The Effect of High-Fidelity Simulation on Educational Outcomes in an Advanced Cardiovascular Life Support Course

Abstract

The use of high-fidelity simulation has been studied in many healthcare education areas. However, the use of this instructional technology in the American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) course has not been extensively reported, despite this program being one of the most widely taught standardized medical courses in the United States. This study examined high-fidelity versus low-fidelity simulation in the context of an AHA ACLS course to determine subjects' educational outcomes as judged by expert raters reviewing videos of subjects performing a simulated cardiac arrest event immediately after the conclusion of the course. A purposeful sample of 34 subjects was enrolled in one of two ACLS classes. One class used high-fidelity simulation (n = 16), whereas the other used low-fidelity simulation (n = 18). The high-fidelity simulation group had a higher overall mean rank score on expert rater video review (M = 59.55 versus M = 44.34). This difference reached a level of statistical significance (P = 0.010, z = -2.592). On item level analysis of the instrument, 9 of 14 items reached levels of significance (P < 0.05). Expert raters judged students in a high-fidelity simulation-based AHA ACLS course as more competent than students in a low-fidelity course. On item level analysis, items focused on manual tasks or actions in the first 1 to 2 minutes of the cardiac arrest event were more likely to be nonsignificant. As the scenario grew longer and more complex, expert rater scores of the high-fidelity trained team leaders' confidence, knowledge, and treatment decisions were higher than the low-fidelity team leaders' score at a statistically significant level.