Advanced Cardiac Life Support Training Research Articles

Effectiveness of simulation-based paediatric cardiopulmonary resuscitation training program among nursing students in Saudi Arabia.

The main objective of this study was to adopt a simulation-based advanced cardiac life support training program to assess nursing students' level of knowledge and practice regarding paediatric advanced cardiac life support and to identify the major knowledge and practice gaps. The methods used in this study were pre-experimental, one group pre and post-test investigation. This study was conducted between September 2022 and November 2022, at the University College of Farasan in the Kingdom of Saudi Arabia. Quantitative data were obtained using the "Cardio Pulmonary Resuscitation Knowledge Questionnaire", "Students' Satisfaction and Self-Confidence Scale," and the "CPR Skill Checklist," which were applied to 75 participants in focus groups. Before the simulation-based CPR training, the students' mean pre-test Paediatric CPR knowledge score was 6.5±2.3 out of 42.0. After the simulation, the mean post-test CPR knowledge score (38.1±2.9) considerably improved (p 0.05). The mean post-test CPR skills score (44.7±1.2) was also considerably higher than the mean pre-test CPR skills score (11.4±2.8) at (p 0.05). Additionally, after the simulation training, students' happiness and confidence levels (61.9±2.2) greatly increased. Themes from the qualitative data showed that the simulation was viewed as an engaging and effective teaching tool by the students. Two themes emerged from the study: "Worries before simulation" and "Satisfaction after simulation". Simulation-based paediatric cardio Pulmonary resuscitation training program has raised nursing students' level of expertise in knowledge, performance, and self-efficacy. Additionally, strong satisfaction and self-confidence levels were discovered following the simulation training.

Evaluation of Basic and Advanced Life Support Knowledge of Resident Doctors at Kayseri Training and Research Hospital

Introduction and Objective Cardiopulmonary resuscitation (CPR), which includes Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Post Resuscitation Care (PRC), has become an important medical topic that is kept current with constantly changing and updated guidelines. Guidelines for CPR and ALCS are published approximately every 5 years. It is especially important for medical residents to approach cardiopulmonary arrest with up-to-date information. The aim of this study was to evaluate whether medical residents (MRs) at Kayseri Training and Research Hospital (KTRH) can recognize cardiac arrest, their knowledge and skill level of BLS and ACLS, the factors that influence them, their interest in recent developments, and the possible benefits of training that can be organized. Materials and Methods This study was conducted between 30.12.2015-01.05.2016, as a descriptive questionnaire study to evaluate the approaches and knowledge levels of MRs working in 11 different clinics at KERH regarding the application of CPR and HRBA. The questionnaire consisted of a personal information form as well as questions assessing BLS and ACLS, CPR training and CPR application history. The questionnaires were administered face-to-face by the researchers. SPSS Statistics 22.0 (SPSS Inc. ®, Chicago, USA) program was used for statistical analysis of the survey data, and variables were expressed as arithmetic mean ± standard deviation or median, minimum and maximum values, and categorical variables were expressed as numbers and percentages according to their distribution structure. The Kolmogorov-Smirnov test was used to assess the conformity of the data to the normal distribution. The Mann-Whitney U test was used to examine differences between two independent groups, and the Kruskal-Wallis test was used to examine differences between more than two independent groups. Results There were 163 participants in the study. When the correct response rate to BLS questions was analyzed, the mean correct response rate was 51.8 ± 14.8% and the mean correct response rate to ACLS questions was 53.6 ± 19.2%. The mean correct response rate to the BLS survey was significantly (p < 0.05) higher among those who considered themselves competent in CPR than among those who did not consider themselves competent in CPR. The mean number of correct responses to the knowledge assessment questions was significantly (p < 0.05) higher among those who felt CPR training in medical school was adequate and who followed ALCS and CPR guidelines than among those who felt CPR training was inadequate and who did not follow CPR guidelines. There was a significant (p<0.05) positive correlation between age and length of practice and the correct rate of Basic Life Support knowledge scores. There was a significant (p<0.05) positive correlation between age and years of practice and Basic Life Support knowledge scores. In addition, the mean ACLS knowledge level correct response rate was significantly (p < 0.01) higher in surgical specialties than in medical specialties. Conclusion. In order to increase the chances of survival in cases of reversible sudden cardiac arrest, BLS and ACLS training should be renewed and updated on a global and national level, starting with the health care professionals.

