scholarly journals The Impact of Advanced Cardiac Life Support Simulation Training on Medical Student Self-reported Outcomes

Cureus ◽  
2020 ◽  
Author(s):  
Kaitlin M Bowers ◽  
Jacob Smith ◽  
Matthew Robinson ◽  
Andrew Kalnow ◽  
Rich Latham ◽  
...  
Keyword(s):  
Medical Student ◽  
Simulation Training ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
The Impact

scholarly journals Progress Toward Improving the Quality of Cardiac Arrest Medical Team Responses at an Academic Teaching Hospital

2011 ◽  
Vol 3 (2) ◽  
pp. 211-216 ◽  
Author(s):  
Aashish Didwania ◽  
William C. McGaghie ◽  
Elaine R. Cohen ◽  
John Butter ◽  
Jeffrey H. Barsuk ◽  
...  
Keyword(s):  
Medical Records ◽  
Simulation Training ◽  
Life Support ◽  
Heart Association ◽  
Advanced Cardiac Life Support ◽  
Retrospective Case ◽  
Human Patient ◽  
Simulation Based ◽  
The Impact

Abstract Background Internal medicine (IM) residents who undergo simulation-based advanced cardiac life support (ACLS) training are significantly more likely to manage actual events according to American Heart Association (AHA) standards than nontrained residents. How long ACLS skills are retained is unknown. Methods We conducted a retrospective case-control study of ACLS responses from January to June 2008 and reviewed medical records to assess adherence to AHA standards. Cases and controls are team responses to ACLS events divided into those directed by postgraduate year 2 (PGY-2) IM resident leaders versus those managed by PGY-3 IM resident leaders. Residents in 2008 completed an educational program featuring deliberate practice in ACLS using a human patient simulator during their second year. Medical records of ACLS events were reviewed to assess adherence to AHA guidelines. We evaluated the effects of simulation training on quality of ACLS care during the 2008 period and in comparison with historical 2004 data. Results In 2008, 1 year after simulation training, PGY-3 residents showed the same adherence to AHA standards (88% [SD, 17%]) as that of PGY-2 residents who were newly simulator trained (86% [SD, 18%]) (P  =  .77). Previously, in 2004, PGY-2 simulator-trained residents showed significantly higher adherence to AHA standards (68% [SD, 20%]) than nonsimulator-trained PGY-3 residents (44% [SD, 20%]) (P < .001). All resident groups in 2008 outperformed their 2004 peers. Conclusions Improved quality of ACLS care was maintained by 2008 PGY-3 simulator-trained residents 1 year after training, likely due to skill retention rather than increased clinical experience, as a prior cohort of PGY-3 residents did not perform as well as PGY-2 residents in actual ACLS care. Our results confirm prior work regarding the impact of simulation-based education to improve the quality of actual patient care.

scholarly journals Mobile App to Improve House Officers’ Adherence to Advanced Cardiac Life Support Guidelines: Quality Improvement Study

10.2196/15762 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e15762
Author(s):  
Vittal Hejjaji ◽  
Ali O Malik ◽  
Poghni A Peri-Okonny ◽  
Merrill Thomas ◽  
Yuanyuan Tang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Quality Improvement ◽  
Chest Compression ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
Mobile App ◽  
Absolute Difference ◽  
Quality Improvement Initiative ◽  
The Impact ◽  
Hospital Cardiac Arrest

Background Effective and timely delivery of cardiac arrest interventions during in-hospital cardiac arrest resuscitation is associated with greater survival. Whether a mobile app that provides timely reminders of critical interventions improves adherence to Advanced Cardiovascular Life Support (ACLS) guidelines among house officers, who may lack experience in leading resuscitations, remains unknown. Objective The aim of this study was to assess the impact of a commercially available, dynamic mobile app on house officers’ adherence to ACLS guidelines. Methods As part of a quality improvement initiative, internal medicine house officers were invited to participate and randomized to lead 2 consecutive cardiac arrest simulations, one with a novel mobile app and one without a novel mobile app. All simulations included 4 cycles of cardiopulmonary resuscitation with different cardiac arrest rhythms and were video recorded. The coprimary end points were chest compression fraction and number of correct interventions in each simulation. The secondary end point was incorrect interventions, defined as interventions not indicated by the 2015 ACLS guidelines. Paired t tests compared performance with and without the mobile app. Results Among 53 house officers, 26 house officers were randomized to lead the first simulation with the mobile app, and 27 house officers were randomized to do so without the app. Use of the mobile app was associated with a higher number of correct ACLS interventions (out of 7; mean 6.2 vs 5.1; absolute difference 1.1 [95% CI 0.6 to 1.6]; P<.001) as well as fewer incorrect ACLS interventions (mean 0.3 vs 1.0; absolute difference –0.7 [95% CI –0.3 to –1.0]; P<.001). Simulations with the mobile app also had a marginally higher chest compression fraction (mean 90.9% vs 89.0%; absolute difference 1.9% [95% CI 0.6% to 3.4%]; P=.007). Conclusions This proof-of-concept study suggests that this novel mobile app may improve adherence to ACLS protocols, but its effectiveness on survival in real-world resuscitations remains unknown.

