Interview with Dr. Khashayar Rafat Zand, founder of Radlinks.ca

radRounds has yet another opportunity to perform an e-interview with a radiology thought leader and rising academic star in medical imaging. We are honored to be featuring Dr. Khashayar Rafat Zand the founder of Radlinks.ca, senior radiology resident at McGill University, and future fellow at Harvard's Beth Israel Radiology Department.
Tell us a bit more about yourself and your interests in radiology, education, and web-based teaching?
Dr. Rafat Zand: First, I would like to thank radRounds for your kind attention to RadLinks.ca and its new educational platform, the “Hot Seat”. and for this opportunity to introduce them further to your members. My first name is Khashayar, but everybody knows me as Khashy (pronounces Kashi, like the cereal box…!). I am a PGY5 resident at McGill University in Montreal, Canada. I will do my fellowship in body MRI at Beth Israel Deaconess Medical Center in Boston. I have been fortunate to have influential teachers and mentors at each stage of my academic life: I feel excited when I learn, and teaching is primarily an emotional outlet for me to share this excitement with others. And despite being a proponent of old-school academia, I do belong to the generation of web-based learners, what I would like to call the “Case-of-the-day Generation”. We effortlessly receive our pre-screened daily dose of electronic teaching in the email every day, and with minimal effort an infinite world of images and information is accessible to us almost instantly. Inevitably, the web-based learner later evolves into the web-based teacher, who can then draw images that no blackboard can hold and address a crowd that no room can accommodate. For someone who is excited about teaching, this break from the physical boundaries of conventional education is elating and invaluable.
What led you to create this excellent resource for board review and radiology education?
Dr. Rafat Zand: I think “excellent” may be too kind a word, considering that I have only started. I have received a few encouraging reviews from my audience and mentors that makes me think I am on the right track. I am sure there is a lot of room for improvement that hopefully comes with time and my audience feedback and contribution. There are three aspects to the “Hot Seat” case discussions: the content, the format and the medium. For the content, the choice was easy and obvious. Rounds are an integral part of radiology training, and the “Hot Seat” format simulation of pressured board examinations are frequently used to prepare the trainees for their final test. Case discussions and differential diagnoses are universally popular with residents as the main building blocks of radiology. For the general quiz cases, I choose cases that lend themselves to a pattern approach or have an important teaching point. For the subspecialty quizzes, I rely on the generous assistance of my fellowship trained colleagues and friends who share my teaching enthusiasm. To the traditional format of multiple-choice questions for the quizzes, I have added time limits and scores to make them more than just a passive test, trying to more actively engage my audience. Rankings and prizes are an attractive addition (although maybe a deterrent to some). The response distribution charts, our web version of audience response system, allows me to better understand the thought process and strengths and weaknesses of participants. Regarding the choice of medium, the concept of “time” was an essential factor, as I explain below: - One of the main strengths of our residency program at McGill is frequent hot seat rounds. However we have a multi-hospital program, and with only a third of our residents present at each hospital rounds, we are practically wasting 60% of our staff teaching time. If there were a way to “save” all these rounds and case discussions for later viewing, then the whole resident body would be able to benefit from each and every teaching round. This is especially important in face of increasing clinical workload reducing our teaching resources. - Compared to the well-known loss of teaching time, there is also an important and overlooked limitation regarding “learning time”. It is a false assumption that our students are or should be ready to learn whenever we are available. In today’s busy daily life, we may not be ready to learn optimally when the situation arises. We have all given lectures to a room full of people, some of which were only there in body. “Saving” the rounds for later, for when our audience is more receptive, will optimize the impact of our teaching. - Finally, as a resident with a young family and a few side activities and interests, I constantly find myself scrambling for time. For all of us, there are many “idle” learning moments in the day that can be “salvaged” by having our teaching resources available as portable electronic media: a 15 minute discussion VodCast of 10 cases can be reviewed in the bus standing, while walking to the grocery store or on the stationary bike. So in summary, I decided that the limited “time” I have to teach is best spent if my rounds and case discussions can reach a larger audience, when my audience is most receptive. Last month about 300 people have viewed the case discussions. The most I could have reached in a traditional radiology round, had I been able to gather and maintain all our residents in their full attention, would be 40 residents. So with some extra effort and use of now widely available multimedia equipment, I can now save and upload these “rounds” as case discussion videos in RadLinks.ca, radRounds videos or our FaceBook fan page, and as VodCasts for some radiology rounds on the go.
How can a trainee benefit the most from RadLinks.ca? What specific ways can they use this website?