Exploring the Impact of Simulation on Nursing students' Knowledge and Skills during Basic and Advanced Cardiac Life Support Training in Saudi Arabia

Introduction: Basic life support (BLS) and advanced cardiac life support (ACLS) training is crucial for healthcare providers to respond effectively to cardiac emergencies. Simulation-based training has been shown to improve knowledge and skills in nursing students during BLS and ACLS training. Objective: The objective of this study was to review the literature on the impact of simulation-based training on nurses' and nursing students' knowledge and skills during BLS and ACLS training in Arab countries and internationally. Methods: A literature search was conducted in several databases, including PubMed, CINAHL, and Scopus. The search was limited to articles published, written in English, and conducted in Saudi Arabia. Two articles met the inclusion criteria and were included in the review. Results: The reviewed studies reported significant improvements in knowledge scores, ability to respond to cardiac arrest scenarios, and confidence in skills among nursing students who participated in simulation-based training. However, challenges in implementing simulation-based training were reported, including lack of resources, time constraints, and resistance to change. Conclusion: The findings of the reviewed literature suggest that simulation-based training can be an effective tool for improving nurses' and nursing students' knowledge and skills during BLS and ACLS training in both Arab countries and internationally. The use of simulation-based training in nursing education has several advantages, including providing a safe and controlled environment for practicing skills, promoting critical thinking and decision-making, and allowing for repetitive practice. However, challenges in implementing simulation-based training need to be addressed, and strategies for effectively integrating simulation-based training into nursing education programs need to be explored.

The effect of simulation-based advanced cardiac life support training on nursing students’ self-efficacy, attitudes, and anxiety in Palestine: a quasi-experimental study

BackgroundCardiac Arrest (CA) is one of the leading causes of death, either inside or outside hospitals. Recently, the use of creative teaching strategies, such as simulation, has gained popularity in Cardio Pulmonary Resuscitation (CPR) instruction. This study aimed to assess the effect of High-Fidelity Simulation (HFS) training on nursing students’ self-efficacy, attitude, and anxiety in the context of Advanced Cardiac Life Support (ACLS).MethodologyThe study design is quasi-experimental employing a pre-test and post-test approach during April and May 2023. A convenient sample of 60 undergraduate nursing students in a 4-year class from a nursing college at the Arab American University/ Palestine (AAUP) participated in this study. The data were analyzed using a paired sample t-test in SPSS program version 26. Three data collection tools were used pre- and post-intervention; the Resuscitation Self-Efficacy Scale (RSES), The Attitudinal instrument, and the State Anxiety Inventory (SAI).ResultsThe total number of nursing students was 60, out of them (56.7%) were female, while the mean age was (22.2) years. Improvements were seen in all four domains of self-efficacy following HFS training: recognition, debriefing, recording, responding and rescuing, and reporting. (t (59) = 26.80, p < 0.001, confidence interval [29.32, 34.05]). After receiving HFS training on ACLS, the post-intervention for the same group attitude scores significantly increased from 32.83 (SD = 15.35) to 54.58 (SD = 8.540) for emotion, from 6.72 (SD = 2.44) to 10.40 (SD = 1.40) for behavior, and from 7.03 (SD = 2.03) to 10.33 (SD = 1.42) for cognitive. The anxiety level decreased post-simulation from 3.53 (SD = 0.3) to 2.14 (SD = 0.65), which was found to be statistically significant (t(59) = 16.68, p < 0.001, 95% CI [1.22 to 1.55]). Female students (M = 73.18), students who observed a real resuscitation (M = 71.16), and who were satisfied with their nursing major (M = 72.17) had significantly higher self-efficacy scores post-simulation.ConclusionThe HFS can be recommended as an effective training strategy among nursing students. The ACLS training-based HFS was effective in improving the students’ self-efficacy and attitudes and decreasing their anxiety.

