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Errors in reading radiologic images create health risks to patients and can adversely affect physicians through litigation and increased insurance costs. This study assessed the usefulness of a radiology teaching database for training physicians to improve their diagnostic accuracy. This tool is particularly important in pediatric radiology because children have unique anatomies and pathologies, and most physicians are generally more familiar with adults. The case collection consisted of normal cases and cases that had changes in the initial interpretations from an existing database of pediatric radiologic images at the Cincinnati Children's Hospital Medical Center. Physicians in the radiology department were surveyed regarding their opinions on the case collections. The most frequent users of the collection were residents and fellows, who used the collection primarily for learning and reference. Attending radiologists used the collection for teaching and daily film reading. The most commonly used cases involved head computed tomography, brain magnetic resonance, and skull radiography. All respondents recognized the value of the database for the enhancement of residents' and fellows' training. Residents and fellows expressed the desire to add complete abnormal and frequently missed case collections to the normal collection. Physicians who used the collections did so very frequently, but many experienced physicians never accessed the collection. Inexperienced physicians' reliance on reference books compared with Internet resources highlights a need for computer-based teaching and reference tools. This study illustrates that easy-to-use computer-based teaching files are useful for training physicians and as reference tools for experienced physicians.