title: Comparison of High-Fidelity Simulation Versus Didactic Instruction as a Reinforcement Intervention in a Comprehensive Curriculum for Radiology Trainees in Learning Contrast Reaction Management: Does It Matter How We Refresh?
abstract: OBJECTIVE
  Simulation-based training has been shown to be a useful adjunct to standard didactic lecture in teaching residents appropriate management of adverse contrast reactions. In addition, it has been suggested that a biannual refresher is needed; however, the type of refresher education has not been assessed.
  
  
  METHODS
  This was a prospective study involving 31 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by high-fidelity simulation-based training. At approximately 6 months, residents were randomized into a didactic versus simulation group for a refresher. At approximately 9 months, all residents returned to the simulation center for performance testing. Knowledge and confidence assessments were obtained from all participants before and after each phase. Performance testing was obtained at each simulation session and scored based on predefined critical actions.
  
  
  RESULTS
  There was significant improvement in knowledge (P < .002) and confidence (P < .001) after baseline education of combined didactic and simulation-based training. There was no statistical difference between the simulation and didactic groups in knowledge or confidence at any phase of the study. There was no significant difference in tested performance between the groups in either performance testing session.
  
  
  CONCLUSIONS
  This study suggests that a curriculum consisting of an annual didactic lecture combined with simulation-based training followed by a didactic refresher at 6 months is an effective and efficient (both cost-effective and time-effective) method of educating radiology residents in the management of adverse contrast reactions.
authors: Department of Radiology and Radiological Sciences, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, 210 CSB, Charleston, SC 29425-3230. Electronic address: picard@musc.edu.
authors: Melissa
authors: M
authors: Picard
authors: Department of Radiology and Radiological Sciences, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, 210 CSB, Charleston, SC 29425-3230.
authors: Nancy
authors: N
authors: Curry
authors: Department of Radiology and Radiological Sciences, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, 210 CSB, Charleston, SC 29425-3230.
authors: Heather
authors: H
authors: Collins
authors: Department of Radiology and Radiological Sciences, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, 210 CSB, Charleston, SC 29425-3230.
authors: LaShonda
authors: L
authors: Soma
authors: Department of Radiology and Radiological Sciences, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, 210 CSB, Charleston, SC 29425-3230.
authors: Jeanne
authors: J
authors: Hill
mesh_terms: D002983:Clinical Competence; D003287:Contrast Media / Q000009:adverse effects*; D003479:Curriculum; D064420:Drug-Related Side Effects and Adverse Reactions / Q000175:diagnosis / Q000628:therapy; D000070856:High Fidelity Simulation Training; D006801:Humans; D007396:Internship and Residency; D011446:Prospective Studies; D011871:Radiology / Q000193:education*; D011897:Random Allocation; D012054:Reinforcement, Psychology
chemical_list: D003287:Contrast Media
keywords: Contrast reaction; radiology; resident education; simulation training