Comparing the Outcomes of Virtual Reality-Based Serious Gaming and Lecture-Based Training for Advanced Life Support Training: Randomized Controlled Trial.

Simulation-based Advanced Cardiac Life Support (ACLS) or Advanced Life Support (ALS) training for health care professionals is important worldwide for saving lives. Virtual reality (VR)-based serious gaming can be an alternative modality to be used as a part of simulation-based ALS training. The aim of this study is to investigate whether a VR-based ALS serious game module can replace classroom-based ALS lectures, the latter being part of existing conventional ALS training protocols in addition to skills training. Participants were students from Acibadem Mehmet Ali Aydinlar University's Vocational School for Anesthesiology (N=29) randomly divided into 2 groups with 15 (conventional training group) and 14 (VR-based training group) participants each. Participants in the conventional training group had to complete the pretest consisting of multiple-choice questions at the beginning of the study. Afterward, they took part in an interactive classroom-based ALS lecture. The next step involved skills training with task trainers to teach them compression skills. Following this, the conventional training group was divided into Code Blue teams, each consisting of 5 participants for the simulation session. Two independent instructors evaluated video recordings in terms of technical and nontechnical skills. The score acquired from the manikin-based simulation session was considered the main performance indicator in this study to measure the learning outcome. A similar workflow was used for the VR-based training group, but this group was trained with the VR-based ALS serious game module instead of the theoretical lecture. The final stage of the study involved completing the posttest consisting of multiple-choice questions. A preference survey was conducted among the study participants. Mann-Whitney U and Wilcoxon signed-rank tests were used to analyze the 2 groups' performances in this study. The improvement in posttest results compared with pretest results was significant in the conventional training group (P=.002). Hands-on technical scores of the conventional training group were higher than those of the VR-based training group during manikin-based simulation, but total scores, including those for technical and crisis resource management skills, acquired from the manikin-based simulation session did not reveal any significant difference between the 2 groups. The results of the VR preference survey revealed that the majority of the participants prefer VR-based serious game-based training instead of classroom lectures. Although hands-on technical scores of the conventional training group during the manikin-based simulation session were higher than those of the VR-based training group, both groups' total performance scores, including those for technical and crisis resource management skills, did not differ significantly. The preference survey reveals that the majority of the participants would prefer a VR-based ALS serious gaming module instead of lecture-based training. Further studies are required to reveal the learning outcome of VR-based ALS serious gaming. ClinicalTrials.gov NCT05798910; https://clinicaltrials.gov/study/NCT05798910.

An Evaluation of Nurse Anesthetists’ Acquisition and Retention of Knowledge and Skill Performance for Brief Basic Life Support and Advanced Cardiac Life Support Training

OBJECTIVE The purpose of this study was to evaluate the acquisition and retention of knowledge and skills of basic (BLS) and advanced cardiac life support (ACLS) for nurse anesthetists at Maharaj Nakorn Chiang Mai Hospital. METHODS The one-group pretest-posttest design study was used. BLS and ACLS training comprised a brief BLS and ACLS review and practice. Knowledge was assessed by multiple-choice questions. The BLS skills were assessed by observing CPR performance on a Resusci- Anne-skill meter manikin and ACLS skills were evaluated using ACLS scenarios. The knowledge and skills were assessed before and after the training weekly for four weeks, and then at three months after the training ended. RESULTS A total of 38 nurse anesthetists participated in the study. There were significant increases in BLS and ACLS knowledge and skills after the training. However, there was short retention of BLS and ACLS knowledge and skills at three months after the training. Foreign body airway obstruction and assessing unresponsiveness were the two most common of BLS skills degradation. While the primary and secondary assessment, assessing ACLS algorithms, electrocardiogram recognition and electrical therapy were the common skills performance of ACLS skills degradation. CONCLUSIONS After the BLS and ACLS training, the knowledge and skills were significantly improved but there was short retention of knowledge and skills at three months after the training. Regular refreshment of CPR education is recommended to enhance the retention of knowledge and practice of nurse anesthetists KEYWORDS knowledge and skills retention, nurse anesthetists, acquisition, basic life support, advanced cardiac life support

