Retention Rates of ACLS Skills in Senior Medical Students

Abstract

Objectives: The aim of this study was to assess the retention rate of Advanced Cardiac Life Support (ACLS) skills in third-year medical students who had few clinical opportunities or responsibilities to use them. It was hypothesised that using high-fidelity simulation would increase skills retention. Methods: This was a prospective observational study of 120 rising third year medical students. All students took and eventually passed a full two-day ACLS provider course. Subsequently, during the end of the year Comprehensive Clinical Performance Examination (CCPX) all students participated in a mega code with a Laerdal Hi-Fidelity Simulator. Their performance in 25 critical actions was dichotomously rated as successful or successful. Results: All students passed the initial ACLS course, six required standard remediation. One hundred and sixteen students took the end of year CCPX exam, and a success rate for critical actions ranged between 3.4% and 100%. Most students did well at recognition of fatal arrhythmias and cardiopulmonary resuscitation (CPR). Students performed poorly in airway/breathing assessment and management, as well as management of arrhythmias. Conclusions: ACLS skills are an important skill set for up coming physicians, and unless they are used in practice, they deteriote very quickly. Simulation did not increase student retention rates of ACLS skills to a great extent. Students did well in identifying problems, but did not treat these appropriately. This study suggests that educators should examine the goals of teaching ACLS to providers who have not clearly defined role in resuscitation.