Abstract 266: Effectiveness of a New Method of Pediatric Advanced Life Support Recertification: PALS on Demand

Abstract

Background: Recent evidence shows poor retention of PALS provider skills. Frequent refresher training, and in-situ simulation are promising interventions. We developed a “PALS on Demand” (PoD) recertification course by deconstructing the training into six 30-min simulation scenario sessions over 6 months. We hypothesized that PoD is as effective as Standard (STD) PALS 1-day recertification delivered with simulation technology (i.e. non-inferiority study). Method: We randomized PALS certified Pediatric ICU nurses and respiratory therapists to PoD vs STD strategy. Training effectiveness outcome was prospectively defined as self-reported provider confidence and competence (Likert scale: 1 = lowest to 7=highest). We analyzed using a Mixed effect model, adjusting for baseline differences (p<0.05 as significant). Results: 36 participants were eligible, completed pre-testing baseline and were randomized: PoD (n=19) and STD (n=17). Median age was 32 (IQR:28-40yrs), discipline: nurses:72%, respiratory therapists:28%, with no significant difference between group demographics . 29 had completed data for baseline, training and post-test scenarios(PoD=17/19 vs STD=16/17). In both PoD and STD groups, self-reported confidence (PoD 0.9, 95%CI, 0.5-1.4, p<0.001, and STD 0.6 95%CI,0.2-1.2, p=0.009) and competence improved(PoD 0.9, 95%CI, 0.6-1.3, p<0.001, and STD 0.8 95%CI, 0.5-1.2, p<0.001). After adjusting for baseline demographics, gender and clinical experience, the PoD vs. STD training strategy was not significantly associated with either confidence (p=0.42) or competence (p=0.65) score improvements. Conclusion: A Simulation-based “PALS-on-Demand” (PoD) approach is feasible. In this non-inferiority study, both PoD and STD simulation-based recertification strategies improved participants’ self-reported confidence and competence equivalently. Further feasibility and objective effectiveness validation of low-dose, high-frequency training is warranted.