title: Improving education for the management of contrast reactions: an online didactic model.
abstract: OBJECTIVE
  Radiologists could improve their knowledge of contrast reaction management. The aim of this study was to evaluate to what degree the implementation of a didactic module resulted in improved technologist, nurse, and physician knowledge and comfort levels regarding the appropriate management of adverse reactions to contrast media.
  
  
  METHODS
  After institutional review board approval was obtained, nurses, technologists, and physicians involved in contrast administration were required to complete the educational module. Premodule and postmodule assessments were designed online. Each assessment included knowledge-based questions regarding the appropriate management of different types of contrast reactions, as well as questions regarding each respondent's comfort level with the treatment of various types of adverse contrast reactions. Comfort level was measured using a 6-point, Likert-type scale. Premodule and postmodule assessment scores were compared using McNemar's test.
  
  
  RESULTS
  After module completion, physicians demonstrated a statistically significant improvement in knowledge regarding the proper administration route, concentration, and dose of intramuscular epinephrine. Physicians demonstrated significantly increased comfort with the administration of intramuscular epinephrine to adult and pediatric patients after module completion (P < .05). Module completion resulted in statistically significant improvements in respondents' comfort levels with the treatment of an adverse reaction to contrast media, although 19% of personnel still reported feeling uncomfortable after completing the module.
  
  
  CONCLUSIONS
  Didactic instruction in contrast reaction management results in improved knowledge and comfort levels for physicians, nurses, and technologists. However, a significant percentage of personnel still reported feeling uncomfortable treating an adverse contrast reaction after module completion, suggesting that didactic instruction alone may be inadequate.
authors.affiliation: Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: bniell@partners.org.
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Niell
authors.affiliation: Department of Internal Medicine, University of Massachusetts, Worcester, Massachusetts.
authors.forename: Vartan M
authors.initials: VM
authors.lastname: Vartanians
authors.affiliation: Department of Radiology, Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Elkan P
authors.initials: EP
authors.lastname: Halpern
mesh_terms: D000328:Adult; D001900:Boston; D002648:Child; D002983:Clinical Competence; D003287:Contrast Media / Q000009:adverse effects*; D003479:Curriculum; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology* / Q000517:prevention & control*; D004496:Education, Continuing / Q000458:organization & administration*; D004521:Educational Measurement; D006801:Humans; D011871:Radiology / Q000193:education*
chemical_list: D003287:Contrast Media
keywords: Education; adult learning; anaphylaxis/prevention and control; contrast media/adverse effects; questionnaires