Effectiveness of a Combined PBL-SBL Training Model for Emergency Management of Iodinated Contrast Media Allergic Reactions.
Saved in:
| Title: | Effectiveness of a Combined PBL-SBL Training Model for Emergency Management of Iodinated Contrast Media Allergic Reactions. |
|---|---|
| Authors: | Yin P; Department of Radiology, Peking University People's Hospital, Beijing, China., Liu Y; Department of Radiology, Peking University People's Hospital, Beijing, China., Xiao S; Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China., Fu L; Department of Radiology, Peking University People's Hospital, Beijing, China. |
| Source: | The clinical teacher [Clin Teach] 2026 Apr; Vol. 23 (2), pp. e70346. |
| Publication Type: | Journal Article; Randomized Controlled Trial |
| Language: | English |
| Journal Info: | Publisher: Blackwell Pub Country of Publication: England NLM ID: 101227511 Publication Model: Print Cited Medium: Internet ISSN: 1743-498X (Electronic) Linking ISSN: 17434971 NLM ISO Abbreviation: Clin Teach Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, UK : Blackwell Pub., c2004- |
| MeSH Terms: | Contrast Media*/adverse effects , Problem-Based Learning*/methods , Drug Hypersensitivity*/therapy , Simulation Training*/methods , Radiology*/education, Humans ; Female ; Male ; Adult ; Clinical Competence |
| Abstract: | Objective: The objective of this study is to evaluate the effectiveness of a novel training model that integrates problem-based learning (PBL) and simulation-based learning (SBL) in improving the emergency response of radiology staff to iodinated contrast media (ICM) allergic reactions. Methods: A sequential exploratory mixed-methods design was employed. First, qualitative data from semi-structured interviews with nine radiology staff members (June-August 2024) were analysed using Colaizzi's method to inform the development of a contextually relevant PBL-SBL training model. Subsequently, a randomised controlled trial (September-December 2024) was conducted with 60 radiology staff (physicians, technologists and nurses), who were assigned to either an observation group (PBL-SBL training) or a control group (traditional lectures and skill demonstration). The primary outcome was emergency skills performance, assessed via a structured practical simulation. Secondary outcomes included critical thinking disposition, measured by the Critical Thinking Disposition Inventory (CTDI-CV), and training satisfaction. Results: Compared to the control group, the observation group performed significantly better in emergency procedures, medication use and teamwork (Z = -6.544 to -6.667, p < 0.05) and scored higher across all critical thinking dimensions (Z = -5.660 to -6.654, p < 0.01). They also reported higher satisfaction with teaching methods, stronger teamwork and self-directed learning, improved learning quality and greater learning interest (Z = -2.149 to -5.161, p < 0.05). Conclusion: The integrated PBL-SBL model is more effective than traditional methods in enhancing emergency skills, critical thinking and learner satisfaction, supporting its adoption for training healthcare providers in managing ICM allergies. (© 2026 Association for the Study of Medical Education and John Wiley & Sons Ltd.) |
| References: | H. M. Dekker, G. J. Stroomberg, and M. Prokop, “Tackling the Increasing Contamination of the Water Supply by Iodinated Contrast Media,” Insights Into Imaging 13, no. 1 (2022): 30, https://doi.org/10.1186/s13244‐022‐01175‐x. H. Lee, S. Song, Y. K. Oh, W. Kang, and E. Kim, “Is Gender Still a Predisposing Factor in Contrast‐Media Associated Adverse Drug Reactions? A Systematic Review and Meta‐Analysis of Randomized Trials and Observational Studies,” European Journal of Radiology 89 (2017): 81–89, https://doi.org/10.1016/j.ejrad.2017.01.015. C. M. Sullivan, N. S. Paul, and M. J. Rieder, “Bridging the Gap Between