Abstract
Introduction: A workshop was designed to evaluate whether high-fidelity simulation with interactive case discussion could improve resident physician knowledge and comfort interpreting and managing bradyarrhythmias. Methods: All the residents completed a pre-test and then participated in a one-hour interactive presentation, which included practice interpreting rhythm strips and 12-lead electrocardiograms. Forty-four residents were assigned to the intervention group and completed 10 simulated cases using a mannequin, a real defibrillator/external pacemaker, a medication cart, and a simulated telemetry monitor displaying real-time electrocardiograms under the guidance of two instructors. Seventeen residents were assigned to the control group and completed the same 10 cases using interactive discussion with the same instructors but without the use of the high-fidelity simulation models. All residents underwent post-testing. Results: For the intervention group, the mean pre- and post-test knowledge scores were 13.93 and 17.28 (p=0.0001), and the mean pre- and post-test comfort scores were 2.92 and 4.24 (p=0.0001). For the control group, the mean pre- and post-test knowledge scores were 14.52 and 18.00 (p=0.005), and the mean pre- and post-test comfort scores were 2.97 and 4.35 (p=0.001). There were no statistically significant differences between pre-test and post-test knowledge and comfort scores for the two groups (p=0.633, p=0.421, p=0.177).Conclusion: Interactive workshops help improve resident knowledge and comfort with identifying and managing bradycardias. The use of high-fidelity simulation models may not be superior to a similar interactive learning experience without the use of high-fidelity simulation tools.
Highlights
A workshop was designed to evaluate whether high-fidelity simulation with interactive case discussion could improve resident physician knowledge and comfort interpreting and managing bradyarrhythmias
Since there is evidence in the medical literature that demonstrates the need for more robust ECG training for medical residents, it is vital that a training curriculum be developed with the goal to enhance resident knowledge and promote retention of information
The purpose of our study was to develop a structured workshop with interactive cases in an effort to improve resident competency and comfort in the management of bradyarrhythmias, and to determine whether the use of high-fidelity simulation mannequins leads to superior competency and comfort scores
Summary
A workshop was designed to evaluate whether high-fidelity simulation with interactive case discussion could improve resident physician knowledge and comfort interpreting and managing bradyarrhythmias. In a study published in in 2009, Eslava and colleagues found low proficiency and low self-perceived confidence in electrocardiogram (ECG) interpretation among first-year internal medicine residents, highlighting a need for more robust ECG training. Since there is evidence in the medical literature that demonstrates the need for more robust ECG training for medical residents, it is vital that a training curriculum be developed with the goal to enhance resident knowledge and promote retention of information. There have been studies published in recent years demonstrating case-based and simulation-based learning strategies as effective methods for training residents in the management of arrhythmias [5,6]. Our residency program has developed a case-based, simulation-based curriculum for the management of bradyarrhythmias
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