HOW IT SUPPORTS RADIOLOGY: How to learn with PACS Introduction The term “eLearning” includes all forms of learning, where digital media or communication tools are involved in the presentation, distribution or communication of learning content. Afterwards the DICOMS are sent to the preferred eLearning application where annotations can be added to key-images and meta-information (e.g. report, anamnesis, problem, media,…) can be added to the case. Didactic basics of eLearning Learning and examinations • One may learn by lectures, by self directed learning or combined • Self directed learning is up to 4 times more efficient than listening to a lecture • Lectures of dedicated clinical experts can stimulate learning and the combination with self directed learning proved to be a useful setting (Blended Learning) • The daily routine in clinical radiology is the backbone of learning professional radiology ePACS as a project developed by the Medical University Vienna in close collaboration with the ESR is an innovative eLearning tool based on case presentation in a real-life environment. As a key feature ePACS offers case collections to various radiological sub-specialties combined with structured reporting schemes to benefit from an expert’s approach to the topic. How do Radiologists learn? • • • • • • • • • „Learning-by-doing“ during daily routine Ward rounds Discussions among radiologists Residency training Systematic reading (books, journals,…) Meetings: Lectures and self-directed learning Hard-copy case-collections ELearning case-collections (Internet, CD,…) Collaborative eLearning Basic eLearning features which may be offered by a standard PACS • Case collections which can be structured by: - Difficulty /target group - Modality - Scientific work and experimental work/routine cases - Diagnosis (pattern recognition) • Interchangeability of cases (e.g. via DICOM nodes) between distant clinics for - eLearning/science portals - Post-graduate training and continuing education - Student training - Specialist training Additional features required for dedicated eLearning For an excellent eLearning strategy many different tools are available, providing useful features which are essential for integration of teaching files into PACS. The first step must always be anonymization, which can already take place in the PACS. Next the case enters a classification state, in which it is classified by certain criteria. This can be done for example with the TCE Selector to which the DICOM Data can be sent directly from the PACS. TCE Selector provides vendor independent integration of PACS and teaching files according to IHE TCE. It implements RadLex as established categorization system for efficient keyword based retrieval. Using IHE related tools, such as TCE, promises interoperability for sharing cases with other institutions. Cases offered in an eLearning system such as ePACS and MIRC are often complex, feature multiple examination techniques, and frequently show incidental findings. Often the focus lies on presenting extraordinary cases with multiple, sometimes very extensive studies. Also follow-ups are often presented to show the progress within a patient. Since 2011, a new initiative incented by the ESR is the European Diploma in Radiology (EDiR) featuring face-to-face oral exams with dedicated expert-examiners as a vital part. Here one tries to stay on a daily-routine layout, meaning that there will be enough pictures and series to show the pathology, but one tries to keep the extent of images to a minimum and so close to a clinical standard situation, where time often is a limiting factor. This fact also guarantees fast image handling and helps to set the difficulty right for the candidates. eLearning References: http://www.elearningeuropa.info http://mediendidaktik.uni-duisburg-essen.de/sites/medida/files/ kerres-tu-darmstadt_0.pdf http://cde.athabascau.ca/online_book/pdf/TPOL_book.pdf http://www.uni-mainz.de/FB/Medizin/Radiologie/agit/berichte/ dicom2008/vortrag/eLearning_in_Radiology_Grunewald.pdf Prepared by Peter Pokieser, Ricarda Hofmeister, Alexander Hirsch, Thomas Moritz, Wolfgang Wiecenec, Martin Tiani, Jürgen Brandstätter, Vienna, Austria