Bench and Clinic: The Importance of Understanding the Mechanism of Iodinated Contrast Media Hypersensitivity,” British Journal of Radiology 96, no. 1141 (2023): 20220494, https://doi.org/10.1259/bjr.20220494. “ACR Manual on Contrast Media: American College of Radiology,” Committee on Drugs and Contrast Media, 2022, retrieved July 10, 2022. J. R. Dillman, A. T. Trout, and M. S. Davenport, “Allergic‐Like Contrast Media Reaction Management in Children,” Pediatric Radiology 48, no. 12 (2018): 1688–1694, https://doi.org/10.1007/s00247‐018‐4241‐6. X. Li, J. Chen, L. Zhang, et al., “Clinical Observation of the Adverse Drug Reactions Caused by Non‐Ionic Iodinated Contrast Media: Results From 109,255 Cases Who Underwent Enhanced CT Examination in Chongqing, China,” British Journal of Radiology 88, no. 1047 (2015): 20140491, https://doi.org/10.1259/bjr.20140491. F. Sodagari, A. Mozaffary, C. G. Wood, 3rd, B. Schmitz, F. H. Miller, and V. Yaghmai, “Reactions to Both Nonionic Iodinated and Gadolinium‐Based Contrast Media: Incidence and Clinical Characteristics,” AJR. American Journal of Roentgenology 210, no. 4 (2018): 715–719, https://doi.org/10.2214/AJR.17.18655. D. K. Wysowski and P. Nourjah, “Deaths Attributed to X‐Ray Contrast Media on U.S. Death Certificates,” AJR. American Journal of Roentgenology 186, no. 3 (2006): 613–615, https://doi.org/10.2214/AJR.04.1790. D. Kaito, K. Homma, and J. Sasaki, “Rapid Collapse of the Inferior Vena Cava in a Patient With Cardiac Arrest Induced by Anaphylactic Shock After Iodinated Contrast Medium Injection,” Journal of the American College of Emergency Physicians Open 1, no. 4 (2020): 379–382, https://doi.org/10.1002/emp2.12166. L. M. Wetzler, I. M. Feavers, S. D. Gray‐Owen, A. E. Jerse, P. A. Rice, and C. D. Deal, “Summary and Recommendations From the National Institute of Allergy and Infectious Diseases (NIAID) Workshop “Gonorrhea Vaccines: The Way Forward”,” Clinical and Vaccine Immunology 23, no. 8 (2016): 656–663, https://doi.org/10.1128/CVI.00230‐16. E. Trygg, A. Bjällmark, B. M. Ahlander, and J. Kihlberg, “Radiographers' Confidence in Handling Iodine Based Contrast Media Hypersensitivity Reactions,” Radiography (Lond) 30, no. 1 (2024): 21–27, https://doi.org/10.1016/j.radi.2023.10.007. C. L. Wang and E. V. Soloff, “Contrast Reaction Readiness for Your Department or Facility,” Radiologic Clinics of North America 58, no. 5 (2020): 841–850, https://doi.org/10.1016/j.rcl.2020.04.002. R. P. Cant and S. J. Cooper, “Use of Simulation‐Based Learning in Undergraduate Nurse Education: An Umbrella Systematic Review,” Nurse Education Today 49 (2017): 63–71, https://doi.org/10.1016/j.nedt.2016.11.015. F. Lateef, “Simulation‐Based Learning: Just Like the Real Thing,” Journal of Emergencies, Trauma, and Shock 3, no. 4 (2010): 348–352, https://doi.org/10.4103/0974‐2700.70743. A. J. Bland and J. Tobbell, “Towards an Understanding of the Attributes of Simulation That Enable Learning in Undergraduate Nurse Education: A Grounded Theory Study,” Nurse Education Today 44 (2016): 8–13, https://doi.org/10.1016/j.nedt.2016.05.011. L. Hazell, H. Lawrence, and H. Friedrich‐Nel, “Simulation Based Learning to Facilitate Clinical Readiness in Diagnostic Radiography. A Meta‐Synthesis,” Radiography (Lond) 26, no. 4 (2020): e238–e245, https://doi.org/10.1016/j.radi.2020.03.006. D. Enríquez, M. J. Lamborizio, L. Firenze, M. P. Jaureguizar, E. Díaz Pumará, and E. Szyld, “Training of Resident Physicians in the Recognition and Treatment of an Anaphylaxis Case in Pediatrics With Simulation Models,” Archivos Argentinos de Pediatría 115, no. 4 (2017): 399–403, https://doi.org/10.5546/aap.2017.399. Z. Y. Li, L. Y. Song, C. Chen, and J. H. Zhang, “Preliminary Investigation of the In‐Situ‐Simulation Training Program for the Management of Anaphylaxis Emergency Caused by Iodine Contrast,” Asian Journal of Surgery 46, no. 2 (2023): 