The Emergent/Critical Care Imaging SIMulation (SIM) is a strategically designed computer aided simulation of an emergency imaging experience that has been rigorously tested and proven to be a reliable and validated means to assess resident preparedness to proceed to the next level of their training – to competently and independently cover Radiology consulting for the hospital, with “phone supervision” from home” by attendings, on the overnight shift in the reading room – a specialty specific Entrustable Professional Activity (EPA).

The SIM encompasses an 8.5 hour online simulation during which sixty-five (65) emergent and critical care cases of varying degrees of difficulty, including normals, are presented via full DICOM image sets (no cueing by multiple choice) with full image manipulation.

Image Viewer Information

• The SIM utilizes a thin client medical image viewer – Visage Imaging

All Emergent/Critical Care Imaging sub-specialties and modalities are included on every SIM.


• Gastrointestinal • Multi-Trauma • Musculoskeletal • Neuro • Pediatric • Reproductive/Endocrine • Thoracic • Urinary


• Computed Tomography (CT) • Computed Tomography Angiography (CTA) • Fluoroscopy • Magnetic Resonance Imaging (MRI) • Magnetic Resonance Angiography (MRA) • Nuclear Medicine • Radiography (x-rays) • Ultrasound

For each case, residents will be asked to:

• Identify the critical finding(s) • Assess the acuity of the finding(s) • Specify an action plan (clinical response)

Results & Analysis

Once all of a program’s scheduled residents have taken the SIM, submissions will be graded by a team of sub-specialists. Each question on the SIM is graded on a ten (10) point scale via a robust grading rubric. All results, including individual, overall program, and comparative data (anonymized) will be electronically provided to the registered program director. Program directors may communicate some or all of the results to their residents.

Individual results will consist of a summary report for each resident that includes: points allocated; correct diagnosis; correct diagnosis detail; sub-specialty; attributes (normal/pediatric/nuclear medicine). Overall program results will consist of a summary report that includes: points allocated; overall % correct; correct diagnosis; correct diagnosis detail; sub-specialty; attributes (normal; pediatric; nuclear medicine). Comparative data will be sent separately, subsequent to all registered programs having completed the SIM for the current academic year.

Once results are released to a program, residents will be provided with access to review clips for each of the cases included on the SIM.


The WIDI team maintains strict confidentiality of SIM results at all times. We are only able to discuss individual and program results with registered program directors. We are unable to discuss results with individual residents.


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