scholarly journals P017: Impact of the use of a checklist for transcutaneous cardiac pacing on competency of junior residents undergoing an advanced cardiac life support course

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S69
Author(s):  
K. Chabot ◽  
J. Morris ◽  
R. Perron ◽  
C. Ranger ◽  
M. Paradis ◽  
...  
Keyword(s):  
Life Support ◽  
Cardiac Pacing ◽  
Advanced Cardiac Life Support ◽  
Limiting Factors ◽  
Control Group ◽  
Size Estimation ◽  
Symptomatic Bradycardia ◽  
The Impact ◽  
Junior Residents ◽  
Experimental Group

Introduction: Transcutaneous cardiac pacing (TCP) is recommended for the treatment of symptomatic bradycardia, a life-threatening condition. Although TCP is taught in ACLS (advanced cardiac life support) courses, it is a difficult skill to master for junior residents. The main objective of this study is to measure the impact of having access to a checklist on successful TCP implementation. Our hypothesis was that the availability of a CL would improve performance of junior residents in the management of symptomatic bradycardia by facilitating TCP. Methods: We conducted a prospective, randomized, single-site study. First-year residents entering postgraduate programs and taking a mandatory ACLS course were enrolled. Students had didactic sessions on the management of symptomatic bradycardia followed by hands-on teaching on a low-fidelity manikin (ALS® simulator, Laerdal) using a CL conceived for this project as a teaching tool. Study participants were then assessed with a simulation scenario requiring TCP. Participants were randomly assigned to groups with and without CL accessibility. Performances were graded on six critical tasks. The primary outcome was the successful use of TCP, defined as having completed all tasks. Participants then completed a post-test questionnaire. Sample size estimation was based on a previous project (Ranger et al., 2018). Accepting an alpha error of 0.05 and a power of 80%, 45 participants in each group would permit the detection of 26.5% in performance gain. Results: Of 250 residents completing the ACLS course in 2017, 85 voluntary participants were randomized to a control group (no CL available during testing, n = 42) or an experimental group (CL available during testing, n = 43). Six participants in the experimental group adequately used TCP compared to five participants in the control group (p = 0.81, chi-squared test). Out of the 43 participants who had access to the CL, only 2 (5%) used it. Reasons why the CL was infrequently used were stated as the following: 24 participants (56%) mentioned not realizing it was available, 8 (19%) considered it was of little to no utility and 5 (19%) forgot a CL existed. Conclusion: Availability of a checklist previously used during simulation teaching did not increase junior residents’ capacity to correctly apply TCP. Non-recognition of CL availability and decreased perceived need for it were the main reasons for marginal use. Our results suggest that there are many limiting factors to CL effectiveness.

Abstract 461: Evaluation of the Impact of Additional Structured Cardiac Arrest Training on Internal Medicine Residents in a Community Hospital

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Abdullah Zoheb Azhar ◽  
Monil Majmundar ◽  
Shmuel Golfeyz ◽  
Tikal Kansara ◽  
Jonna Mercado ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cardiac Arrest ◽  
Community Hospital ◽  
Life Support ◽  
Statistical Significance ◽  
Advanced Cardiac Life Support ◽  
Hospital Staff ◽  
The United States ◽  
Bivariate Analysis ◽  
The Impact