922–923, https://doi.org/10.1016/j.asjsur.2022.07.057. C. Lozano Terrón, R. Lorenzo Álvarez, and P. F. Sendra, “A Problem‐Based Learning Experience in a Radiology Rotation for Sixth‐Year Medical Students,” Radiologia (Engl Ed) 66, no. 3 (2024): 207–218, https://doi.org/10.1016/j.rxeng.2022.10.016. R. Morrow, A. Rodriguez, and N. King, “Colaizzi's Descriptive Phenomenological Method,” Psychologist 28, no. 8 (2015): 643–644. Y. Yan, W. Yuehong, L. Kun, et al., “Implementation of Mind Mapping With Problem‐Based Learning in Prosthodontics Course for Chinese Dental Students,” BMC Medical Education 23, no. 1 (2023): 530, https://doi.org/10.1186/s12909‐023‐04479‐8. Y. Zhang, X. Xu, F. Wang, et al., “The Use of Bedside Case‐Based Learning in the Clinical Practice of Midwifery Education in China,” BMC Medical Education 24, no. 1 (2024): 1308, https://doi.org/10.1186/s12909‐024‐06251‐y. D. Meyran, P. Cassan, M. Nemeth, et al., “The Ability of First Aid Providers to Recognize Anaphylaxis: A Scoping Review,” Cureus 15, no. 7 (2023): e41547, https://doi.org/10.7759/cureus.41547. J. Leszkowicz, A. Pieńkowska, W. Nazar, et al., “Does Informal Education Training Increase Awareness of Anaphylaxis Among Students of Medicine? Before‐After Survey Study,” International Journal of Environmental Research and Public Health 18, no. 15 (2021): 8150, https://doi.org/10.3390/ijerph18158150. A. Lovink, M. Groenier, A. van der Niet, H. Miedema, and J. J. Rethans, “How Simulated Patients Contribute to Student Learning in an Authentic Way, an Interview Study,” Advances in Simulation (London) 9, no. 1 (2024): 4, https://doi.org/10.1186/s41077‐023‐00277‐w. L. Ma, R. Yan, X. Wang, et al., “Enhancing Surgical Nursing Student Performance: Comparative Study of Simulation‐Based Learning and Problem‐Based Learning,” Journal of Multidisciplinary Healthcare 7, no. 17 (2024): 991–1005, https://doi.org/10.2147/JMDH.S440333. W. S. Peng, L. Wang, H. Zhang, et al., “Application of Virtual Scenario Simulation Combined With Problem‐Based Learning for Paediatric Medical Students,” Journal of International Medical Research 49, no. 2 (2021): 300060520979210, https://doi.org/10.1177/0300060520979210. X. Li, F. Xie, X. Li, et al., “Development, Application, and Evaluation of a Problem‐Based Learning Method in Clinical Laboratory Education,” Clinica Chimica Acta 510 (2020): 681–684, https://doi.org/10.1016/j.cca.2020.08.037. Y. Yang, Z. Guo, X. Guo, and Y. Zhao, “Enhancing Postpartum Hemorrhage Training by Integrating Case‐Problem Based Learning With Simulation: A Quasi Experimental Study,” Journal of Obstetrics and Gynaecology 45, no. 1 (2025): 2443617, https://doi.org/10.1080/01443615.2024.2443617. M. Abbasi, M. Shirazi, H. Torkmandi, S. Homayoon, and M. Abdi, “Impact of Teaching, Learning, and Assessment of Medical Law on Cognitive, Affective and Psychomotor Skills of Medical Students: A Systematic Review,” BMC Medical Education 23, no. 1 (2023): 703, https://doi.org/10.1186/s12909‐023‐04695‐2. H. K. Son, “Effects of Simulation With Problem‐Based Learning (S‐PBL) on Nursing Students' Clinical Reasoning Ability: Based on Tanner's Clinical Judgment Model,” BMC Medical Education 23, no. 1 (2023): 601, https://doi.org/10.1186/s12909‐023‐04567‐9. N. Komasawa, B. W. Berg, and T. Minami, “Problem‐Based Learning for Anesthesia Resident Operating Room Crisis Management Training,” PLoS ONE 13, no. 11 (2018): e0207594, https://doi.org/10.1371/journal.pone.0207594. J. Su, J. M. Xiong, F. X. Yan, et al., “Effects of a Virtual Simulation‐Based Interprofessional Education Activity for Rehabilitation Nursing Using Shared Resources: A Quasi‐Experimental Study,” Nurse Education Today 126 (2023): 105832, https://doi.org/10.1016/j.nedt.2023.105832. N. Li, C. Zhang, J. Cui, Q. Wang, T. Li, and G. Peng, “Using Nobel Prize Case‐Based Learning in Medical Immunology to Cultivate Critical