Accepted for/Published in: JMIR Medical Education
Date Submitted: Nov 5, 2023
Date Accepted: Feb 15, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Radiology Residency Distance Learning during COVID-19: Implications for China’s Health System Recovery
ABSTRACT
Background:
Health systems resilience and recovery relies heavily on appropriate competencies of health workers. Distance learning, an alternative to in-person learning, has gained popularity during the COVID-19 pandemic. This study aims to investigate the strengths and weaknesses of distance learning on residents’ competency development and to explore the moderating effect of mental health on relevant associations.
Objective:
It is hypothesized that radiology residents who were trained through distance learning were more likely to report higher competencies, compared to those who did not receive distance learning. Mental health problems moderated the association between distance learning and competency among radiology residents.
Methods:
A cross-sectional survey was conducted in 2021, targeting all the radiology residents in 407 radiology residency programmes across 31 provinces of China. To estimate long-term outcomes of radiology residents’ training after the initial COVID-19 outbreak, this study measured six core competencies developed by the US Accreditation Council for Graduate Medical Education (ACGME). Multiple linear regression and moderating effect analysis were used to examine the associations between distance learning, mental health, and competencies.
Results:
A total of 2,381 radiology residents responded to the survey. Of those, 71.4% were provided with distance learning in the context of COVID-19, and 73.2% reported slight or more mental health struggles then. Radiology residents who were trained through distance learning (β=0.35, 90%CI=0.24-0.45) were more likely to report higher competencies. This was particularly true for the competency domain ‘interpersonal and communication skills’ (β=0.55, 90%CI=0.39-0.70), while distance learning least benefited the competency domain ‘patient care and technical skills’ (β=0.14, 90%CI=0.01-0.26). Mental health problem significantly moderated the aforementioned relationship (β = -0.15, 90%CI=-0.27 – -0.02).
Conclusions:
Distance learning, a means of promoting enabling environments, serves its purpose and helps generally improve residents’ competencies, though different competency domains benefit unequally. The impact of mental health calls for special attention so that distance learning can fulfil its potential of facilitating health systems resilience & recovery.
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