Patient-simulated cases increase confidence of trainees when managing adverse events related to radiological procedures

Purpose: Simulation-based learning is a well-known tool used to supplement students’ understanding. However, not all radiology programs have implemented this as part of resident training for a variety of reasons. In the face of these obstacles, we explore whether incorporating a simulation-based exercise in addition to lecture-based content will serve to increase the trainees’ confidence when approaching adverse events pertaining to radiological procedures and provide a return on investment for implementing this into the program.

Methods/Materials: A lecture was prepared and presented to current radiology residents, fellows, and rotating medical students that highlighted how to recognize and manage adverse events related to intravenous contrast administration and sedation during radiological procedures/imaging. After the lecture, trainees were given a questionnaire to assess their impressions on the content and how well they can apply the concepts in the real-world setting. Next, all trainees participated in several patient-simulated cases that reinforced the material presented in the lecture. Lastly, after successful completion of the simulation exercises, the trainees were again asked to assess their impressions on the content and how well they can apply the concepts in the real-world setting.

Results: When assessing how confident (scale 1-10) the trainee was in managing adverse reactions to iodinated intravenous contrast based on the ACR guidelines, trainees reported a statistically higher level of confidence (p-value < 0.005; when alpha = 0.05) after participating in the simulation scenarios than the lecture alone. When assessing how confident (scale 1-10) the trainee was in managing adverse reactions related to procedural sedation, trainees reported a statistically higher level of confidence (p-value < 0.01; when alpha = 0.05) after participating in the simulation scenarios than the lecture alone. Note: one-tailed two sample z test was used to obtain p-value.

Conclusions: In conclusion, patient-simulated cases serve as a great adjunct when teaching trainees how to recognize and manage patients experiencing adverse events with intravenous contrast and sedation during radiological procedures/imaging.