Toshiba America Medical Systems

Moving Towards Modern Medical Education and Training
- An Essay Series by Anthony Mancuso, M.D.


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Anthony Mancuso M.D. has a mission to modernize post graduate medical education.  He has  spent the last eight years developing a competency based curriculum and evaluation, based on modern learning theory, with his team at the University of Florida.  They have leveraged extraordinary Learning Technologies to deliver this platform anywhere in the world. In his essay series, Moving Towards Modern Medical Education and Training, Dr. Mancuso will examine in detail: the specific pathway to this adherence to modern learning, educational theory, and the outcome of the application of those principles in this sphere of medical education.


Part 1:  How did we arrive at the current state?

Description:  Historically, our patients have always expected and deserved competent healthcare providers. Right or wrong they have put their faith in their “healers” from ancient times to the present. This is especially true of their physicians. What guarantees that competence and that their trust is well placed? What is the foundation and process for attaining competence? Moreover, what method establishes mastery of a specific competency? These are all questions under review in the context of the current methods of general medical education. Change is coming.

 
 
 
 Part 2:  "See one, do one, teach one”: Changing our approach to post graduate medical training.
 
Description:  “See one, Do one, Teach one.” Most everyone has heard this expression during some aspect of their medical education. Examined carefully it appears to be somewhat romantically attractive; perhaps as a cavalier or swashbuckling approach usually quoted during procedural training often by someone who, in reality, knows better. Hidden in the concept is a bit of unintentional cynicism that somehow medical training, whether it’s decision-making or procedural, can be approached simply and in the absence of demonstration of true mastery and competency. Most often, the concept is not true to the real training paradigm; however, it does reflect a potential attitude that most of our patients would find unacceptable.
 
 
 
 Part 3A:  Teaching to the Test.
 
Description:  “Teaching to the Test” is far a less acceptable educational behavior, as a concept in medical education and training, than it is in primary and secondary school and university education. Such tendencies either should marginalized or eliminated at all levels but most especially in medical education, both at graduate and post graduate levels. “Teaching to the Test” erodes the curriculum and significantly reduces the validity of the test of mastery; both of these circumstances are serious decrements to the goal of establishing mastery/competency in a profession that requires critical thinking and problem solving as fundamental skills. 
 
 
 
 Part 3B:  Competency or Passing the Boards? Every patient wants an expert.
 
Description:  In this installment in the series we will review of the current state of post graduate medical education and training, and the related methods of competency evaluation. The focus will be on three key components of our education and training model and, in particular, how they might affect our unwritten social contract 1 to prove to our patients that our approach to education creates a safe and effective system of professional behavior and competency on their behalf.


 
 
 
 Part 3C:  The challenge to achieving expert performance: reducing the historic 30% error rate.
 
Description:  When we review the historic error rates for radiology trainees, we begin to understand the challenge to achieving expert performance. 

 


 
 
 

Anthony A. Mancuso, MD

Dr. Mancuso graduated from the University of Miami School of Medicine in 1973 and completed a Residency and fellowship training in Diagnostic Radiology, including 2 years of subspecialty Neuroradiology training, at UCLA Health. He joined the faculty at UCLA Health where he was fortunate to have a founding member of organized neuroradiology in the United States, Dr. William Hanafee, as his friend and lifelong mentor. Dr. Mancuso owes much of the professional development in his career to Dr. Hanafee both with regard to his dedication to development of effective educational methodology and a devotion to discovery of practices that make a positive impact on patient care. He is a Past President of the American Society of Head and Neck Radiology and Senior Member of the American Society of Neuroradiology.

In 1983, Dr. Mancuso joined the faculty at the UF Health to direct the development of the MRI clinical and clinical research program. In 2000, he became Chairman of the Department of Radiology and remains in that position currently. He is also the President of the Florida Clinical Practice Association at UF Health.

Dr. Mancuso is an acknowledged international expert in the area of ENT radiology having been recognized for his achievements by Gold Medals from the American and European Societies of Head and Neck Radiology and a Presidential Citation from the American Society of Head and Neck chirurgery. He has over 170 refereed publications most in the area of Head and Neck Radiology, and has written several books, most recently, a comprehensive 3 volume text covering the clinical practice of head and neck imaging.

Dr. Mancuso's current research interests have been in developing novel methodologies for radiology education, exploiting foundational and modern learning techniques and merging those techniques with IT tools that make personalized, asynchronous delivery of an effective Radiology curriculum finally possible. His clinical research interest is now focused on the development of advanced brain MRI utilizing DTI and fMRI for the evaluation of traumatic brain injury and a wide range of neuropsychiatric disorders.