Current Status of Residency Training of Allergic-like Adverse Events to Contrast Media

Rationale and Objectives: Acute allergic-like adverse reactions to contrast media are rare but life-threatening events. Residents may complete training without ever managing such an event. Surveys have shown practicing radiologists to incorrectly dose and administer medications for treatment. Thus, contrast education may be deficient or inconsistent. The purpose of this study was to assess the current status of contrast reaction education in US radiology residency programs and the methods used to test residents' knowledge. Materials and Methods: A 10-question anonymous survey on residency education methods and testing pertaining to allergic-like adverse events to contrast media was distributed through the Association of Program Directors in Radiology to program directors of US diagnostic radiology residency programs. The past 4 years of the American College of Radiology in-service examination were reviewed to assess the number of contrast reaction questions. Results: Fifty-one programs responded to the Association of Program Directors in Radiology survey. Forty-nine percent of programs train with one lecture per year, 29.4% train with two lectures, and 16% train with three or more lectures. Only 44% include role-playing training during the lectures. Eighteen percent of programs are incorporating simulation training. Fewer than 50% of programs formally test residents' knowledge, and there were no questions on the 2007 to 2010 American College of Radiology in-service examinations. Conclusions: Resident education for contrast reaction management is primarily performed with annual lectures. Only 18% of programs are using simulation training, and <50% are testing residents' knowledge or skills. These findings suggest that education may need revision to incorporate simulation or other means of psychomotor learning.