Introduction: There are approximately 200,000 cases of in-hospital cardiac arrest (IHCA) annually in the United States. Of these cases, only 40-50% achieve return of spontaneous circulation (ROSC) and only 20-30% are discharged. Though most hospital staff are trained in cardiac arrest resuscitation, a significant disparity in resuscitation has been noted between different hospital settings. We thus instituted additional structured cardiac arrest training in an Internal Medicine residency program, to supplement the biennial advanced cardiac life support (ACLS) training. Hypothesis: We hypothesized that institution of a dedicated structured cardiac arrest team (code team) in addition to monthly training for those on the team, would improve the confidence, skills, and leadership level, of residents at managing an IHCA situation. Methods: A structured code team with specific roles for each resident was instituted in a New York City-based community hospital. Training was guided by audio-visual lectures and then reinforced by performing mock cardiac arrest drills. Resident assessments were done pre and post-training through an anonymous standardized questionnaire. Summative measures of mean confidence, mean ACLS skills, and leadership were evaluated. Uni and bivariate analysis, and T-tests for statistical significance were performed using STATA 15 software. Results: Our sample of 32 residents showed an increase in mean learning scores across all the three domains. Confidence scores increased from 7.23 to 8.44, ACLS skills increased from 7.40 to 8.57 and leadership scores increased from 6.56 to 7.88. Paired T-tests demonstrated high significance (P<0.000). Conclusion: This study demonstrates the effectiveness of additional structured cardiac arrest training on confidence, skills, and leadership of resident physicians in an Internal Medicine program. The next phase of this study will be to re-evaluate knowledge and confidence at 3 and 6 months after training.

scholarly journals Impact of training in Advanced Cardiac Life Support (ACLS) in the professional career and work environment

2018 ◽  
Vol 23 (3) ◽  
pp. 883-890 ◽  
Author(s):  
Lunia Sofia Lima Azevedo ◽  
Lucas Gaspar Ribeiro ◽  
André Schmidt ◽  
Antônio Pazin Filho
Keyword(s):  
Work Environment ◽  
Life Support ◽  
Environmental Changes ◽  
Multivariable Analysis ◽  
Heart Association ◽  
Advanced Cardiac Life Support ◽  
Professional Career ◽  
Final Study ◽  
Study Population ◽  
The Impact

Abstract We sought to evaluate the impact of Advanced Cardiac Life Support (ACLS) training in the professional career and work environment of physicians who took the course in a single center certified by the American Heart Association (AHA). Of the 4631 students (since 1999 to 2009), 2776 were located, 657 letters were returned, with 388 excluded from the analysis for being returned lacking addressees. The final study population was composed of 269 participants allocated in 3 groups (< 3 years, 3-5 and > 5years). Longer training was associated with older age, male gender, having undergone residency training, private office, greater earnings and longer time since graduation and a lower chance to participate in providing care for a cardiac arrest. Regarding personal change, no modification was detected according to time since taking the course. The only change in the work environment was the purchase of an automated external defibrillator (AED) by those who had taken the course more than 5 years ago. In multivariable analysis, however, the implementation of an AED was not independently associated with this group, which showed a lower chance to take a new ACLS course. ACLS courses should emphasize also how physicians could reinforce the survival chain through environmental changes.

scholarly journals Pediatric Pharmacists' Participation in Cardiopulmonary Resuscitation Events

2018 ◽  
Vol 23 (6) ◽  
pp. 502-506
Author(s):  
Peter N. Johnson ◽  
Amy Mitchell-Van Steele ◽  
Amy L. Nguyen ◽  
Sylvia Stoffella ◽  
J. Maria Whitmore ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Basic Life Support ◽  
Life Support ◽  
Training Programs ◽  
Medical Emergency Team ◽  
Advanced Life Support ◽  
Advanced Cardiac Life Support ◽  
Medical Emergency ◽  
Emergency Team ◽  
The Impact

The Pediatric Pharmacy Advocacy Group (PPAG) understands the dilemma and varying factors that many institutions face concerning the routine participation of pharmacists in emergency resuscitation events. Acknowledging these obstacles, the PPAG encourages all institutions to strongly consider creating, adopting, and upholding policies to address pharmacists' participation in cardiopulmonary resuscitation (CPR) as evidenced by the impact pharmacist participation has shown on the reduction of hospital medication error and mortality rates in children. The PPAG advocates that pharmacists be actively involved in the institution's CPR, medical emergency team committees, and preparation of emergency drug kits and resuscitation trays. The PPAG advocates that all institutions requiring a pharmacist's participation in CPR events consider adoption of preparatory training programs. Although the PPAG does not advocate any one specific program, consideration should be taken to ensure that pharmacists are educated on the pharmacotherapy of drugs used in the CPR process, including but not limited to basic life support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support algorithms; medication preparation and administration guidelines; medication compatibility; recommended dosing for emergency medications; and familiarity with the institutional emergency cart.

scholarly journals Comparison the impact of face-to-face training package for resuscitation with presentation by messaging software on emergency medicine rotation interns

