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. 2011 Jun;3(2):211-6.
doi: 10.4300/JGME-D-10-00144.1.

Progress toward improving the quality of cardiac arrest medical team responses at an academic teaching hospital

Aashish Didwania, William C McGaghie, Elaine R Cohen, John Butter, Jeffrey H Barsuk, Leonard D Wade, Rozanna Chester, Diane B Wayne

Progress toward improving the quality of cardiac arrest medical team responses at an academic teaching hospital

Aashish Didwania et al. J Grad Med Educ. 2011 Jun.

Abstract

Background: Internal medicine (IM) residents who undergo simulation-based advanced cardiac life support (ACLS) training are significantly more likely to manage actual events according to American Heart Association (AHA) standards than nontrained residents. How long ACLS skills are retained is unknown.

Methods: We conducted a retrospective case-control study of ACLS responses from January to June 2008 and reviewed medical records to assess adherence to AHA standards. Cases and controls are team responses to ACLS events divided into those directed by postgraduate year 2 (PGY-2) IM resident leaders versus those managed by PGY-3 IM resident leaders. Residents in 2008 completed an educational program featuring deliberate practice in ACLS using a human patient simulator during their second year. Medical records of ACLS events were reviewed to assess adherence to AHA guidelines. We evaluated the effects of simulation training on quality of ACLS care during the 2008 period and in comparison with historical 2004 data.

Results: In 2008, 1 year after simulation training, PGY-3 residents showed the same adherence to AHA standards (88% [SD, 17%]) as that of PGY-2 residents who were newly simulator trained (86% [SD, 18%]) (P = .77). Previously, in 2004, PGY-2 simulator-trained residents showed significantly higher adherence to AHA standards (68% [SD, 20%]) than nonsimulator-trained PGY-3 residents (44% [SD, 20%]) (P < .001). All resident groups in 2008 outperformed their 2004 peers.

Conclusions: Improved quality of ACLS care was maintained by 2008 PGY-3 simulator-trained residents 1 year after training, likely due to skill retention rather than increased clinical experience, as a prior cohort of PGY-3 residents did not perform as well as PGY-2 residents in actual ACLS care. Our results confirm prior work regarding the impact of simulation-based education to improve the quality of actual patient care.

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Figures

FIGURE 1
FIGURE 1
Timeline of AHA ACLS Training, Clinical Training, and Simulator Training by Resident Groups
FIGURE 2
FIGURE 2
Adherence to AHA Guidelines for ACLS Event by Resident Cohort
See this image and copyright information in PMC

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References

    1. Chan PS, Nichol G, Krumholz HM, Spertus JA. Nallamothu BK for the American Heart Association National Registry of Cardiopulmonary Resuscitation (NRCPR) Investigators. Hospital variation in time to defibrillation after in-hospital cardiac arrest. Arch Intern Med. 2009;169:1265–1273. - PubMed
    1. Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O'Hearn N, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA. 2005;293:305–310. - PubMed
    1. Andreatta PB, Woodrum DT, Birkmeyer JD, Yellamanchilli RK, Doherty GM, Gauger PG, et al. Laparoscopic skills are improved with LapMentor training: results of a randomized, double-blinded study. Ann Surg. 2006;243(6):854–860. - PMC - PubMed
    1. Blum MG, Powers TW, Sundaresan S. Bronchoscopy simulator effectively prepares junior residents to competently perform basic clinical bronchoscopy. Ann Thorac Surg. 2004;78(1):287–291. - PubMed
    1. Sedlack RE, Kolars JC. Computer simulator training enhances the competency of gastroenterology fellows at colonoscopy: results of a pilot study. Am J Gastroenterol. 2004;99(1):33–37. - PubMed

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