PURPOSE:Medical house staff must be proficient in cardiopulmonary rescescitation (CPR). Critical elements of CPR include initial airway management (IAM) and chest compressions (CC). Scenario based training (SBT) with computerized patient simulator (CPS) is effective in training for IAM. We investigated whether simultaneous training of CC with IAM compared to separate training sessions would interfere with retention of skills.
METHODS:This randomized prospective study involved two teaching hospitals studying 89 incoming PGY1 house-staff, who received standard ACLS training. Interns were divided into two groups: group 1 (n=45) received SBT in initial airway management (IAM) alone, followed 2 weeks later with training in chest compressions (CC). Group 2 (n = 44) received both IAM and CC training together. Each PGY1 was trained individually to full competence. IAM and chest compressions were divided into scorable steps. All interns were tested pre and 6 weeks post training using an 18 point skill set. Scoring was performed by two trained observers.
RESULTS:Before training, Group 1 score was (mean±SD) 4.3 ± 1.70; Group 2 score was 4.84±1.80. Post training, group 1 improved to 11.91 ± 3.61 (p<0.01); group 2 improved to 12.36 ± 2.38 (p<.01). There was no significant difference between groups 1 and 2 pre training (p = 0.14); or post training groups 1 and 2 (p=0.49).
CONCLUSION:Standard ACLS training is inadequate for IAM and CC. SBT with CPS improves house staffs competency in these critical skills. We determined that simultaneous training of IAM and CC does not interfere with the acquisition of these skills when compared to training each skill set separately.
CLINICAL IMPLICATIONS:Standard ACLS training requires integration of numerous skills in a short time, which may overwhelm the learner. A solution to this is to provide SBT with CPS targeted to critical elements of CPR. Training in IAM and CC may be provided in a single session. This has implications regarding allocation of educational resources.
DISCLOSURE:Seth Koenig, No Financial Disclosure Information; No Product/Research Disclosure Information