Most Missed SIM Case
SpCA0002-Most Missed SIM Case
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SpCA0002-Most Missed SIM Case
Case InfoHistory
32 year old female with acute onset weakness, diplopia, and altered mental status. Possible seizure.
Exam
Non Contrast CT of the Head.
Prior Study
None.
Answer
The Education Gap
Hyperdense Basilar Artery
FINDINGS
There is a hyperdense basilar artery on this non contrast study indicative of acute thrombosis of the basilar artery. Otherwise there is normal brain formation and differentiation of the grey-white junction. Ventricular size and cisternal patterns are appropriate for age. No mass. No intra-axial or extra-axial fluid collection. Paranasal sinuses are clear. Orbits appear normal.
IMPRESSION
Hyperdense basilar artery consistent with acute thrombosis
The stroke team has been alerted.
ACUITY
Emergent
STATISTICAL ANALYSIS OF SIM RESULTS
103 residents interpreted this case of basilar artery thrombosis as one of 65 cases during an 8-hour simulated on-call shift, with a median score of 0 out of 10 and an overall average score of 0.87 out of 10.
Overall, the average number of points lost out of 10 to observational discipline was 8.93. At the same time, 0.19 points were lost due to interpretive errors on the part of the residents.
We define an effective report to be one which achieves scores between 7 and 10. In terms of letter grades, this would be A & B. In this “most missed” case 9% of residents produced effective reports.
We define a report having a critical error to be one with scores between 0 and 2. In terms of letter grades, this would be F & D. In this “most missed” case 90% of residents produced reports with critical error(s).
There is a hyperdense basilar artery on this non contrast study indicative of acute thrombosis of the basilar artery. Otherwise there is normal brain formation and differentiation of the grey-white junction. Ventricular size and cisternal patterns are appropriate for age. No mass. No intra-axial or extra-axial fluid collection. Paranasal sinuses are clear. Orbits appear normal.
IMPRESSION
Hyperdense basilar artery consistent with acute thrombosis
The stroke team has been alerted.
ACUITY
Emergent
STATISTICAL ANALYSIS OF SIM RESULTS
103 residents interpreted this case of basilar artery thrombosis as one of 65 cases during an 8-hour simulated on-call shift, with a median score of 0 out of 10 and an overall average score of 0.87 out of 10.
Overall, the average number of points lost out of 10 to observational discipline was 8.93. At the same time, 0.19 points were lost due to interpretive errors on the part of the residents.
We define an effective report to be one which achieves scores between 7 and 10. In terms of letter grades, this would be A & B. In this “most missed” case 9% of residents produced effective reports.
We define a report having a critical error to be one with scores between 0 and 2. In terms of letter grades, this would be F & D. In this “most missed” case 90% of residents produced reports with critical error(s).