Dr. Rafat Zand: At its most basic level, RadLinks.ca is a rather complete, largely bilingual (English and French) collection of useful Canadian radiology links, both academic and practice related. Most of the “traditional” educational material on the site can be found under “The Essentials” section. They include “Patient Safety” resources, which are especially handy on call. “PGY2 Call Prep” features a large and growing compilation of high yield emergency radiology articles based on the ASER core curriculum that will serve the more junior residents for their call preparation. We also have a guide on “Residents’ Locums” and a “Fellowship Guide” to help the residents in the later stages of their training. ”Radiology for students” contains useful information for medical students in radiology electives, or those who are considering a radiology career. We already have a Video/Vodcast on radiology residency application, and I am looking to expand the multimedia student resources in the near future. We also have a triple (YottaLook, Google, ARRS Goldminer) Radiology Search tool that can be incorporated into your homepage, saving a few clicks per each search. Our “Review Room” is a unique feature that deserves special mention. It is designed as an informative tool for applicants to Canadian radiology programs. In the review room PGY5 radiology residents or fellows with at least 6 months of training in a Canada can anonymously share their radiology training experience with those who seek to follow their path. Reviews are generated after completion of customized questionnaires by our members in training, and include some of the principal factors to consider when applying to residency or fellowship programs. The strengths of the programs are highlighted, and the weaker points can be discussed at the time of the application or interview. Program directors can add their comments to the reviews for clarifications or supplemental information and updates. I understand that residency / fellowship application is a complicated and stressful process, and more information will reduce the anxiety and assist in better decision making, especially for our large body of international applicants. The “Review Room” is currently limited to Canadian programs, but I am working on expanding it to include the US radiology programs as well, which is more difficult logistically considering the large number of radiology programs in the US. And last but definitely not least, the “Hot Seat” is our radiology quiz and case discussion portal, which I hope to become an enjoyable addition to our current resident teaching resources.
How do you envision electronic learning resources such as yours to complement existing CME courses, books, and other clinical training tools?
Dr. Rafat Zand: I am happy that you use the word “complement”, as I am a strong proponent of the traditional elements of medical education, especially textbooks. I think classic textbooks convey not only knowledge, but also a wealth of radiology culture and eloquence. There is a strong human element in leaning over a classic textbook in a library, which I think should be recognized and preserved. Nevertheless, the volume of what we need to know is on the rise, yet our learning opportunities remain the same if not decreasing. Teaching resources are strained under workload and economic pressures. Electronic learning resources are an ideal way to prevent wasting of the non-renewable limited time we have to teach our peers and students: by analogy you may call it “academic environmentalism”. It only takes a modest microphone to turn any presentation into a permanent electronic resource, unlimited to time and space. We now have the resources to prevent a lecture form ending once it finishes, to preserve it as a permanent reference and not a fleeting educational event. Currently, handouts and course notes try to preserve some content of these educational efforts, for example in CME courses. However, I find the human element greatly enhances the effective transfer of information: it is very different to listen to the nuances and emphases and humor of a lecturer, rather than reading a text in bullet format. Once the practice of digital preservation of radiology education becomes standardized and widespread, it will be amenable to indexing and customized search and use. Consider this fictional scenario: A few years from now I will see a case of Mazabraud’s syndrome at the workstation. After a brief review of online literature, I use a “Portable Personalized Medical Education” search engine which generates the following: - “AFIP Course 2008”, Fibrous Lesions of the musculoskeletal system, 27 minutes - “RSNA Image Interpretation Session”, Dec 2013 Sunday film panel, Case 4, 8 minutes - “Hot Seat” Dec 2009 general quiz case discussion, T2 bright soft tissue mass, Case 9, 4 minutes - etc I choose the content that I want, download them at a click of a button to a portable device, and view them on my way home. I automatically receive CME credits or add the cases/discussion to my MOC learning portfolio. Finally, I really would like to see future radiology publications undergo the same evolution. The graphic nature of many radiology articles, especially educational exhibits, makes them an ideal substrate for this conversion. With a few extra hours of effort, that usually pales in comparison to the time spent to finalize a manuscript, a portable multimedia teaching tool containing key images and concepts can be prepared, enhanced by authors’ more human and personal access to the audience. I know that most residents have difficulty keeping up with the radiology literature, and portable multimedia publications will address this ongoing need for radiologists in training and practice alike.
What is in the future for you and RadLinks.ca?
Dr. Rafat Zand: In the immediate future, radiology boards, a year of MRI fellowship and an academic position awaits me. Anything beyond that is hard to predict. RadLink.ca is still an idea in evolution; the site will maintain its basic function as a Canadian radiology information hub, while its educational offerings will continue to expand, hopefully to address a larger audience. I plan to incorporate OSCE style quizzes as well in the future, which is another important part of Canadian board exams. In addition, the site will be a platform for some new ideas and experiments. In the end, RadLinks.ca will be whatever its users demand it to be. This, however, requires more feedback from our users regarding the strengths and shortcomings of the site, it potential uses and its future directions.
Tell us anything else you'd like members and fans of radRounds to know!
Dr. Rafat Zand: I would like to invite radRounds members to participate in our monthly quizzes, as it will help them benefit more from the case discussions. You may even find yourself the winner of our 25$ monthly prize! If you are a fellow or a subspecialty trained radiologist and like our methods, please contact us to submit your cases and discussions. The quiz submission interface is quite easy to use. In conclusion, allow me to thank you again for your attention to our videos and website. Our case discussion videos are now features on radRounds, which certainly help us reach out to more radiologists. Well done on an excellent radiology site, networking and learning tool! It is a pleasure to be a part of this community, and I look forward to continuing our collaboration in the future. Have a nice day!
Thank you very much Dr. Rafat Zand for this opportunity to speak with you and to share your story with radRounds members! For more information on Dr. Rafat Zand's latest project, please visit Radlinks.ca for more information! Here are some screenshots below of Radlinks.ca