Systemic barriers to the development of diagnostic imaging skills in family medicine residents
Keywords:
medical education; family medicine; ability; imaging; institutional organizationAbstract
Introduction: Deficiencies in the development of diagnostic imaging skills among Family Medicine residents transcend didactic causes and stem from systemic curricular, organizational, and cultural factors. The objective was to analyze the factors that act as barriers to the systematic development of diagnostic imaging skills.
Method: A qualitative study with a phenomenological-hermeneutic approach was conducted at the Juana Naranjo León University Polyclinic between February and July 2025. Methodological and source triangulation was employed: documentary analysis of the national program and specialty directors; twelve phenomenological interviews with directors, tutors, and the Imaging specialist at the polyclinic; and three focus groups with 21 residents. The analysis, using NVivo 12, followed a hermeneutic cycle through thematic analysis and consensus coding until theoretical saturation was reached.
Results: Interconnected barriers were identified in four dimensions: curricular—Normative, based on a null curriculum, without objectives or evaluation; Organizational and operational barriers include fragmented rotations, prioritizing patient care, and a disconnect between outpatient clinics and hospitals; cultural and pedagogical barriers include opportunistic self-directed learning, the perception of imaging as an external domain, and non-standardized supervision; and resource and access barriers include limited access dependent on initiatives, a lack of dedicated spaces, and informal tutoring. Resources, such as digital archives, are insufficient to counteract these barriers.
Discussion: The identified barriers are systemic and self-reinforcing, creating a cycle that perpetuates training deficiencies. Therefore, isolated interventions at the micro level are insufficient and require a comprehensive approach that studies, in a coordinated manner, the macro level, such as curriculum policy; the meso level, in institutional management; and the micro level, from the perspective of the educational system's pedagogical culture.
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Copyright (c) 1970 Miguel Angel Amaró Garrido, Carmen Lydia Díaz Quintanilla , Andel Pérez González , Carlos Lázaro Jiménez Puerto, Jim Alex González Consuegra, Eliecer González Valdéz
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