Resuscitation team training in Rwanda: A mixed method study exploring the combination of the VAST course with Advanced Cardiac Life Support training

IntroductionThe influence of non-technical skills training on resuscitation performance in low-resource settings is unknown. This study investigates combining the Vital Anaesthesia Simulation Training Course with Advanced Cardiac Life Support training on resuscitation performance in Rwanda. MethodsParticipants in this mixed method study are members of resuscitation teams in three district hospitals in Rwanda. The intervention was participation in a 2-day Advanced Cardiac Life Support course followed by the 3-day Vital Anaesthesia Simulation Training Course. Quantitative primary endpoints were time to initiation of cardiopulmonary resuscitation, time to epinephrine administration, and time to defibrillation. Qualitative data on workplace implementation were gathered during focus groups held 3-months post-intervention. ResultsForty-seven participants were recruited. Quantitative data showed a statistically significant decrease in time to cardiopulmonary resuscitation, epinephrine administration, and defibrillation from pre- to post-Advanced Cardiac Life Support, with times of [43.3 (49.7) seconds] versus [16.5 (20) sec], p = <0.001; [137.3 (108.9) sec] versus [51.3 (37.9)], p = <0.001; and [218.5 (105.8) sec] versus [110.8 (87.1) sec], p = <0.001; respectively. These improvements were maintained following the Vital Anaesthesia Simulation Training Course, and at 3-month retention testing. Qualitative analysis highlighted five key themes: ability to initiate cardiopulmonary resuscitation; team coordination for task allocation; empowerment; desire for training and mentorship; and advocacy for system improvement. ConclusionA modified 2-day Advanced Cardiac Life Support course improved resuscitation time indicators with retention 3-months later. Combining the Vital Anaesthesia Simulation Training Course and Advanced Cardiac Life Support led to better team coordination, empowerment to act, and advocacy for system improvement. This pairing of courses has promise for improving Advanced Cardiac Life Support skills amongst healthcare workers in low-resource settings.ClinicalTrials.gov Identifier: NCT05278884.

Knowledge and attitude of healthcare workers toward advanced cardiac life support in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia, 2022.

The aim of this study was to investigate the knowledge and attitude regarding advanced cardiac life support among healthcare workers, 2022. A cross-sectional study was conducted from March to May 2022 among healthcare workers who were working in Felege Hiwot Comprehensive Specialized Hospital Bahir Dar, Ethiopia. All physicians and nurses who were willing to participate this study were involved. A structured self-administered questionnaire was used for data collection. The data were entered into the statistical software Epi Data version 4.6.0.4 and analyzed with statistical package for social science version 26. Logistic regression analysis was used to differentiate the effects of each independent variable on the dependent variable. Among the total study participants (400) with a response rate of 96%, most (238) (59.5%) healthcare workers (nurses and physicians) had poor knowledge toward advanced cardiac life support. Two hundred twenty-five (56.25%) healthcare workers had positive attitude. Being a physician, having more than 6 years of work experience, working in an emergency department for more than 10 years, and having advanced cardiac life support training all contribute to superior knowledge of advanced cardiac life support. Most healthcare workers, especially, nurses, have under estimated knowledge and a negative attitude toward advanced cardiac life support. This implies they require knowledge building and attitude empowerment regarding advanced cardiac life support. Being a physician, having training in advanced cardiac life support, having work experience of more than 6 years, and working in an emergency unit for more than 10 years were positively associated with better knowledge of advanced cardiac life support among healthcare workers.

The Emergency Preparedness of Level-Four Primary Health Care Centers in the Gaza Strip, the Occupied Palestinian Territory: An Assessment of Primary Care Providers' Competencies and Facilities Preparedness.

