Dr. Julie Gill

Q&A with Dr. Julie Gill: How tech innovation has created gaps in the radiology student’s education

December 22, 2017
by John W. Mitchell, Senior Correspondent
According to Dr. Julie Gill, the chairperson of the Allied Health Department at the University of Cincinnati's Blue Ash College, and a veteran expert in advanced imaging technology, changes in radiology have resulted in blank spots in a radiologist’s training and can contribute to a disconnect between members of a patient’s care team.

At issue is the ability to discuss procedures and pronounce medical terms correctly, vital skills that are often developed through interactions with physicians and technologists in the teaching environment. Gill, who is also on the Ohio Society of Radiologic Technologists’ board of directors and a board member for the American Society of Radiologic Technologists, believes technological advancements have left a void in this part of a student’s education and can lead to compromised patient care.

HealthCare Business News spoke to Gill about this issue, potential solutions to this problem and how a whole team approach to radiology may be beneficial to everyone involved.

HCB News: Where in the care continuum do you see a failure to communicate among radiology team members?
Julie Gill: In a teaching environment, radiologists encompass the staff physicians and the resident and the fellow. What seems to have happened with the use of digital imaging is there is very little face-to-face communication between the technologist and the imaging physician.

It used to be I would take images, they’d come out of the processor, I’d hang them up on the view boxes in a common area that people often called the light room. There were radiologist residents and radiologists there looking at the image and perhaps even the attending physician would be there discussing the films. The technologists and imaging students would hear those conversations, they would learn about the pathology and they would hear the words spoken correctly. But with digital imaging, the technologists complete the radiologic procedures digitally before sending the images electronically to the radiologists where they will view and interpret them in their office. So, there isn’t that communication.

HCB News: How did you become interested in this problem?
JG: I teach our radiographic pathology course and I noticed that the students were having difficulty pronouncing terms used throughout the course, even some that are common in medical imaging. So, I incorporate an exercise with a PowerPoint with difficult pathology words. They are often five or six syllables.

If I’m done with class material early one day I’ll pull up that PowerPoint and we’ll go around the room pronouncing them. They can tag out once, or call a friend, the person sitting next to them, if they can’t say the word. It’s a worthwhile exercise because, in the medical field, if you don’t pronounce the words correctly, you’re looked at as not as intelligent as other professionals who can say them and use them correctly in a sentence.

I think a lot of that goes back to the students and technologists not hearing those physicians dictating, not hearing them discuss cases with other radiologists or attending physicians, which now would be your hospitalists. They’re just not having that opportunity because that is all being done now in the privacy of the radiologist’s office.

HCB News: Has research been done to illustrate the importance of this kind of education?
JG: I haven’t seen any studies. I have done informal discussions. In Ohio, our educators group is very collegial and very collaborative. We often just ask each other about issues. Other educators throughout the state are making comments in terms of their students not having that relationship with the radiologists, not being able to communicate as clearly as we want them to. It would be a great research study.

HCB News: Would you say this issue is part of a larger discussion about how digital technology and the EHR are isolating care providers?
JG: It is. Although there are countless advantages when you compare our new digital system to the film system of old, the lack of communication amongst health care team members is directly attributable to not having opportunities to communicate. I think it is an obvious disadvantage.

HCB News: How does this problem manifest itself in patient outcomes?
JG: I think if the technologist doesn’t understand some of the terminology associated with the patient’s pathology or clinical history, it could result in suboptimal communication of that, or of any pertinent clinical information to the radiologist.

When those films used to hang in the light room, I would always see the technologist learning from the physicians. Some of that opportunity has now been taken away due to the isolation of the radiologist in his or her office.

HCB News: What do you think the solution is – a conscientious effort to address this issue?
JG: Conscientious effort is a good phrase. I know that many educational programs now ask the radiology group if their students can do a short rotation while the radiologist is dictating, or perhaps even communicating with another physician via phone. I think that is a great opportunity for our students.

HCB News: Is your program looking at doing that?
JG: Yes, we are. We’re just now in the beginning of the communications with our radiologist groups. We have at least seven clinical sites, so our students are throughout Cincinnati. Our clinical coordinator is reaching out to see if that’s a possibility, even if it’s one day. We’re in the infancy and we have a program meeting in a couple of weeks, so the clinical coordinator will report back.

If we include this rotation, we wouldn’t do that before the spring semester in January. But it depends on the radiologists willing to allow the student to sit and perhaps take some time to educate. They’re great teachers and they work in an educational setting because they want to teach.

I just see this whole issue of communication as a vital part of our scope of practice through the American Society of Radiologic Technologists. Knowing that communication is vital, not only with radiologists, but with the students. And if you work in a private practice setting, the technologists might do some billing and coding. So being able to understand the procedure and the terminology could affect the patient in both positive and negative ways stemming from proper and frequent communications.

Click here to learn more about the Blue Ash College Online Bachelor of Radiation Science Technology program.