Thinking Dispositions for Medical Undergraduates,” BMC Medical Education 24, no. 1 (2024): 1213, https://doi.org/10.1186/s12909‐024‐06155‐x. H. K. Son, “Effects of S‐PBL in Maternity Nursing Clinical Practicum on Learning Attitude, Metacognition, and Critical Thinking in Nursing Students: A Quasi‐Experimental Design,” International Journal of Environmental Research and Public Health 17, no. 21 (2020): 7866, https://doi.org/10.3390/ijerph17217866. H. H. A. Elnaga, M. B. Ahmed, M. S. Fathi, and S. Eissa, “Virtual Versus Paper‐Based PBL in a Pulmonology Course for Medical Undergraduates,” BMC Medical Education 23, no. 1 (2023): 433, https://doi.org/10.1186/s12909‐023‐04421‐y. Y. A. Lu, S. H. Lee, M. Y. Hsu, et al., “Effects of Problem‐Based Learning Strategies on Undergraduate Nursing Students' Self‐Evaluation of Their Core Competencies: A Longitudinal Cohort Study,” International Journal of Environmental Research and Public Health 19, no. 23 (2022): 15825, https://doi.org/10.3390/ijerph192315825. C. Y. Huang and Y. H. Wang, “Toward an Integrative Nursing Curriculum: Combining Team‐Based and Problem‐Based Learning With Emergency‐Care Scenario Simulation,” International Journal of Environmental Research and Public Health 17, no. 12 (2020): 4612, https://doi.org/10.3390/ijerph17124612. |
| Grant Information: | 2021YB32 Peking University Health Science Center Educational Teaching Research Project |
| Contributed Indexing: | Keywords: emergency training; iodinated contrast media allergy; problem‐based learning; scenario‐based learning; semi‐structured interview |
| Substance Nomenclature: | 0 (Contrast Media) |
| Entry Date(s): | Date Created: 20260121 Date Completed: 20260121 Latest Revision: 20260121 |
| Update Code: | 20260130 |
| DOI: | 10.1111/tct.70346 |
| PMID: | 41565482 |
| Database: | MEDLINE |
Full Text Finder 
Nájsť tento článok vo Web of Science | Abstract: | Objective: The objective of this study is to evaluate the effectiveness of a novel training model that integrates problem-based learning (PBL) and simulation-based learning (SBL) in improving the emergency response of radiology staff to iodinated contrast media (ICM) allergic reactions.<br />Methods: A sequential exploratory mixed-methods design was employed. First, qualitative data from semi-structured interviews with nine radiology staff members (June-August 2024) were analysed using Colaizzi's method to inform the development of a contextually relevant PBL-SBL training model. Subsequently, a randomised controlled trial (September-December 2024) was conducted with 60 radiology staff (physicians, technologists and nurses), who were assigned to either an observation group (PBL-SBL training) or a control group (traditional lectures and skill demonstration). The primary outcome was emergency skills performance, assessed via a structured practical simulation. Secondary outcomes included critical thinking disposition, measured by the Critical Thinking Disposition Inventory (CTDI-CV), and training satisfaction.<br />Results: Compared to the control group, the observation group performed significantly better in emergency procedures, medication use and teamwork (Z = -6.544 to -6.667, p < 0.05) and scored higher across all critical thinking dimensions (Z = -5.660 to -6.654, p < 0.01). They also reported higher satisfaction with teaching methods, stronger teamwork and self-directed learning, improved learning quality and greater learning interest (Z = -2.149 to -5.161, p < 0.05).<br />Conclusion: The integrated PBL-SBL model is more effective than traditional methods in enhancing emergency skills, critical thinking and learner satisfaction, supporting its adoption for training healthcare providers in managing ICM allergies.<br /> (© 2026 Association for the Study of Medical Education and John Wiley & Sons Ltd.) |
|---|---|
| ISSN: | 1743-498X |
| DOI: | 10.1111/tct.70346 |