Kyle Elmer Pfeifer MD, Presenter: Nothing to Disclose

Jay Kumar Pahade MD, Abstract Co-Author: Nothing to Disclose

Jonathan D. Kirsch MD, Abstract Co-Author: Nothing to Disclose

Melih Arici MD, Abstract Co-Author: Nothing to Disclose

Jennifer Arango, Abstract Co-Author: Nothing to Disclose

Lawrence H. Staib PhD, Abstract Co-Author: Nothing to Disclose

Reactions to contrast material are uncommon in diagnostic radiology, and vary in presentation from urticaria to life threatening anaphylaxis. It is the responsibility of the radiologist to provide appropriate care. Prior work has shown a high error rate in contrast reaction management, with smaller studies using simulation showing variable data on effectiveness. Using the largest study population to date, (>150 radiologists) we sought to assess the effectiveness of high fidelity simulation in managing contrast reactions.

A 20 question multiple-choice test and Likert scale questions assessing subjective comfort levels and knowledge of management of contrast reactions was created. Three simulation scenarios (moderate reaction, severe reaction, and reaction mimic) were designed to provide simulation training. Each course was completed in one hour in groups of 8-10 with 2-3 “responders” per simulation. All participants completed a pre-test, post simulation debriefing, and post-test to assess effectiveness on test scores and subjective Likert ratings of comfort in managing reactions.

151 radiologists participated (residents=53, fellows=24, faculty=74). There was a statistically significant increase in the post-test scores after the simulation (p=0.03). Post simulation Likert scores regarding comfort in managing contrast reactions showed a significant increase across mild, moderate, and severe reactions (P<0.05). No statistical difference in test scores was noted when comparing residents to fellows to faculty.

High fidelity simulation is an effective learning tool, allowing practice of “high acuity” situations in a non-threatening setting. Our study revealed a statistically significant improvement in test scores, and subjective comfort in management of reactions. The study supports the use of high fidelity simulation as an effective teaching tool for contrast reaction management.

Our study illustrates the successful implementation of a high fidelity contrast reaction simulation program across an entire radiology department and is the largest to date. It further supports the implementation of simulation as an effective teaching tool in contrast reaction management training with the goal of improving patient outcomes.

Pfeifer, K, Pahade, J, Kirsch, J, Arici, M, Arango, J, Staib, L, High Fidelity Contrast Reaction Simulation Training: A Single Department's Comparison of Performance and Comfort Level Amongst Faculty, Fellows, and Residents.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000946.html