The Interactive Clinical Anatomy and Radiology Utilization Simulator (I.C.A.R.U.S.) was designed by Dr. Lily Belfi as a virtual learning environment for medical students and trainees. ICARUS presents an innovative approach to patient care by combining real patient scenarios with clinical decision support in the management of each case. The clinical decision support software developed by Medicalis provides a platform for informed ordering of studies based on evidence-based medicine including the ACR Appropriateness Criteria for imaging. Each clinical scenario presents an opportunity for exploration and greater understanding of the guidelines for selecting the best imaging study as well as pertinent patient safety issues. This learning experience is further enhanced by interaction with actual images from each ordered study to provide radiologic and anatomic correlation for each diagnosis. This comprehensive approach to patient care allows for informed selection of optimal imaging studies and detailed review of their findings to create the best clinical outcome.