Amina Pervaiz
Detroit Medical Center- Wayne State University
Detroit, MI
Disclosure information not submitted.
Shefali Godara, MD
Fellow in training
Wayne State University, United States
Disclosure information not submitted.
Neelambuj Regmi, MD
Fellow in training
Wayne State University, United States
Disclosure information not submitted.
Kunwardeep Dhillon, MD
Fellow in training
Wayne State University, United States
Disclosure information not submitted.
Asil Daud, MD
Fellow in training
Wayne State University, United States
Disclosure information not submitted.
Amir Laktineh, MD
Fellow in training
Wayne State University, United States
Disclosure information not submitted.
Chetna Jinjuvadia, MD
Assistant Professor of Medicine
Wayne State University, United States
Disclosure information not submitted.
Zubin Mukadam, MD
Assistant Professor of Medicine
Wayne State University, United States
Disclosure information not submitted.
Sara Lee, MD, MPH
Assistant Professor of Critical Care Medicine
Wayne State University, United States
Disclosure information not submitted.
Title: A simulation-based program to train medical residents to master advance cardiac life support skills
Introduction: IM residents are often integral to the in-hospital code response team (CRT). Despite ACLS training, residents often feel under prepared to lead the CRT. Assessment tools can appraise improvement after simulation-based code blue training. The aim of this simulation-based training curriculum was to improve the confidence, knowledge and skills of the IM residents in leading the in-hospital CRT.
Methods: From April through June 2021, fifteen simulation sessions each with a team of 4-5 residents were held with a pretest-posttest study design. Prior to the training, as a refresher, video links were sent describing and demonstrating the appropriate use of the equipment including the defibrillator, crash cart and bag-valve-mask. Each session had two hours of standardized training (chronologically): A baseline knowledge pretest; a 15-minute didactic on cardiac rhythms and ACLS algorithms; a 1.5 hour session of five preprogrammed clinical scenarios on a high-fidelity manikin followed by debriefing using standardized checklists based on the American Heart Association guidelines; and a knowledge-based posttest. A 5-point Likert scale survey with 8 questions was also used to assess the residents’ confidence to lead a code team, recognize the cardiac rhythm, and manage the equipment. Statistical analysis was performed using paired t-test (P < 0.05 as significant) through MedCalc version 19.4.
Results: Among the 71 residents who underwent this program, the median time from last ACLS certification to the simulation training was one year (range, 0-2). The post-test performance significantly improved (scale 0-15) from a mean pretest score of 10.29 to 12.56 (95% CI 1.02-2.49, p< 0.0001). Median time from cardiac arrest to the initiation of chest compression improved from >30 seconds in the 1st scenario to < 10 sec in the 5th scenario. Mean overall pre-and post-simulation Likert score improved from 2.57 to 3.65 (95% CI 0.80-1.34, p< 0.001).
Conclusion: The results suggest ACLS knowledge and skills decay over time for which simulation training may improve upon, especially for members of the code response team who are physicians in-training.