Dr. Bregman: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. Dr. Thau: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada. Dr. Pusic: Division of Pediatric Emergency Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard University; Boston, MA. Dr. Perez: Department of Diagnostic Imaging, University of Toronto, Ontario, Canada. Dr. Boutis: Division of Pediatric Emergency Medicine, Department of Pediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.

Correspondence: Kathy Boutis, MD, MSc, Department of Pediatrics, Division of Emergency Medicine, 525 University Avenue, 12th Floor, Toronto, Ontario M5G 2L3, Canada ([email protected]).

K.B. is married to Dr. Martin Pecaric who owns Contrail Consulting Inc. Contrail Consulting Inc. provides software development and support services for ImageSim. Data used for this research was extracted from the ImageSim platform. This relationship is managed under formal contract and relationship management agreement with the Hospital for Sick Children and University of Toronto. K.B. is also the ImageSim academic director and Dr. M.P. is the ImageSim learning analytics director. However, Drs. Boutis and Pusic are not paid for their roles or affiliations for this platform. ImageSim is a nonprofit course that operates under the auspices of the Hospital for Sick Children and University of Toronto (https://imagesim.com/non profit-course-operations-and-privacy/). The other investigators have nothing to declare. There are no funding sources to declare.

This study was approved by the Hospital for Sick Children Research Ethics Board