High-fidelity training helps radiologists with contrast reaction management

High-fidelity training sessions can improve contrast reaction management skills for radiologists at all levels, according to a study published by the Journal of the American College of Radiology (JACR).

Kyle Pfeifer, MD, Yale New Haven Hospital department of radiology, and colleagues wrote that radiologists should get more opportunities to practice contrast reaction management, especially when one considers the severity of such reactions.

“Contrast reactions are one of the few medical emergencies encountered in diagnostic radiology, and the ability to appropriately manage a reaction is essential for the supervising radiologist,” Pfeifer and colleagues wrote. “However, owing to the relative infrequency of contrast reactions, radiologist knowledge about their management is often insufficient. Most physician education on contrast reaction management is gained through didactic lectures; relatively few programs use simulation training.”

The authors dove deeper into the subject by assessing the knowledge of 150 radiologists with various levels of experience before high-fidelity training, one month later, and then again six months later.

“Assessing the benefits of simulation across all levels of training provides a means to study a population who vary in age and experience,” the authors wrote. “In addition, this type of assessment more accurately reflects actual clinical practice, in which any type of radiologist (trainee or senior faculty) may be called on to respond to a potential contrast reaction.”

Overall, participants scored an average of 14.1 out of 20 before the training session and 16 out of 20 one month after the session. Six months after training, the average score was 15.6.

Improvement was observed in all participants, from first-year residents to experienced radiology faculty. First-year residents averaged a score of 12.9 before the training session, which jumped to 15.5 one month later and then 16.6 six months later. Meanwhile, faculty members with over 15 years of experience averaged a score a 14.2 before the training session, which jumped to 16.3 one month later and then slightly dropped to 16.0 six months later.

Comfort level also increased as a result of the high-fidelity training session. Participants rated their comfort on a scale of 1 (not comfortable at all) to 5 (very comfortable), and the average comfort level for managing reactions was 2.9 before the training session, 3.7 one month later, and 3.5 six months later.

For managing severe contrast reactions, the comfort level was 2.4 before the session, 3.4 one month later, and 3.1 six months later.

“High-fidelity simulation is an effective learning tool, allowing practice in what would be high-acuity situations, but in a nonthreatening setting,” the authors wrote.

The authors also noted that 57 percent of participants said they thought the high-fidelity training should be carried out annually.

In August, another study from the JACR touched on how radiologists manage contrast reactions, calling for more specific standards to be put in place.