title: Prospective analysis of an interprofessional team training program using high-fidelity simulation of contrast reactions.
abstract: OBJECTIVE
  Successful management of a contrast reaction requires prompt recognition and treatment and effective team dynamics among radiologists, technologists, and nurses. A radiology department implemented a simulation program in which teams of nurses, technologists, and physicians managed simulated contrast reactions. The purpose of this study was to evaluate whether simulation improved the participants' abilities to manage a contrast reaction and work in a team during an emergency.
  
  
  METHODS
  Physicians, nurses, and technologists worked in inter-professional teams to manage two high-fidelity simulated adverse contrast reactions. Participants completed surveys before and after the simulation that included knowledge-based questions about the appropriate management of contrast reactions. Surveys also included questions for assessing participants' perceptions of their ability to manage adverse contrast reactions, measured with a 6-point Likert scale. Before and after comparisons were made with the McNemar test with a Bonferroni correction requiring p ≤ 0.003 for significance. For the other analyses, p ≤ 0.05 was considered significant.
  
  
  RESULTS
  After completion of the simulation exercises, participants had significant improvement in knowledge (p < 0.001). After the simulation, participants reported significant improvement in their ability to manage an anaphylactoid reaction and their ability to work in a team (p < 0.00001). Participants requested repeat simulation exercises every 6-12 months.
  
  
  CONCLUSIONS
  Simulation exercises improved the self-reported ability of radiology personnel to manage contrast reactions and work in a team during an emergency. Simulation should be incorporated into future educational initiatives to improve patient safety in radiology practices.
authors.affiliation: 1 Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Bethany L
authors.initials: BL
authors.lastname: Niell
authors.forename: Taj
authors.initials: T
authors.lastname: Kattapuram
authors.forename: Elkan F
authors.initials: EF
authors.lastname: Halpern
authors.forename: Gloria M
authors.initials: GM
authors.lastname: Salazar
authors.forename: Alexandra
authors.initials: A
authors.lastname: Penzias
authors.forename: Shawn S
authors.initials: SS
authors.lastname: Bonk
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Forde
authors.forename: Emily
authors.initials: E
authors.lastname: Hayden
authors.forename: Margaret
authors.initials: M
authors.lastname: Sande
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Minehart
authors.forename: James A
authors.initials: JA
authors.lastname: Gordon
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D001900:Boston; D003194:Computer-Assisted Instruction / Q000379:methods*; D003287:Contrast Media / Q000009:adverse effects*; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D016544:Patient Simulation; D011446:Prospective Studies; D011871:Radiology / Q000193:education*
chemical_list: D003287:Contrast Media
keywords: contrast reactions; education; interprofessional; simulation; team training