Purpose or Case Report: The Wisdom in Diagnostic Imaging SIMulation (WIDI SIM) is a strategically designed computer aided simulation of an emergency imaging experience, which rigorously tests residents’ readiness to diagnose various Radiology emergencies. It has proven to be a reliable means for assessing resident preparedness to competently and independently cover radiology call. The residents are provided with a total of 65 cases of varying difficulty, including normal studies. The residents respond using free text which is then scored by faculty members utilizing a robust grading rubric. The identification of pertinent GU emergencies by the “on-call” resident is of the utmost importance as it the resident who must then notify the clinicians of this concern and so that emergent treatment can be expedited.
Methods & Materials: The WIDI simulation, an 8 hour web based ED shift simulation, was utilized as a call-readiness simulation for residents from programs around the country and then scored accordingly. The amount of residents who underperform (score less than 5 points out of 10) were tabulated.
Results: A total of 351 radiology residents were given a case of renal laceration with urine leak and a case of bilateral severe hydroureter, hydronephrosis, uretrocele and malpositioned foley. In this group, 29.6% of residents undeperformed for the first case and 65.2% for the second case. Additionally, a total of 253 residents were given a case of pyelonephritis. Nine percent of residents underperformed for this case. The diagnosis of these GU emergencies was consistently under-called by radiology residents being tested for call readiness, hence proving a huge educational gap in diagnosing the GU emergencies.
Conclusions: Radiology residency is lacking in teaching residents to accurately recognize various findings in pediatric GU emergencies. This has great implications for programs where a radiology attending is not present at night as it raises the concern that certain GU emergencies will be missed by residents taking overnight call. Clinicians rely upon the radiologist to help recognize pertinent findings that can significantly affect management. The solution proposed and being implemented by our institute is the WIDI learn platform, which will have the online modules on Critical/ Emergent Radiology diagnosis. WIDI Consult, integrated in the Learn platform, provides rapid scenario-based (clinical problem + a specific imaging test at hand) access to an expert approach to such a specific critical care problem.