The Gaza Strip lives in a protracted emergency crisis and experienced several Israeli escalations. These escalations have overwhelmed the hospitals and highlighted the need to optimize Primary Health Care Centers (PHCCs) to form part of the emergency response system. This study, therefore, aimed to assess the emergency preparedness of the Ministry of Health (MoH)-run level-four PHCCs in the Gaza Strip (where Emergency Medical Services are provided along with preventive and curative services). The study was cross-sectional, used quantitative methods, and utilized two tools. The first tool was a self-administered structured questionnaire exploring Primary Care Providers' ([PCPs]; doctors and nurses) experiences, perceived capabilities, and training needs. The second tool was an observational checklist used to assess the preparedness of the emergency rooms (ERs) at level-four PHCCs in the Gaza Strip. Two hundred and thirty-eight PCPs (34.5% doctors and 65.5% nurses) working in 16 level-four PHCCs were included. Overall, 64.4% of the participants had experience working in PHCCs during Israeli escalations, though 35.3% of them were unaware of the contingency plan (CP) of PHCCs. More nurses were aware of CPs than doctors (66.9% versus 42.7%; P <.001). Moreover, 65.7%, 46.7%, and 42.5% of the participants were trained in Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), and Primary Trauma Care (PTC), respectively. However, many had received the training for more than two years, and none of the PHCCs had all its staff trained. Only 36.8% of the participants were trained in Post-Trauma/Post-Operative Care (wound care and dressing), and the percentage of trained nurses was significantly higher than those of doctors (36.8% versus 13.9%; P <.001). The majority of the participants admitted they need ACLS training (89.2%), PTC training (89%), BLS training (81.1%), and Post-Trauma/Post-Operative Care training (76.8%). Only 29.63% of emergency drugs and 37.5% of the equipment and disposables were available in the ERs of all PHCCs, and none of the PHCCs had all the essential emergency drugs, equipment, and disposables available. Level-four PHCCs in the Gaza Strip are not adequately prepared to respond to emergencies. Generally, PCPs lack appropriate competencies for emergency response, and many PHCCs lack the infrastructure to support Primary Emergency Care (PEC). Thus, PCPs need continuous education and training in disaster preparedness and response and PEC.

Rapid Cycle Deliberate Practice: Application to Adult Advanced Life Support.

IntroductionThis curriculum includes three in-person simulation cases for Advanced Cardiac Life Support (ACLS) training using the rapid cycle deliberate practice (RCDP) technique. RCDP is a model for simulation-based medical education (SBME) that provides frequent feedback and opportunities to practice techniques until learning is cemented. The intent of these cases was to improve teamwork and communication, role designation, defibrillator operation, leadership, and clinical treatment of cardiac emergencies.MethodsEach case provided an ACLS scenario for an adult patient in the postanesthesia care unit setting. The curriculum required high-fidelity mannequins and instructors trained to provide SBME through RCDP. Learners worked in teams and were expected to perform appropriate steps per the ACLS algorithm, with facilitators pausing learners and providing expert feedback and opportunities for deliberate practice throughout.ResultsEighty-four postgraduate year 2 anesthesiology residents participated in the simulation curriculum over eight course offerings. Facilitators noted improved communication and teamwork among participants, as well as more accurate and effective defibrillator use. Feedback from learners was positive and indicated that they believed the experience would improve their clinical performance.DiscussionThis curriculum provides instruction on using the RCDP variant of SBME to prepare health care providers to deliver effective care in situations necessitating ACLS. Because RCDP allows for repeated iterations of the same skill, knowledge can be cemented and muscle memory created. Given the positive feedback, we believe the curriculum can provide an effective framework for ACLS reinforcement through RCDP implementation across multiple types of learners and institutions.

Effects of a Designated Ambulance Team Response on Prehospital Return of Spontaneous Circulation and Advanced Cardiac Life Support of Out-of-Hospital Cardiac Arrest: A Nationwide Natural Experimental Study

