Gregory Wigger, MD
Emory University School of Medicine
Atlanta, Georgia
Disclosure information not submitted.
Lisa Daniels, BA, MD
Assistant Professor of Medicine
Emory University, United States
Disclosure information not submitted.
Jessica Nave, MD
Assistant Professor of Medicine
Emory University School of Medicine, United States
Disclosure information not submitted.
Daniel Dressler, MD, MSc
Professor of Medicine
Emory University School of Medicine, United States
Disclosure information not submitted.
Title: Resuscitating a Resident Resuscitation Readiness Program
Introduction: The Resident Resuscitation Readiness (RRR) curriculum for Emory University’s Internal Medicine (IM) residency program trains and assesses resident performance of guideline-based management of Advanced Cardiac Life Support (ACLS) in preparation for managing rapid responses and cardio-pulmonary arrests in the hospital. Previous curriculum was limited by openly available ACLS testing materials, rigid simulations, and lack of secondary data (e.g., ultrasound images and ECGs) integration. Our goal was to augment the RRR program by creating a pliable curriculum, incorporating relevant secondary data. Our hypothesis was that learners would feel better prepared for clinical responsibilities after participating.
Methods: This single-center study included residents in the Emory IM residency program following re-design of the RRR curriculum in several ways. First, 40 novel questions of ACLS knowledge were created and paired, i.e., preventing repeats, and randomized for pre- and post-curriculum assessments. Additionally, the simulation was designed such that each cardiac rhythm had its own simulation algorithm, secondary data incorporation, and evaluation rubric - allowing the creation of numerous ACLS scenarios in a “plug-and-play” design. The evaluation rubric consisted of a checklist of actions per ACLS guidelines with 3-5 required “critical steps.” Primary outcomes were learner pre- and post-intervention attitude surveys. Secondary outcomes included simulated performance and ACLS knowledge assessment.
Results and Conclusions: Overall, 59 PGY-2 IM residents participated. After completing the curriculum, learners reported significant improvement in self-perception of overall ACLS skills (p < 0.001), code leadership skills (p < 0.001), technical skills (p < 0.001), and medical knowledge (p < 0.001). Nearly 90% of the learners achieved clinical competency to perform resuscitation independently. There was no difference between pre- and post-assessment knowledge scores.
Our curriculum’s re-design assured each trainee learned and was evaluated on components for each cardiac rhythm type – including simulation, secondary data, and rubric – with variation more akin to a true clinical experience. The curriculum, along with novel pre and post-test questions, provides a valuable tool to resuscitation training and competency.