High-Fidelity Simulation Training for the Diagnosis and Management of Adverse Contrast Media Reactions

Adverse reactions to contrast media are potentially life-threatening events that require prompt recognition and management by radiologists who may have little experience with them. The objectives of this project were to develop and assess a simulation-based program that would equip radiology trainees with appropriate knowledge and skills to recognize and manage adverse contrast media reactions.

Fifteen adverse contrast media reaction scenarios were developed to run on high-fidelity adult and pediatric mannequins in a simulation center. Ninety-six radiology trainees (postgraduate year 2-6) participated in the program, which consisted of two didactic lectures and a simulation session. For each simulation session, seven scenarios were chosen. Objective quizzes assessing knowledge and subjective questionnaires assessing comfort were completed both before and after the simulation. A survey assessing the overall program was also completed.

All 96 radiology trainees viewed the didactic lectures, attended a simulation session, and completed the pre- and postsimulation quizzes and questionnaires. Mean scores increased from 69% to 82% (p < 0.001) and from 3.1 to 4.5 out of 5 (p < 0.001) on the objective and subjective tests, respectively. Statistically significant improvement was also seen when participants were separated according to level of training. On the final program evaluation survey, scores ranged from 4.5 to 4.7 out of 5.

We describe the development of a high-fidelity simulation program with a larger variety of scenarios than in prior studies that can provide radiologists the knowledge and skills needed to recognize and manage adverse contrast media reactions. We saw a statistically significant improvement in knowledge and comfort levels across all levels of training.