Most Missed SIM Case
SpCA0020-Most Missed SIM Case

SpCA0020-Most Missed SIM Case
Case InfoHistory
40 year old female with atypical low back after a fall yesterday.
Exam
XR PELVIS W/BILATERAL HIPS
Prior Study
None.
Answer
The Education Gap

Fracture, Sacrum
FINDINGS
There is a non-displaced fracture of the left sacral ala which does not appear to involve the neural foramen or SI joint. The bony mineralization is within normal limits. There are no acute or concerning soft tissue abnormalities.
IMPRESSION
Non-displaced left sacral ala fracture. A CT scan could be obtained for further evaluation.
COMMENT
The results were called to the ED at the time of dictation.
ACUITY RANK
Urgent
STATISTICAL ANALYSIS OF SIM RESULTS
321 residents interpreted this case of sacral fracture 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 1.29 out of 10.
On average, 8.71 points out of 10 were lost due to missed observations. At the same time, 0.00 points were lost due to interpretive errors.
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 6% 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 80% of residents produced reports with critical error(s).
There is a non-displaced fracture of the left sacral ala which does not appear to involve the neural foramen or SI joint. The bony mineralization is within normal limits. There are no acute or concerning soft tissue abnormalities.
IMPRESSION
Non-displaced left sacral ala fracture. A CT scan could be obtained for further evaluation.
COMMENT
The results were called to the ED at the time of dictation.
ACUITY RANK
Urgent
STATISTICAL ANALYSIS OF SIM RESULTS
321 residents interpreted this case of sacral fracture 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 1.29 out of 10.
On average, 8.71 points out of 10 were lost due to missed observations. At the same time, 0.00 points were lost due to interpretive errors.
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 6% 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 80% of residents produced reports with critical error(s).