The Effect of High Fidelity Simulators on Knowledge Retention and Skill Self Efficacy in Pediatric Advanced Life Support Courses in a Rural State

Abstract

PurposeRural health care providers (HCPs) care for millions of Americans despite challenges. Pediatric Advanced Life Support (PALS) provides rural HCPs training in assessment and interventions for critically ill/injured pediatric patients (American Heart Association, 2015). The purpose of this study was to determine the effects of integration of high fidelity simulators into PALS courses in a rural setting. Design and MethodsParticipants were randomized by course to control or experimental PALS conditions where the control group received PALS with low fidelity static manikins (LFM) and the experimental group received PALS with high-fidelity simulators (HFS). Multiple level modeling (MLM) was used to examine participants time-to-task on pre-identified skills on PALS core case scenarios during testing on the last day of the course. MLM also was used to examine the differences in PALS knowledge and skills self-efficacy (SEI) between control and experimental groups at course end and six months later. ResultsThe experimental and control groups had similar scores on the PALS post course knowledge exam, however the skill performance of the experimental group on time-to-task in core case scenarios was significantly better when compared to the control group (p=0.05). A decrease in knowledge exam scores and SEI scores occurred in both groups over time, however the control group had significantly greater declines in PALS written exam (p=0.042) and SEI (p=0.003). Conclusions and Practice ImplicationsIntegration of HFS into PALS may increase HCPs' ability to recall valuable knowledge when seconds matter most. Further research in long-term recall of knowledge and retention of skills following PALS training is needed.