Radiology resident proficiency in pediatric trauma cases: a comparative analysis based on trauma center status using the WIDI SIM exam.

Purpose: To investigate the correlation between pediatric and adult trauma center status and radiology resident performance on pediatric trauma cases using the WIDI SIM exam.

Materials and methods: The WIDI SIM is a validated computer-aided simulation that assesses radiology residents' preparedness for independent call duty. It includes 65 cases across various imaging modalities derived from actual patient encounters. Faculty score free-text responses using a standardized 0-10 scale rubric. We analyzed 8,488 WIDI SIM exam scores from 35 pediatric trauma cases across 52 programs. A negative binomial regression model adjusting for resident level, imaging modality, and case specialty was employed to evaluate the impact of pediatric and adult trauma center status on resident performance.

Results: Both pediatric trauma center status (p = 0.0005) and adult trauma center status (p = 0.0003) were significant predictors of higher resident scores. Resident level was also significant, with higher-level residents performing better than first-year residents (p < 0.001). Residents performed worse on MR and US modalities compared to CT, and performance varied by case specialty.

Conclusion: Radiology residents' pediatric trauma imaging skills are significantly linked to pediatric and adult trauma center status. Given most pediatric traumas occur outside pediatric trauma centers, targeted training strategies should be considered to ensure residents develop essential diagnostic skills.