing a broadening of perspective.”

Dr. Cooke, associate professor in the Department of Radiology and Radiological Sciences and director of the diagnostic radiology residency program at Vanderbilt University in Nashville, TN, serves as the department’s director of arts, a role in which she incorporates  arts-related activities into the radiology department.

“Besides acting as a bonding mechanism among radiologists and trainees, art can also promote discussion, empathy and appreciation for other people, including patients,” Dr. Cooke said. 

Kari Visscher, MD, MScBMC, a  radiologist and adjunct professor at McMaster University in Ontario, Canada, who also holds a master’s degree in biomedical communication describes herself as an “artist, radiologist and mother.” She has similar feelings about the power of art.

“It provides an opportunity to re-center, take a breath, process emotions and express them in a way that can create beauty even from a place of unpleasantness,”  she said.

RSNA's Popular Art of Imaging Exhibit at the Annual Meeting

A unique exhibit takes place in the Learning Center during the RSNA annual meeting. The Art of Imaging is a contest for RSNA members to submit their art that makes use of imaging.

Categories for submission include:

Radiology art—Medical images altered to become works of art.

Artificial Intelligence Art—Images representing AI or created using AI

Connections Through Art—Images illustrating the power of connections. 

In 2023, close to 300 entries were submitted. More than 2,000 registered attendees participated in the voting to determine which 16 submissions would be showcased at the annual meeting.

The RSNA 2024 contest is open .

View last year’s entries at RSNA.Wishpond.com/Radiology-Art-2023 .

Using VTS to Analyze Art

In the world of art appreciation, various  techniques are taught for analyzing and interpreting art, such as Visual Thinking Strategies (VTS), which help guide viewers in making observations, synthesizing information and avoiding pitfalls.

“VTS is an approach to using art images in teaching through facilitated group discussion focusing on an art image,” Dr. Cooke said. “Participants are guided in looking carefully at the piece and on ways to communicate those observations. As it is a group exercise, the perceptions can build upon what others share.”

Application of arts-based activities such as VTS can help radiologists and trainees examine their ways of working and practice strategies to minimize discrepancies in interpretation and underlying cognitive biases, and to promote creative and flexible critical thinking, she noted.

“To me, looking at art has many crossovers to looking at radiologic images. I enjoy making findings and observations, using my experiences and knowledge to try to create the story and differential for, ‘What is going on?’ in this image or study,” said Sarah Sarvis Milla, MD, chief of pediatric radiology, vice chair of radiology and the John D. Strain Endowed Chair for Radiology at Children’s Hospital Colorado in Aurora. “VTS allows practice of validating one’s conclusions with visual cues and features, while also asking, ‘What more can we find?’”

A recent Academic Radiology study used VTS to investigate whether a better understanding of paintings depicting radiology encounters could broaden medical students’ understanding of the radiology profession. The researchers concluded that exploring radiology-specific artwork yielded benefits including helping the medical students learn to challenge negative stereotypes of the profession and of radiologists.

Implementing Art Appreciation Programs

The Vanderbilt Radiology Art Gallery hosts annual art exhibits to provide an avenue for creative expression and develop a means of connection, Dr. Cooke noted.

“We have a small committee that holds a call for art and reviews the submissions,” she said. “All departmental staff, faculty, residents, fellows, medical students as well as family members are encouraged to submit.”

The goal, she said, is to create connections between radiologists, trainees and staff on the technologist and administrative side through conversations about the arts.

Like Dr. Cooke, Andrew M. Singer, MD, a radiologist and assistant professor at UMass Chan Medical School in Worcester, believes in the value of making art appreciation part of radiology. Since 2016, Dr. Singer and colleagues have been exploring and refining art observation training techniques with the help of an art observation program they created in collaboration with the Worcester Art Museum. The workshop consists of a onehour lecture followed by a two-hour museum visit. Dr. Singer explained that the radiology residents are instructed to be as specific as possible regarding the visual elements of each of the four paintings they observed.

“The purpose was to identify and describe findings without interpretation, and then to give the findings context, in order to clearly analyze and present the ‘story’ that the artist is conveying in the artwork,” Dr. Singer said. “This parallels the radiologist’s presentation of the findings and impression for an imaging study.”

“Feedback indicates that residents acquired increased comfort in closely analyzing imaging studies, developed a deeper understanding of putting the findings together in a cohesive manner and were better able to see ‘the big picture’ and appreciate the interconnectedness of the image elements,” he said.