2021 ◽  
Vol 6 (1) ◽  
pp. e06-e06
Author(s):  
Farnaz Takavar ◽  
Mehdi Momeni ◽  
Narges Mohammadrezaie ◽  
Ahmad Ghoochani Khorasani ◽  
Mehrad Aghili
Keyword(s):  
Emergency Medicine ◽  
Life Support ◽  
Training Group ◽  
Advanced Cardiac Life Support ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Cross Sectional ◽  
Virtual Training ◽  
Face To Face ◽  
The Impact

Introduction: Conventional approaches in advanced cardiac life support (ACLS) are used, including; lectures, video presentations, practical educations on moulage, also employing messenger applications can potentially be regarded as a method to train interns. Objectives: The current study aims to compare two methods of face-to-face and virtual training by WhatsApp messenger, regarding the impact of training on interns’ knowledge and satisfaction for advanced cardio resuscitation rotational interns in emergency medicine. Patients and Methods: In this cross-sectional study, 73 rotation interns of emergency medicine of Tehran University of Medical Sciences from 2017 to 2018 were divided into two groups: 1) face-to-face training, 2) virtual training by using WhatsApp messenger application. Initially, a pretest of 10 questions about main topics in advanced cardiac support was conducted on interns. At the end of training course, a posttest of 20 questions was conducted for both groups. Results: Mean value of pretest was 6.46 for face-to-face training group and 5.97 for WhatsApp group (P=0.29). Posttest mean score was 14.08 for face-to-face group and 12.03 for WhatsApp (P=0.003). Interns’ satisfaction scores were 7.68 and 7.36 for face-to-face and WhatsApp group respectively (P=0.25). Mean scores of pretest and posttest within group had no significant differences between groups, but Cohen’s effect size for face-to-face group was greater than WhatsApp trained group. Conclusion: Face-to-face training was associated with better results in promoting knowledge of interns, compared to WhatsApp training. That’s advisable to employ face-to-face training for interns.

scholarly journals Mobile App to Improve House Officers’ Adherence to Advanced Cardiac Life Support Guidelines: Quality Improvement Study (Preprint)

2019 ◽  
Author(s):  
Vittal Hejjaji ◽  
Ali O Malik ◽  
Poghni A Peri-Okonny ◽  
Merrill Thomas ◽  
Yuanyuan Tang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Quality Improvement ◽  
Chest Compression ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
Mobile App ◽  
Absolute Difference ◽  
Quality Improvement Initiative ◽  
The Impact ◽  
Hospital Cardiac Arrest

BACKGROUND Effective and timely delivery of cardiac arrest interventions during in-hospital cardiac arrest resuscitation is associated with greater survival. Whether a mobile app that provides timely reminders of critical interventions improves adherence to Advanced Cardiovascular Life Support (ACLS) guidelines among house officers, who may lack experience in leading resuscitations, remains unknown. OBJECTIVE The aim of this study was to assess the impact of a commercially available, dynamic mobile app on house officers’ adherence to ACLS guidelines. METHODS As part of a quality improvement initiative, internal medicine house officers were invited to participate and randomized to lead 2 consecutive cardiac arrest simulations, one with a novel mobile app and one without a novel mobile app. All simulations included 4 cycles of cardiopulmonary resuscitation with different cardiac arrest rhythms and were video recorded. The coprimary end points were chest compression fraction and number of correct interventions in each simulation. The secondary end point was incorrect interventions, defined as interventions not indicated by the 2015 ACLS guidelines. Paired <i>t</i> tests compared performance with and without the mobile app. RESULTS Among 53 house officers, 26 house officers were randomized to lead the first simulation with the mobile app, and 27 house officers were randomized to do so without the app. Use of the mobile app was associated with a higher number of correct ACLS interventions (out of 7; mean 6.2 vs 5.1; absolute difference 1.1 [95% CI 0.6 to 1.6]; <i>P</i>&lt;.001) as well as fewer incorrect ACLS interventions (mean 0.3 vs 1.0; absolute difference –0.7 [95% CI –0.3 to –1.0]; <i>P</i>&lt;.001). Simulations with the mobile app also had a marginally higher chest compression fraction (mean 90.9% vs 89.0%; absolute difference 1.9% [95% CI 0.6% to 3.4%]; <i>P</i>=.007). CONCLUSIONS This proof-of-concept study suggests that this novel mobile app may improve adherence to ACLS protocols, but its effectiveness on survival in real-world resuscitations remains unknown.

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