Assessment of radiology resident competency in identifying conditions amenable to interventional radiology and recognition of procedural complications

Purpose: The purpose of this study was to assess the ability of radiology residents to identify conditions that may benefit from IR intervention and recognize complications of IR procedures during a simulated emergency radiology call shift. Materials and methods: This study utilized the Wisdom in Diagnostic Imaging Simulation (WIDI SIM) platform, an emergency imaging simulation designed to assess radiology resident preparedness for independent call. During an 8-hour simulation, residents were tested on 65 cases across various imaging modalities of varying complexity, including normal studies. We identified four cases involving conditions amenable to IR intervention or postprocedural complications that were included in simulations administered between 2016 and 2023. Cases were assessed using a standardized grading rubric by subspecialty radiology faculty, with errors subsequently classified by type. Results: A total of 1152 scores from radiology residents were assessed on four IR cases over the course of seven years of testing. Cases included splenic trauma with pseudoaneurysm, pseudoaneurysm following renal transplant biopsy, ruptured hepatocellular carcinoma, and IVC filter complication. Analysis revealed that residents underperformed in identifying conditions amenable to IR intervention and recognizing post-procedural complications. Points were primarily lost to observational error. Conclusions: Timely diagnosis of these conditions is imperative to prevent life-threatening complications. Our results highlighted challenges in radiology residents' proficiency in identifying these conditions. Addressing these challenges through simulation training and targeted education is essential to improve resident competency in diagnosing conditions amenable to IR intervention and recognizing post-procedural complications.