Objectives This study aimed to investigate the effects of adding advanced cardiac life support (ACLS) training to an existing basic life support program and the operation of a designated team response for patients with out-of-hospital cardiac arrest (OHCA) on prehospital return of spontaneous circulation (ROSC) and ACLS management. Methods A natural experimental study was conducted for emergency medical service (EMS)-treated adult patients with OHCA in 2020. In 2019, a quarter of the EMS clinicians were trained in a 3-day ACLS courses, and they were designated to be dispatched first in suspected OHCA. Some were dispatched only to major emergencies, such as OHCA and myocardial infarction (dedicated team), while others were dispatched to all emergencies with priority to major ones (non-dedicated team). The exposure was the ambulance response type: dedicated, non-dedicated, and basic teams (others). The primary outcome was prehospital ROSC. The secondary outcomes were prehospital ACLS (advanced airway management and intravenous access). A multivariable logistic regression analysis was conducted to investigate the effect of ambulance response type on study outcomes. Results Among 23,512 eligible patients with OHCA, 54.8% (12,874) were treated by the basic team, 36.5% (8,580) by the non-dedicated ACLS team, and 8.8% (2,058) were treated by the dedicated ACLS team. Prehospital ROSC was greater for the designated team than for the basic team (dedicated ACLS team 13.8%, non-dedicated ACLS team 11.3%, and basic team 6.7%) (p < 0.01). In the final logistic regression analysis, compared with the basic team, the designated ACLS team was associated with a higher probability of prehospital ROSC (AOR (95% CIs), 1.88 (1.68–2.09) compared to the non-dedicated ACLS team, and 2.46 (2.09-2.90) compared to the dedicated ACLS team), prehospital advanced airway management (1.72 (1.57-1.87) and 1.73 (1.48-2.03), respectively), and intravenous access (2.29 (2.16-2.43) and 2.76 (2.50-3.04), respectively). Conclusion Additional ACLS training and operation of a designated OHCA team response were associated with higher rates of prehospital ROSC and prehospital ACLS provision. However, further research is needed to find the optimal operation for EMS to improve survival outcomes.

Assessment of Knowledge on Basic Life support and Advanced Cardiac Life Support in a Medical College of Kathmandu

Introduction: Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) are part of cardio-pulmonary resuscitation. The knowledge of BLS and ACLS is very important in saving lives for healthcare workers for which they need training and updated knowledge on these topics. The aim of the study was to assess the knowledge on BLS and ACLS in a medical college of Kathmandu. Methods: This was a cross sectional retrospective study conducted in Nepalese Army Institute of Health Sciences. The pretest and posttest scores of the trainees who participated in BLS and ACLS training were analyzed to assess the improvement in the knowledge. The duration of the study was from 1st May 2021 to 31st October 2021 where two sessions of the training were conducted. Data were entered in Microsoft Excel and analysis was done in Statistical Package for Social Sciences version 16. Results: Out of 72 participants, the mean pretest score was 5.67 ± 1.91 (56.67%) on BLS (Total score 10) and 9.06 ± 2.21 (60.37%) on ACLS (Total score 15). Post-test scores for BLS and ACLS were 8.69 ± 1.03 (86.94%) and 11.43 ± 1.77 (76.20%) respectively. Statistically significant increase in the mean scores were seen in both BLS [df (71) = -13.532, p &lt; 0.001] and ACLS ([df (71) = -9.956, p &lt; 0.001] with 95% CI while comparing pretest BLS and ACLS with posttest BLS and ACLS scores. Conclusions: Improvement in knowledge was seen amongst participants after the training. This highlights the importance of such training in imparting knowledge regarding BLS and ACLS among healthcare personnel.

Evaluating the effectiveness of interprofessional advanced cardiac life support training: a sequential mixed-methods approach

ABSTRACT Interprofessional advanced cardiac life support (IP-ACLS) training is a holistic learning experience; thus, our research team incorporated this training into an undergraduate programme. Considering that IP-ACLS training is a new paradigm in nursing education, evaluating its effectiveness is essential. This research aimed to (1) evaluate the effectiveness of this training on improving the perceived level of interprofessional collaboration, self-efficacy and emotion regulation and (2) explore the learning experience of nursing students during training. The study design adopted a sequential mixed-method approach comprising a two-group pretest and posttest design amongst 120 students, followed by nine focus group discussions. Quantitative results demonstrated significant improvements in the perceived level of interprofessional collaboration, self-efficacy and emotion regulation at post-intervention and follow-up. Qualitative data were collected through video recording and field notes. Thematic analysis was performed following the method of Braun and Clarke. Qualitative analysis of focus group transcripts identified three themes: synergistic partnership, clinical readiness and improving further training. Quantitative and qualitative results were integrated in accordance with the mixed data analysis framework. These results complemented one another. The training provided an authentic learning experience and a good steppingstone to nursing students who are preparing to work interprofessionally in the future.

