Standards for Radiology Events and Learning Meetings (REALMs), 2nd edition (2026)

This updated guidance provides a practical framework for creating safe, supportive and effective Radiology Events and Learning Meetings (REALMs) across all reporting settings.

Everyone who interprets images will, at some point, miss or misinterpret something. The 2026 REALM standards recognise that fallibility is part of clinical practice and that learning is strongest when radiological events are discussed openly, compassionately and without blame. The guidance helps departments establish protected, anonymised learning meetings that support reflection, shared learning and meaningful service improvement.

The revised standards reflect the changing radiology landscape, including remote and hybrid working, teleradiology, a growing multi-professional reporting workforce and the rapid integration of artificial intelligence into clinical workflows. They draw on human factors, cognitive psychology and safety science to help teams understand why errors happen and how systems can be improved.

The guidance includes:

• ten standards for developing a compassionate, psychologically safe learning culture

• recommended arrangements for protected meeting time, attendance, leadership and administration

• clear separation between educational REALM activity and performance management

• practical approaches to anonymising and preparing cases, communicating learning and escalating system-level concerns

• a dedicated REALM(AI) framework for learning from human–AI interactions

• templates, prompts and resources to support implementation, reflective practice and staff wellbeing

The standards are intended for consultant radiologists, SAS and locally employed doctors working in radiology, radiology residents, reporting radiographers, sonographers, teleradiology providers, REALM leads and departmental leaders. Clinicians outside radiology who interpret and report imaging are also encouraged to apply the same principles.