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Education, Research, and Quality Improvement |

The Effect of Simulation-Based ACLS Training on Confidence and Attitudes Towards Teamwork in Internal Medicine Residents

Joseph Pitcher, MD; Curtis Sessler, MD; Catherine Grossman*, MD
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Virginia Commonwealth University Health Systems, Richmond, VA


Chest. 2012;142(4_MeetingAbstracts):540A. doi:10.1378/chest.1389825
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Abstract

SESSION TYPE: Education and Teaching in Critical Care Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Teamwork is an essential component of ACLS and has the potential to improve quality of care, reduce errors and improve patient safety. The aim of this study was to determine whether deliberate practice of team-based code simulation training would improve attitudes towards teamwork in code situations, and confidence in performing ACLS.

METHODS: Residents participated in a curriculum, which spanned a two month time frame, composed of lectures on team leadership and membership, and four two-hour high fidelity ACLS simulation sessions (multiple scenarios rotating through multiple roles, debriefing following each simulation). Scenarios were constructed to specifically test/challenge critical aspects of teamwork. Pre and post-course surveys included questions about ACLS knowledge, confidence in performing team member and leader roles, attitudes towards teamwork, and numbers of codes participated in.

RESULTS: 25 second year medical residents participated in the curriculum. There was an increase in confidence (using likert scale 1=very unconfident to 5=very confident) in performing the role of team member (p=0.005, pre-course 3.6±.4, post-course 4.3±.3) and team leader (p=.0003, pre-course 2±.3, post-course 3±.4), and increase in knowledge (p=0.02, pre-course 79±7% correct to post-course 88±4% correct). Team based attitudes were favorable to begin with and did not change post course. The number of codes participated in as team leader remained small (average < 1 pre-course, 2 post-course) and number of codes as a team member did not change with an average of 6 pre and post-course.

CONCLUSIONS: Our simulation-based training course improved confidence and knowledge in performing ACLS but did not significantly change teamwork attitudes (which were overall favorable to begin with.) Interestingly on average, residents pre and post-course responded neutrally (likert scale 3 - neither agree or disagree) to the statement that the “team’s mission was of greater value than the needs of individual team members.” This may have been due to our simulation course design.

CLINICAL IMPLICATIONS: Future simulation training sessions should improve education on the role of teamwork in ACLS events and the importance of team behaviors and skills.

DISCLOSURE: The following authors have nothing to disclose: Joseph Pitcher, Curtis Sessler, Catherine Grossman

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Virginia Commonwealth University Health Systems, Richmond, VA

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