title: Development and implementation of a systems-based practice project requirement for radiology residents.
abstract: OBJECTIVE
  Radiology residents must now participate in a learning activity that involves identification and analysis of system errors and implementation of potential solutions. Evidence of participation must be documented in the resident's learning portfolio.
  
  
  METHODS
  An activity based on adult learning principles was designed for residents to increase their knowledge of health care systems and problems; gain experience in writing a proposal, conducting an investigation, and reporting results; organize and present information in a supportive environment; and document participation in their portfolio. Postgraduate year 2 residents identify a systems problem. A written proposal is required and must include a "plan" that includes a hypothesis, a methods section that explains what they will "do" as an intervention, a "study" that involves collection and analysis of relevant data, and a systems change or "act." Proposals approved by the program director are presented to the radiology department. Residents complete projects, evaluate their effectiveness, and present their results by spring of postgraduate year 3.
  
  
  RESULTS
  Goals, objectives, and guidelines were written. Assessment tools were identified. From 2006 to 2008, nine projects were proposed and conducted by 12 residents. Local and national systems issues were selected, and interventions involved residents, faculty, and medical students. A timeline was imposed to promote sustained effort.
  
  
  CONCLUSIONS
  Opportunities of daily work can be used to teach and learn systems-based practice concepts. Residents can use the scientific method to test effects of change on health care systems. Relevant and practical projects enable residents to learn while improving their clinical and learning environments.
authors.affiliation: University of Arkansas for Medical Sciences, College of Medicine, Department of Radiology, 4301 W. Markham, No. 556, Little Rock, AR 72205, USA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Buchmann
authors.forename: Linda A
authors.initials: LA
authors.lastname: Deloney
authors.forename: Sreechandra K
authors.initials: SK
authors.lastname: Donepudi
authors.forename: Curtis Matthew
authors.initials: CM
authors.lastname: Mitchell
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Klein
mesh_terms: D007396:Internship and Residency / Q000592:standards*; D011361:Professional Competence; D011871:Radiology / Q000193:education*; D014481:United States