Studies have shown that life-threatening contrast agent reactions in adults are very rare, and even less common in children. The rarity of severe allergic reactions to contrast material challenges educators to achieve radiology resident competency in this setting. However, using a simulated anaphylactic contrast reaction paradigm, we have drawn two conclusions: (1) Residents are insufficiently prepared to recognize and manage these life-threatening events and (2) with an interactive, computer-based tool we can significantly improve resident performance in these situations. Simulation is a growing tool in medicine and allows standardized resident exposure to uncommon events in a setting that is conducive to resident education without fear of repercussions (see Ruddy and Patterson in this issue of Pediatric Radiology). More important, simulation provides a cornerstone in patient safety resident education without putting patients at risk.