Utilization of a Voice-Based Virtual Reality Advanced Cardiac Life Support Team Leader Refresher: Prospective Observational Study.

BackgroundThe incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of training are expensive, time consuming, and difficult to scale, which necessitates improvements in advanced cardiac life support (ACLS) training. Virtual reality (VR) has been proposed as an alternative or adjunct to high-fidelity simulation (HFS) in several environments. No evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills and demonstrate a cost comparison.ObjectiveThis study aimed to explore the utility of a voice-based VR ACLS team leader refresher as compared with HFS.MethodsThis prospective observational study performed at an academic institution consisted of 25 postgraduate year 2 residents. Participants were randomized to HFS or VR training and then crossed groups after a 2-week washout. Participants were graded on technical and nontechnical skills. Participants also completed self-assessments about the modules. Proctors were assessed for fatigue and task saturation, and cost analysis based on local economic data was performed.ResultsA total of 23 of 25 participants were included in the scoring analysis. Fewer participants were familiar with VR compared with HFS (9/25, 36% vs 25/25, 100%; P<.001). Self-reported satisfaction and utilization scores were similar; however, significantly more participants felt HFS provided better feedback: 99 (IQR 89-100) vs 79 (IQR 71-88); P<.001. Technical scores were higher in the HFS group; however, nontechnical scores for decision making and communication were not significantly different between modalities. VR sessions were 21 (IQR 19-24) min shorter than HFS sessions, the National Aeronautics and Space Administration task load index scores for proctors were lower in each category, and VR sessions were estimated to be US $103.68 less expensive in a single-learner, single-session model.ConclusionsUtilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction. The VR module was more cost-effective and was easier to proctor; however, HFS was better at delivering feedback to participants. Optimal education strategies likely contain elements of both modalities. Further studies are needed to examine the utility of VR-based environments at scale.

Abstract 400: Advanced Cardiac Life Support Taught in a Transitional Medical School Course Improves Retention: A Prospective Cohort Study

Introduction: Advanced cardiac life support (ACLS) is taught in a two-day course. Studies show decay in retention of ACLS starting at 3 months, while repeat simulation may improve performance. Hypothesis: We hypothesize that teaching ACLS using a low-dose, spaced curriculum will improve retention of knowledge and skills. Methods: In March and April 2018, we collaborated with the AHA to incorporate ACLS training into Ready 4 Residency (R4R), a month-long course for 4 th year medical students meeting course completion requirements for ACLS. In September 2018, we consented interns, who completed traditional ACLS or ACLS in R4R. Interns completed 20 multiple-choice questions, two minutes of compressions, and one minute of ventilations for a 20-dollar gift card. Student’s t-test, chi-squared, and Fisher’s exact tests were used for statistical analyses. Results: Of 28 participants, 18 had completed traditional ACLS, and 10 had completed ACLS in R4R. For the 20-question exam, the results were 13.90 +/- 2.81 in ACLS in R4R compared to 13.83 +/- 2.38 in traditional ACLS (p = 0.95). Interns who completed ACLS in R4R performed an average rate of compressions at 111 +/- 10.3 compared to traditional ACLS for a rate of 122.89 +/- 11.05 (p=0.013), table 1. For interns who completed ACLS in R4R, 50% completed rescue breaths in range compared to 0% interns who completed traditional ACLS (p = 0.002), table 2. Conclusions: Integration of low-dose, spaced ACLS training for 4 th year medical students may improve retention of skills. Since interns are frequently ‘first-responders’ during in-hospital arrest, improved ACLS skills may improve resuscitation outcomes.