At the University of Colorado School of Medicine, Dr. Milla is working to develop a relationship between art and radiology. She is a facilitator in the School of Medicine’s course on Art in Medicine, co-developed with the Centre for Bioethics and Humanities and the Denver Art Museum, which gives medical students the opportunity to study, interpret and create art. She recently published their experiences in the Art of Medicine course with her collaborators: an emergency room physician and an art museum educator from the Denver Art Museum.

Dr. Milla recently completed an art museum-based health professions education fellowship at the Harvard Macy Institute in Boston and is a certified facilitator of VTS.

“Techniques, such as VTS, allow empathy, deep listening, critical thinking, perspective taking and tolerance of ambiguity," Dr. Milla said. "These skills have intrinsic crossover not only in medicine, but in team dynamics and leadership.”

These skills, noted Dr. Visscher, showcase how art can be used as an effective learning tool throughout a physician’s career.

“It minimizes power differentials between instructors and learners while engaging emotional states, which provokes and stimulates learning,” she said.

For More Information

Access the Vanderbilt Radiology Art Gallery at VUMC.org/radiology/art .

Access the Clinical Imaging study at sciencedirect.com/journal/clinical-imaging .

Access the International Review of Psychiatry paper at tandfonine.com/journals/iirp20.

Read previous RSNA News articles about art and radiology:

• Radiologist Draws on Art Background to Create Unique Educational Tool
• Using Technology And Creativity To Bring Innovation To Radiology Education
• Extensive Art Collection Enhances The Experience Of Visiting Chicago’s McCormick Place

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Jessica Grose

What teachers told me about a.i. in school.

By Jessica Grose

Opinion Writer

Leila Wheless, a North Carolina teacher who has been an educator since 1991, tried to keep “an open heart” about using artificial intelligence in her middle school English and language arts classroom. She reviewed the guidance of her state’s generative A.I. “ recommendations and considerations ” for public schools. But the results of her students’ A.I. use were dispiriting.

“For one particular assignment related to the novel ‘Persepolis,’ I had students research prophets,” Wheless explained, because the main character fantasizes about being a prophet. But, she told me via email, internet searches that incorporated A.I.:

Gave students jewels such as “the Christian prophet Moses got chocolate stains out of T-shirts” — I guess rather than Moses got water out of a rock(?). And let me tell you, eighth graders wrote that down as their response. They did not come up to me and ask, “Is that correct? Moses is known for getting chocolate stains out of T-shirts?” They simply do not have the background knowledge or indeed the intellectual stamina to question unlikely responses.

After I wrote a series in the spring about tech use in K-12 classrooms , I asked teachers about their experiences with A.I. because its ubiquity is fairly new and educators are just starting to figure out how to grapple with it. I spoke with middle school, high school and college instructors, and my overall takeaway is that while there are a few real benefits to using A.I. in schools — it can be useful in speeding up rote tasks like adding citations to essays and doing basic coding — the drawbacks are significant.

The biggest issue isn’t just that students might use it to cheat — students have been trying to cheat forever — or that they might wind up with absurdly wrong answers, like confusing Moses with Mr. Clean. The thornier problem is that when students rely on a generative A.I. tool like ChatGPT to outsource brainstorming and writing, they may be losing the ability to think critically and to overcome frustration with tasks that don’t come easily to them.

Sarah Martin, who teaches high school English in California, wrote to me saying, “Cheating by copying from A.I. is rampant, particularly among my disaffected seniors who are just waiting until graduation.”

When I followed up with her over the phone, she said that it’s getting more and more difficult to catch A.I. use because a savvier user will recognize absurdities and hallucinations and go back over what a chatbot spits out to make it read more as if the user wrote it herself. But what troubles Martin more than some students’ shrewd academic dishonesty is “that there’s just no grit that’s instilled in them. There’s no sense of ‘Yes, you’re going to struggle, but you’re going to feel good at the end of it.’”

She said that the amount of time her students are inclined to work on something that challenges them has become much shorter over the seven years she’s been teaching. There was a time, she said, when a typical student would wrestle with a concept for days before getting it. But now, if that student doesn’t understand something within minutes, he’s more likely to give up on his own brain power and look for an alternative, whether it’s a chatbot or asking a friend for help.

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