High Fidelity Simulation Improves Provider Confidence During ACLS Training Even Among Experienced Staff: Are We Missing an Opportunity?
Journal Title: Emergency Medicine – Open Journal - Year 2016, Vol 2, Issue 1
Abstract
Background: Advanced Cardiac Life Support (ACLS) resuscitation requires rapid assessment and intervention. It is unclear, however, whether high fidelity simulation improves confidence in providers who are experienced as most simulation training focuses on new graduates or hires. We tested the hypothesis that practicing providers undergoing high-fidelity simulation of cardiopulmonary arrest scenarios will express greater confidence in ACLS skills. Methods: We conducted a prospective cohort study at an urban level 1 trauma center from January to October, 2011 with a convenience sample of nurses, nurse practitioners, and physicians. They participated in high-fidelity (Laerdal 3G) simulation sessions of cardiopulmonary arrest about 3 months apart. Each session included two scenarios and lasted 30 minutes, including debriefing. We recorded demographics and confidence on a validated 5 point Likert scale confidence measurement tool before and after each session. Responses ranged from not at all confident (1) to very confident (5) in: recognizing signs and symptoms, appropriately intervening, and evaluating intervention effectiveness in cardiac and respiratory arrests. Descriptive statistics, paired t-tests, and ANOVA were used for data analysis. Sensitivity testing evaluated subjects who completed their second session at 6 months rather than 3 months. Results: Sixty-five subjects completed consent, 35 completed 1 session and 23 completed at least 2 sessions with no missing data. Ninety-two percent were registered nurses, median clinical experience was 11-15 years, and 59% were from an intensive care unit. Provider confidence increased significantly after a single session. There was a trend for further increased confidence with an additional session and the increased confidence was maintained for at least 3-6 months given the sensitivity analysis. The number of cardiopulmonary arrests directly participated in during the past year and the years of clinical experience in their current role did not influence confidence scores. Conclusion: High fidelity simulation significantly increases provider confidence even among experienced providers. Further study of the link between provider confidence in ACLS skills and resuscitation quality measures is needed.
Authors and Affiliations
Jonathan V. McCoy
Keywords
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- EP ID EP548217
- DOI 10.17140/EMOJ-2-120
- Views 141
- Downloads 0
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