Prospective randomized study of contrast reaction management curricula: Computer-based interactive simulation versus high-fidelity hands-on simulation

Management of Acute Contrast Reactions—Understanding Radiologists' Preparedness and the Efficacy of Simulation-Based Training in Canada

“…The use of simulation-based training has been incorporated in residency training throughout various fields of medicine, including anesthesia, emergency medicine, surgery, obstetrics and gynecology, pediatrics, and internal medicine [21]. More recently, various US studies have demonstrated the utility of high-fidelity simulation in assessing and improving radiologists' skills in recognizing and appropriately managing severe contrast reactions [12–20]. Our findings are consistent with those of Gaca et al, Tubbs et al, and Tofil et al, with each of these groups showing that high-fidelity simulation training improved radiology resident scores on multiple-choice knowledge assessments [12–14].…”

“…In 2011, Wang et al compared traditional didactic lectures with high-fidelity simulation and found that although performance on written tests was equal between the 2 groups, the simulation group performed better in contrast reaction simulation scenarios [16]. In 2013, they compared high-fidelity simulation with a computer-based interactive simulation and found equivalent performance on both written knowledge tests and a simulated contrast reaction scenario [17]. Results from our study showed that 15 (79%) of 19 participants felt that a computer-based simulation refresher would be sufficient, which is further supported by Wang et al's findings.…”

“…Results from our study showed that 15 (79%) of 19 participants felt that a computer-based simulation refresher would be sufficient, which is further supported by Wang et al's findings. Given the increased operating costs of a simulation course compared to didactic lectures or computer-based simulation, computer-based training courses may provide a cost-effective alternative for annual or biannual retraining of radiologists after successful completion of a simulation-based course [17,22,23]. The development and implementation of a computer-based training course would also increase access to this vital training among community-based radiologists throughout the country—radiologists who arguably would garner the greatest benefit from this training because they may have more limited access to critical care teams during their daily practice.…”

“…Likely as a result of a lack of exposure and training, radiologists have been shown to make management errors in simulated contrast reaction scenarios, with studies demonstrating that <50% of radiologists provided the correct dose of medication through the correct route and 89% did not know the equipment necessary for an emergency contrast reaction kit [9–11]. In an effort to combat this ongoing issue, studies in the United States have attempted to assess the efficacy of simulation-based training for the improvement of radiologists' performance and comfort in managing contrast reactions [8,12–20].…”

Comparative Effectiveness of Hands-on Versus Computer Simulation–Based Training for Contrast Media Reactions and Teamwork Skills

“…Importantly, to prevent a dangerous situation of increasing comfort but unrecognized declining knowledge over time, these results highlight the importance of frequent refresher training (such as biannually, as suggested by other authors) to mitigate knowledge decay and objectively assess knowledge [16,23]. For refresher training, maximum compliance should be emphasized; thus, computer-based training or a didactic lecture is probably sufficient [16,24]. The significant decline in both groups' delayed written TS scores suggests that refresher training should also address nontechnical skills (Fig.…”