Abstract 461: Evaluation of the Impact of Additional Structured Cardiac Arrest Training on Internal Medicine Residents in a Community Hospital

Introduction: There are approximately 200,000 cases of in-hospital cardiac arrest (IHCA) annually in the United States. Of these cases, only 40-50% achieve return of spontaneous circulation (ROSC) and only 20-30% are discharged. Though most hospital staff are trained in cardiac arrest resuscitation, a significant disparity in resuscitation has been noted between different hospital settings. We thus instituted additional structured cardiac arrest training in an Internal Medicine residency program, to supplement the biennial advanced cardiac life support (ACLS) training. Hypothesis: We hypothesized that institution of a dedicated structured cardiac arrest team (code team) in addition to monthly training for those on the team, would improve the confidence, skills, and leadership level, of residents at managing an IHCA situation. Methods: A structured code team with specific roles for each resident was instituted in a New York City-based community hospital. Training was guided by audio-visual lectures and then reinforced by performing mock cardiac arrest drills. Resident assessments were done pre and post-training through an anonymous standardized questionnaire. Summative measures of mean confidence, mean ACLS skills, and leadership were evaluated. Uni and bivariate analysis, and T-tests for statistical significance were performed using STATA 15 software. Results: Our sample of 32 residents showed an increase in mean learning scores across all the three domains. Confidence scores increased from 7.23 to 8.44, ACLS skills increased from 7.40 to 8.57 and leadership scores increased from 6.56 to 7.88. Paired T-tests demonstrated high significance (P&lt;0.000). Conclusion: This study demonstrates the effectiveness of additional structured cardiac arrest training on confidence, skills, and leadership of resident physicians in an Internal Medicine program. The next phase of this study will be to re-evaluate knowledge and confidence at 3 and 6 months after training.

Interprofessional Advanced Cardiac Life Support Training on Collaborative Skills, Self-Efficacy And Emotion Regulation: A Prospective, Open-Label Non-Randomized Controlled Trial

Interprofessional Advanced Cardiac Life Support Training on Collaborative Skills, Self-Efficacy And Emotion Regulation: A Prospective, Open-Label Non-Randomized Controlled Trial

Interprofessional Simulation–Based Advanced Cardiac Life Support Training: Video-Based Observational Study

BackgroundInterprofessional simulation–based advanced cardiac life support (IPS-ACLS) training provides opportunities for nursing and medical students to enhance their performance in clinical situations. MethodA video observational quantitative design was used using the Clinical Teamwork Scale and Communication and Team Skills Assessment in the center for health care simulation of one Baccalaureate University. ResultsA total of 80 teams participated in the study. The total scores of the Clinical Teamwork Scale and Communication and Team Skills Assessment were improved substantially after the IPS-ACLS (p < .001). ConclusionsOur result suggested that the IPS-ACLS could enhance team performance (d = 2.1). Thus, it helps undergraduate students prepare thoroughly for collaborative real-world practice.

Comparison of the validity of checklist assessment in cardiac arrest simulations with an app in an academic hospital in Taiwan: a retrospective observational study

IntroductionRobust assessment is a crucial component in Advanced Cardiac Life Support (ACLS) training to determine whether participants have achieved learning objectives with little or no variation in their overall outcomes....

A situation-based flipped classroom to improving nursing staff performance in advanced cardiac life support training course

ABSTRACTThe Advanced Cardiac Life Support (ACLS) training aims to help nurses establish the basic competence of the comprehension of electrocardiograms (ECG/ EKG). However, learners usually have difficulty memorizing the meanings of different EKG waveforms, which could represent clinical symptoms or even the feeling of dying, via traditional instruction. Some serious problems could lead to death if the nursing staff do not make correct judgments and provide timely treatment. Thus, this paper reports an explorative study investigating the effects of a flipped classroom approach on nursing staffs’ ACLS learning achievement. A 2-week experiment was conducted to compare the learning achievement of the nursing staff who learned with the ACLS situation-based flipped classroom approach to those who learned with the ACLS traditional flipped approach. The experimental results show that the nursing staff who learned with the proposed approach had better learning achievements, motivation, and satisfaction than those who learned with the ACLS traditional flipped approach.