0 4 - 2 6 Research Part icipat ion and Mentoring of Residents: Pract ice and Percept ion Piotr S. Kisza, MD, New Jersey Medical School, Newark, N J, Stephen R. Baker, MD, Kenneth R. Tomkovich, MD, Sohail Contractor, MD

Purpose: To determine the prevalence of mentoring in diagnos- tic radiology residency programs and their effect on research pro- ductivity by trainees.

Mate r ia l & Methods : A survey was mailed to chairmen, pro- gram directors and chief Residents in all U.S. diagnostic radiol- ogy residency programs. The questionnaire focused on men- tor ing-- i t s practice, and the perception of its effectiveness by faculty and residents. Responses were desegregated by commu- nity versus university programs.

Results: Of the 315 respondents, 193 were chairmen and pro- gram directors, and 122 were chief residents. 241 (76.5%) were university based, 74 (23.5%) communi ty based. Mentorship was acknowledged by 87 respondents (27.6%). Sixty-five of these were f rom university programs. According to chairmen/program directors, where mentors are present, residents are active in re- search in 67% of university programs and 33.3% of communi ty programs. Without mentors present, residents were active in 53% of university and 17.6% of community based programs. Accord- ing to chief residents, with mentors present, residents were in- volved in research in 68.7% of university programs and 25% of community hospital-based programs. Without a mentor ' s pres- ence felt, trainees are active in research in 33% of university pro- grams and 28% communi ty hospital programs.

Conclusion: The perception of chairmen/program directors and residents was that trainees were more likely to engage in research When formal mentorship was in place. In review, mentoring of residents appears to have a positive effect on university-based programs but no appreciative effect in communi ty hospital based programs.

0 4 - 2 7 Correlat ion between Radiology Resident Rotat ion Performance and Examinat ion Scores Saroja Adusumilli, MD, University of Michigan Medical Center, Ann Arbor, MI, Richard H. Cohan, MD, Kelley W. Marshall, MD, James T. Fitzgerald, PhD, Mary Oh, BS, James H. Ellis, MD

Purpose: To determine whether there is a relationship between assessed radiology resident performance on individual rotations and resident performance on the American College of Radiology (ACR) in-training examination and the written American Board of Radiology (ABR) examination.

Mate r ia l s and Methods: Evaluation forms and written examina- tion scores of radiology residents enrolled between 1991 and 1998 were reviewed. Residents were graded in areas of general knowledge and overall performance on each of their rotations. Standardized scores were calculated for each year in both catego- ries. Compar isons were then made between these standardized scores and resident performance (percentage correct) on the ACR or the ABR exam taken in the same year.

Results: Evaluation scores were not correlated with ACR perfor- mance for the first year of residency. There were some significant correlations between evaluation scores and ACR exam performance in the second (knowledge: r = .27, P = .05, n = 52; overall: r = .31, P = .02, n = 52) and third (knowledge only: r = .34, P = .02, n = 46) years. There were also significant correlations between ABR scores and fourth year residency evaluation scores (knowledge: r = .30, P = .03, n ---54; overall: r = .32, P = .02, n = 54).

Conclusion: Resident rotation performance as assessed on sub- jective evaluation forms does not predict ACR exam perfor- mance in the earliest part of radiology residency. There is a posi- tive correlation between resident performance and written exam scores later in the residency.

0 5 - 2 8 How Common Are Al lergic React ions to Contrast Me- dia during Diagnostic Angiography and Intervent ional Radiology, and Can They Be Avoided? George G. Hartnell, MD, Beth Israel Deaconess Medical Center, Boston, MA, Julia Gates, MD, Jonathan Underhill, BS, Cameron Akbari, MD

Purpose: Allergic reactions to iodinated contrast media (CM) occur in up to 10% of patients with allergies. Up to 35% patients with a history of CM allergy have a repeat reaction. Steroid pre- medication and non-ionic CM reduces the repeat reaction rate. We assessed the incidence of allergic reactions complicating an- giographic procedures to determine the level of risk and identify scope for further risk reduction.

Mate r ia l s and Methods: Complications of all angiographic pro- cedures were recorded over 44 months. Allergic reactions, risk factors, steroid premedication and use of non-ionic CM were re- corded. Patients with a history of CM allergy, other allergies or asthma were premedicated with steroids.

Results: During the study period 4893 procedures were per- formed. Non-ionic CM was used for a history of allergy or asthma in 22%. In 175 patients with a history of CM allergy there were no allergic reactions. Allergic reactions occurred in 11/4893 (0.22%); 4/2158 after non-ionic CM (all minor reac- tions, 2 had steroid premedication); 7/2735 after ionic CM. Two major reactions followed ionic CM.

Conclusion: Allergic reactions to CM in angiographic proce- dures are rare, with limited scope for further risk reduction, when a consistent policy of steroid premedication, and non-ionic CM is used for at-risk patients.

0 5 - 2 9 What Are the Risk Factors for Puncture-Si te Hematoma Complicat ing Diagnostic Angiography and Vascular Interventional Procedures? George G. Hartnell, MD, Beth Israel Deaconess Medical Center, Boston, MA, Julia Gates, MD, Jonathan Underhill, BS, Cameron Akbari, MD

Purpose: Hematoma is a significant risk following diagnostic angiography and vascular intervention. We set out to identify factors that increase the risk of hematoma and allow prospective identification of "at-risk" patients.

Mater ia l s and Methods: All hematomas occurring over a 44- month period were recorded. Factors that might increase the risk of hematoma formation were recorded and compared with data f rom all patients (or appropriate control groups).

Results: Characteristics which were more frequent in 77 patients with hematomas (compared with a total population of 3914) in- cluded brachial artery puncture in 31% (4.9%), balloon angio- plasty/stent in 17% (7.9%), chemoembolizat ion in 14% (9.2%), and thrombolysis in 17% (3.3%). There were no differences in mean age, history of hypertension, or recorded systolic blood pressure. When controlled for procedure and anticoagulation there was no relationship to size of puncture (range 4-8.5 Fr.), or use of vascular sheaths.

Conclusion: Interventional procedures and brachial artery punc- ture increase the risk of hematoma by a factor of 2 and 6 respec- tively. There was no relationship to patient age, history of hyper- tension, systolic blood pressure at the time of the procedure, size of puncture or vascular sheath use. Patients undergoing interven- tional procedures or brachial artery puncture require increased postprocedure supervision.

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